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Transdermal fentanyl: little absorption in two patients with systemic sclerosis?
1Department of Anesthesiology, Pain Clinic, Hannover Medical School, Germany. Karst.Matthias@MH-Hannover.de
Pain Medicine (Malden, Mass.)
|April 23, 2004
Summary
Systemic sclerosis patients may have limited absorption of transdermal fentanyl, affecting pain management. Oral conversion doses did not match expectations, indicating potential absorption issues in these patients.
Area of Science:
- Pharmacology
- Dermatology
- Pain Management
Background:
- Systemic sclerosis (SSc) is an autoimmune disease characterized by skin thickening and internal organ involvement.
- Pain is a common symptom in SSc, often managed with various analgesics.
- Transdermal drug delivery offers a continuous and controlled release of medication.
Purpose of the Study:
- To investigate the absorption of transdermal fentanyl in patients with systemic sclerosis.
- To evaluate the efficacy of transdermal fentanyl compared to oral opioids in SSc patients.
- To assess potential differences in transdermal drug absorption based on skin condition.
Main Methods:
- Case study of two SSc patients experiencing pain.
- Treatment with transdermal fentanyl (25 micro/hr) for localized pain.
- Comparison of transdermal fentanyl efficacy and conversion to oral morphine or methadone.
- Observation of transdermal testosterone absorption in contrast.
Main Results:
- Transdermal fentanyl doses did not yield expected therapeutic effects.
- Oral conversion of fentanyl to morphine or methadone did not align with standard conversion ratios.
- Transdermal testosterone absorption was not found to be restricted in these patients.
Conclusions:
- Patients with systemic sclerosis may exhibit impaired absorption of transdermal fentanyl.
- Altered pharmacokinetics in SSc patients necessitate careful consideration of transdermal opioid therapy.
- Skin integrity in systemic diseases might influence transdermal drug bioavailability.