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Fentanyl

Fentanyl was first synthesized in Belgium in the late 1950s, with an analgesic potency of about 80 to 100 times that of morphine, and introduced into medical practice in the 1960s as an intravenous anesthetic under the trade name of Sublimaze®. Thereafter; two other analogs were introduced; alfentanil (Alfenta®), an ultra-short (5-10 minutes) acting analgesic, and sufentanil (Sufenta®), an exceptionally potent analgesic (5 to 10 times more potent ) for use in heart surgery. 


Today, fentanyl are extensively used for anesthesia and analgesia. Duragesic®, for example, is a transdermal patch used in chronic pain management, and Actiq® is a solid formulation of citrate on a stick that dissolves slowly in the mouth for transmucosal absorption. Actiq® is intended for opiate-tolerant individuals and is effective in treating breakthrough pain in cancer patients. Carfentanil (Wildnil®) is an analog of fentanyl with an analgesic potency 10,000 times that of morphine and is used in veterinary practice to immobilize certain large animals.

Illicit use of pharmaceutical fentanyl first appeared in the mid-1970s in the medical community and continues to be a problem in the United States. To date, over 12 different analogs of fentanyl have been produced clandestinely and identified in the U.S. drug traffic.

The biological effects of the fentanyl are indistinguishable from those of heroin, with the exception that the fentanyl may be hundreds of times more potent. Fentanyl is most commonly used by the intravenous administration, but like heroin, they may also be smoked or snorted.

Source: DEA

This narcotic drug has been diverted by pharmacy theft, fraudulent prescriptions, and illicit distribution by patients, physicians, and pharmacists. Theft has also been identified at nursing homes and other long-term care facilities. Oral transmucosal lozenges (Actiq®) are typically sold at $20-25 per unit or $450 per carton (contains 24 units) while transdermal patches (Duragesic®) are sold at prices ranging from $10 to $100 per patch depending upon the dose of the unit and geographical area. There is evidence of large illegal distribution rings selling fentanyl products along with other opioid pharmaceuticals.

Source: DEA Diversion Control Program Drop dead and suicide packets are street terms for fentanyl products.


The drug naloxone can reverse a fentanyl overdose when applied in time. However, because fentanyl is 50 times more potent than heroin, it may require several doses of naloxone to bring someone out of a fatal fentanyl overdose. Unfortunately, the person applying the naloxone will probably not know if fentanyl was present or how much fentanyl was consumed, and will probably not know that it is necessary to administer more naloxone to save the addicts life.


More info in the Prescription Drug Brochure



Other Sources:

  1. Transdermal Patch 
  2. Fentanyl patches are used to relieve severe pain in people who are expected to need pain medication … and who cannot be treated with other medications.
  3. As a Narcotic 
  4. This narcotic is used to treat breakthrough pain (sudden episodes of pain that occur despite round the clock … effects of the medication) to narcotic pain medications.
  5. Nasal Spray 
  6. A nasal spray is used to treat breakthrough pain (sudden episodes of pain that occur despite round … effects of the medication) to narcotic pain medications.
  7. https://www.nlm.nih.gov/medlin
  8. Other SourcesDrug Identification GuideCDC FactsCDC Addiction InfoCDC Overdose StatsCDC Substance TreatmentWhitehouse Drug Free CommunitiesSamhsa Workplace ProgramsDrug FreeFederal Register Codification

Zyprexa

By Bob Hansen • January 29, 2022
Zyprexa (Olanzapine) is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder. More information/images in the Prescription Drug Brochure. When you receive Zyprexa extended-release injection, the medication is usually released slowly into your blood over a period of time. However, when you receive olanzapine extended-release injection, there is a small chance that olanzapine may be released into your blood too quickly. If this happens, you may experience a serious problem called Post-injection Delirium Sedation Syndrome (PDSS). If you develop PDSS, you may experience dizziness, confusion, difficulty thinking clearly, anxiety, irritability, aggressive behavior, weakness, slurred speech, difficulty walking, muscle stiffness or shaking, seizures, drowsiness, and coma (loss of consciousness for a period of time). You are most likely to experience these symptoms during the first 3 hours after you receive the medication. You will receive Zyprexa extended-release injection in a hospital, clinic, or another medical facility where you can receive emergency medical treatment if it is needed. You will need to remain in the facility for at least 3 hours after you receive the medication. While you are in the clinic, the medical staff will watch you closely for signs of PDSS. When you are ready to leave the facility, you will need a responsible person to be with you, and you should not drive a car or operate machinery for the rest of the day. Get emergency medical help right away if you experience any symptoms of PDSS after you leave the facility. A program has been set up to help people receive Zyprexa extended-release injection safely. You will need to register and agree to the rules of this program before you receive olanzapine extended-release injection. Your doctor, the pharmacy that dispenses your medication, and the medical facility where you receive your medication will also need to register. Ask your doctor if you have any questions about this program. For people being treated with olanzapine extended-release injection or Zyprexa injection: Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as olanzapine have an increased chance of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or mini-stroke during treatment. Olanzapine injection and olanzapine extended-release injection are not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is being treated with olanzapine injection or olanzapine extended-release injection. For more information visit the FDA website: http://www.fda.gov/Drugs Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with olanzapine extended-release injection and each time you receive an injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide. extended-release injection, the medication is usually released slowly into your blood over a period of time. However, when you receive olanzapine extended-release injection, there is a small chance that olanzapine may be released into your blood too quickly. If this happens, you may experience a serious problem called Post-injection Delirium Sedation Syndrome (PDSS). If you develop PDSS, you may experience dizziness, confusion, difficulty thinking clearly, anxiety, irritability, aggressive behavior, weakness, slurred speech, difficulty walking, muscle stiffness or shaking, seizures, drowsiness, and coma (loss of consciousness for a period of time). You are most likely to experience these symptoms during the first 3 hours after you receive the medication. You will receive olanzapine extended-release injection in a hospital, clinic, or another medical facility where you can receive emergency medical treatment if it is needed. You will need to remain in the facility for at least 3 hours after you receive the medication. While you are in the clinic, the medical staff will watch you closely for signs of PDSS. When you are ready to leave the facility, you will need a responsible person to be with you, and you should not drive a car or operate machinery for the rest of the day. Get emergency medical help right away if you experience any symptoms of PDSS after you leave the facility. A program has been set up to help people receive olanzapine extended-release injection safely. You will need to register and agree to the rules of this program before you receive olanzapine extended-release injection. Your doctor, the pharmacy that dispenses your medication, and the medical facility where you receive your medication will also need to register. Ask your doctor if you have any questions about this program. For people being treated with olanzapine extended-release injection or olanzapine injection: Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as olanzapine have an increased chance of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or mini-stroke during treatment. Olanzapine injection and olanzapine extended-release injection are not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is being treated with olanzapine injection or olanzapine extended-release injection. For more information visit the FDA website: http://www.fda.gov/Drugs  Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with olanzapine extended-release injection and each time you receive an injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.

Zoloft

By Bob Hansen • January 29, 2022
Zoloft (Sertraline) is included in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). This class of drugs is used to treat depression, anxiety, and other mood disorders.

Zanaflex

By Bob Hansen • January 29, 2022
Zanaflex (Tizanidine) is a short-acting muscle relaxer. Tizanidine is used to relieve the spasms and increased muscle tone caused by multiple sclerosis (MS, a disease in which the nerves do not function properly and patients may experience weakness, numbness, loss of muscle coordination and problems with vision, speech, and bladder control), stroke, or brain or spinal injury. Tizanidine is in a class of medications called skeletal muscle relaxants. It works by slowing action in the brain and nervous system to allow the muscles to relax. Tizanidine comes as a tablet and a capsule to take by mouth. It is usually taken consistently either always with or always without food two or three times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tizanidine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Tizanidine capsules may be opened and sprinkled on soft foods such as applesauce. Talk to your doctor before opening the capsules because the effects of the medication, when used in this manner, may be different than when swallowing the capsule whole. The medication in the capsule is absorbed differently by the body than the medication in the tablet, so one product cannot be substituted for the other. Each time you have your prescription filled, look at the tablets or capsules in the bottle and make sure that you have received the right product. If you think you received the wrong medication, talk to your doctor or pharmacist right away. Your doctor will probably start you on a low dose of tizanidine and gradually increase your dose, depending on your response to this medication.  Do not stop taking tizanidine without talking to your doctor. If you suddenly stop taking tizanidine, your heart may beat faster and you may have increased blood pressure or tightness in your muscles. Your doctor will probably decrease your dose gradually.
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