Abuse potential is relatively high as there is a dependence formed with prolonged use. The adverse effects that contribute to death are shallow breathing (respiratory depression) and low blood pressure (cardiovascular collapse). Therapeutic doses are in micrograms and the lethal dose is considered to be around 2 milligrams. It is classified as an opioid, similar to morphine or oxycodone. Recreational, or otherwise abused, fentanyl is certainly dangerous. When blazing through a structure or neighborhood, however, fire can have catastrophic effects on property and life. When in a fireplace, fire can bring warmth, comfort, and security. If you needed further sedation, you would be given ketamine or propofol.įentanyl can be compared to fire.
Chances are if you broke a bone, ruptured a vessel in your brain, or suffered a bad burn, you would be given fentanyl in the emergency department. They are used on a daily basis in every emergency department and operating room in the country. Unlike methamphetamine and heroin, however, these agents are very commonly used class II and III medicines. This has caused some in the general public to perceive these pharmaceuticals as very dangerous drugs of abuse without legitimate utility, similar to schedule I drugs like methamphetamine or heroin. The CDC, for example, reports as much as ⅔ of the 100,000 overdose deaths over a 12 month period ending a year ago are believed to be due to fentanyl. Medications such as ketamine, propofol, and certainly fentanyl have been to blame for many tragic deaths over recent years, giving them infamous notoriety. Absolutely not!ĭoctor: It sounds like you keep up on the news… Patient: Fentanyl? Oh no… not that dangerous drug. Let’s get some xrays and start an IV so we can give you some pain medication.ĭoctor to nurse: Would you please start an IV and give 50 micrograms of fentanyl. Propofol? Isn’t that the “Michael Jackson drug?”ĭoctor to patient: There is a very good chance you broke several bones around your ankle. Since this is uncomfortable, we will briefly sedate you with a medication called propofol. The treatment is to shock it back into a normal rhythm. Newsworthy stories about pharmaceutical misuse and abuse can add an extra layer of complexity to our daily doctor-patient interactions in the emergency department.ĭoctor to patient: Your heart is stuck in a very fast, abnormal rhythm. By Erik Smith, MD – physician at Sheridan Memorial Hospital’s Emergency Department
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