Fentanyl HCl Patient-Controlled lontophoretic Transdermal System for the Management of Acute Postoperative Pain

@article{Mayes2006FentanylHP,
  title={Fentanyl HCl Patient-Controlled lontophoretic Transdermal System for the Management of Acute Postoperative Pain},
  author={Stacey L Mayes and Marcus Ferrone},
  journal={Annals of Pharmacotherapy},
  year={2006},
  volume={40},
  pages={2178 - 2186}
}
Objective: To summarize the pharmaceutics, pharmacokinetics, development, and clinical application of IONSYS, the fentanyl HCl patient-controlled iontophoretic transdermal system for the management of acute postoperative pain. Data Sources: Clinical literature including both primary sources and review articles was accessed through a search of the MEDLINE databases (1980–October 2006). Key search terms included cutaneous analgesia, fentanyl, IONSYS, opioid, postoperative pain, and patient… 

Figures from this paper

Fentanyl iontophoretic transdermal system versus morphine intravenous patient-controlled analgesia for pain management following gynecological surgery: a meta-analysis of randomized, controlled trials.
TLDR
Following gynecological surgery, patients and investigators were more satisfied (had a higher percent of an 'excellent' rating on the PGA and IGA) with fentanyl ITS than morphine iv. PCA as a method of pain control.
The Pharmacology of Spinal Opioids and Ziconotide for the Treatment of Non-Cancer Pain
TLDR
Intrathecal therapy has level-one evidence for use for malignant pain and nonmalignant pain, with continued cost savings and improved safety, and a clear appreciation for the pharmacology of commonly employed intrathecal agents is paramount.
A Comparative Efficacy of Propacetamol and Ketorolac in Postoperative Patient Controlled Analgesia
TLDR
The efficacy of propacetamol is comparable to that of ketorolac in postoperative PCA with fentanyl, and patient satisfaction levels of each drug when combined with fentanyl patient-controlled analgesia (PCA).
Emerging treatment modalities: balancing efficacy and safety.
  • E. Viscusi
  • Medicine, Biology
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2007
TLDR
The fentanyl Iontophoretic Transdermal System has demonstrated therapeutic equivalence with morphine intravenous patient-controlled analgesia and similar safety and Selective opioid antagonists are under development that may selectively block gastrointestinal opioid receptors while preserving analgesia.
Topical preparations for pain relief: efficacy and patient adherence
TLDR
This review presents recent findings regarding topical formulations of the most widely used drugs for pain treatment, such as nonsteroidal anti-inflammatory agents, anesthetics, and capsaicin, and the role of physical agents as delivery enhancers (phonophoresis and iontophoresIS).
Iontophoretic drug delivery systems
COMPARISON OF EFFICACY OF BUTORPHANOL AND FENTANYL AS INTRATHECAL ADJUVANT TO BUPIVACAINE
TLDR
Both fentanyl and butorphanol given intrathecally along with hyperbaric Bupivacaine prolong the duration of effective analgesia.
Novel formulations and routes of administration for opioids in the treatment of breakthrough pain
TLDR
Treatment of BTP should be individualized to fit the special needs of the single individual patient, and will depend on various patient-related conditions, such as stage of disease, performance status, compliance and the acceptability of different interventions.
Opioids in the treatment of postoperative pain: old drugs with new options?
TLDR
New approved options with opioids in the postoperative setting may include new ways of administration, new combinations with other drugs and new opioid drugs, and the mixture of different opioids given together for oral use may also have some analgesic synergy with an improved side-effect profile, although more studies are needed.
Opioids in the treatment of postoperative pain: old drugs with new options?
  • J. Raeder
  • Medicine, Biology
    Expert opinion on pharmacotherapy
  • 2014
TLDR
Tapentadol is a new partial µ-receptor opioid agonist with a combined action on norepinephrine-induced analgesia, representing a promising drug in terms of less side effects at equianalgesic doses compared with pure agonists.
...
...

References

SHOWING 1-10 OF 58 REFERENCES
Characterisation of the Pharmacokinetics of the Fentanyl HCl Patient-Controlled Transdermal System (PCTS)
TLDR
The fentanyl HCl patient-controlled transdermal system (PCTS) is a self-contained, preprogrammed, noninvasive analgesic delivery system for acute pain management that was well tolerated, even after repeated application.
The Safety and Efficacy of a Fentanyl Patient-Controlled Transdermal System for Acute Postoperative Analgesia: A Multicenter, Placebo-Controlled Trial
TLDR
This study showed that a fentanyl HCl PCTS 40 &mgr;g for PCA was superior to placebo and well tolerated for the control of moderate to severe postoperative pain for up to 24 h after major surgery.
Iontophoretic delivery of morphine for postoperative analgesia.
TLDR
The morphine group used significantly less PCA meperidine to maintain analgesia than the control group (p = 0.001), however, following the institution of iontophoresis and continuing up to 12 hr following completion of iontegoresis, the morphine group made use of the PCA device more than theControl group during the baseline period.
Effects of Application Site and Subject Demographics on the Pharmacokinetics of Fentanyl HCl Patient-Controlled Transdermal System (PCTS)
TLDR
Fentanyl HCl is comparably absorbed from the PCTS when it is applied to the upper outer arm or chest, and the pharmacokinetic parameters are unaffected by sex, age, race or weight.
The Fentanyl HCl Patient-Controlled Transdermal System (PCTS)
TLDR
Clinical studies have shown that the fentanyl HCl PCTS is effective in the management of acute postoperative pain, and it is demonstrated that the system is safe and well tolerated by patients.
Patient-controlled transdermal fentanyl hydrochloride vs intravenous morphine pump for postoperative pain: a randomized controlled trial.
TLDR
An investigational PCA transdermal system using iontophoresis to deliver fentanyl provided postsurgical pain control equivalent to that of a standard intravenous morphine regimen delivered by a PCA pump.
The Effect of Dosing Frequency on the Pharmacokinetics of a Fentanyl HCl Patient-Controlled Transdermal System (PCTS)
TLDR
The amount of fentanyl absorbed from the PCTS increases as a function of time and is independent of both dosing frequency and total number of doses delivered, suggesting that the bioavailability of fentanyl delivered by the P CTS is generally safe and well tolerated.
Pharmacodynamics, pharmacokinetics, and clinical uses of fentanyl, sufentanil, and alfentanil.
TLDR
Fentanyl, sufent anil, and alfentanil are potent synthetic opioids that are used for anesthesia and postoperative analgesia and the advantages of these opioids compared with morphine are short duration of action, lack of hyperglycemic response to surgery, decrease in catecholamine levels, and high lipid solubility.
The Iontophoresis of Fentanyl Citrate in Humans
TLDR
Clinically significant doses of fentanyl can be administered by iontophoresis for delivery periods of 2 h, and a charge‐ dose relation exists after administration with currents of 1.0 and 2.0 mA.
...
...