Faculty Opinions recommendation of Aberrant drug-related behavior observed during clinical studies involving patients taking chronic opioid therapy for persistent pain and fentanyl buccal tablet for breakthrough pain.

2011 ◽  
Author(s):  
Marcin Chwistek
Keyword(s):  
Clinical Studies ◽  
Breakthrough Pain ◽  
Opioid Therapy ◽  
Persistent Pain ◽  
Chronic Opioid Therapy ◽  
Fentanyl Buccal Tablet ◽  
Buccal Tablet

Opioid-Induced Muscle Activity: Implications for Managing Chronic Pain

1995 ◽  
Vol 29 (11) ◽  
pp. 1118-1121 ◽  
Author(s):  
Robert K Sylvester ◽  
Ralph Levitt ◽  
Preston D Steen
Keyword(s):  
Breakthrough Pain ◽  
Oral Morphine ◽  
Opioid Therapy ◽  
Chronic Opioid Therapy ◽  
Transdermal Fentanyl ◽  
Management Options ◽  
Morphine Infusion ◽  
Involuntary Muscle ◽  
Metastatic Lung ◽  
Morphine Solution

Objective: To increase awareness of opioid-induced involuntary muscle hyperactivity and to present management options. Case Summary: A ventilator-dependent 71-year-old man presented with pain caused by metastatic lung cancer. Transdermal fentanyl therapy was titrated to 200 μg/h. Two days later a continuous morphine infusion was initiated because of frequent administration of oral morphine solution for breakthrough pain. The patient became progressively less responsive and began exhibiting involuntary muscle hyperactivity thought to represent breakthrough pain. Despite the inability to assess pain control effectively in this unresponsive patient, the morphine infusion rate was increased from 22 to 717 mg/h within 7 days. No change in muscle hyperactivity was observed. Discussion: Over the last decade involuntary muscle hyperactivity has been documented as an adverse effect of chronic opioid therapy. The literature describing the incidence of this toxicity, possible risk factors for its development, and recommendations for its management are discussed. Conclusions: The occurrence of muscle hyperactivity in an unresponsive patient receiving chronic opioid therapy may represent opioid toxicity. Recommendations for managing opioid-induced muscle hyperactivity include reduction of the opioid dosage and/or administration of clonazepam therapy.

Fentanyl Buccal Tablet: A New Breakthrough Pain Medication in Early Management of Severe Vaso-Occlusive Crisis in Sickle Cell Disease

Pain Practice ◽  
2015 ◽  
Vol 16 (6) ◽  
pp. 680-687 ◽  
Author(s):  
Lucia De Franceschi ◽  
Paolo Mura ◽  
Vittorio Schweiger ◽  
Elisa Vencato ◽  
Francesca Maria Quaglia ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Breakthrough Pain ◽  
Pain Medication ◽  
Cell Disease ◽  
Early Management ◽  
Fentanyl Buccal Tablet ◽  
Buccal Tablet
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