Document Detail

Oral transmucosal fentanyl citrate for dyspnea in terminally ill patients: an observational case series.
MedLine Citation:
PMID:  18454622     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the efficacy and safety of oral transmucosal fentanyl citrate (OTFC) in terminally ill patients experiencing dyspnea. METHODS: Nonblinded, non-controlled observational study of patients admitted to the hospice/palliative care unit for dyspnea from May 2006 to March 2007. Eligible patients were older than 18 years of age with satisfactory baseline cognitive function diagnosed with end-stage congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or cancer complaining of dyspnea. At the onset of dyspnea, enrolled patients were instructed to slowly dissolve the OTFC lozenge and rate their dyspnea on a 10 point visual analog scale at 15-minute intervals for 60 minutes. Respiratory rate (RR) and arterial oxygen saturation (SaO(2)) were recorded at similar intervals. Patients were observed for approximately 48 hours. RESULTS: Four patients were found eligible. In all four cases, patients experienced rapid relief of dyspnea as soon as five minutes. No significant adverse events were reported. CONCLUSIONS: OTFC appears to be safe and effective for dyspnea in terminally ill patients. The study population is limited to four cases, however, the initial findings are promising and merit further research.
Alberto A Gauna; Sheila K Kang; Mary Lawhon Triano; Erica Rachel Swatko; Vincent Jay Vanston
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of palliative medicine     Volume:  11     ISSN:  1096-6218     ISO Abbreviation:  J Palliat Med     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-10-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808462     Medline TA:  J Palliat Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  643-8     Citation Subset:  IM    
Department of Internal Medicine, Scranton Temple Residency Program, Scranton, PA 18510, USA.
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MeSH Terms
Aged, 80 and over
Analgesics, Opioid / administration & dosage,  therapeutic use*
Dyspnea / drug therapy*,  etiology
Fentanyl / administration & dosage,  therapeutic use*
Heart Failure / complications
Lung Neoplasms / complications
Middle Aged
Oxygen Consumption / drug effects
Pain Measurement
Pulmonary Disease, Chronic Obstructive / complications
Pulmonary Fibrosis / complications
Terminal Care / methods*
Terminally Ill*
Reg. No./Substance:
0/Analgesics, Opioid; 437-38-7/Fentanyl

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