ABSTRACT
Objective: Among the opioids used for treating dyspnea in cancer patients, the evidence for clinical use of fentanyl is not adequate. We report a case that suggested that fentanyl citrate patch improved dyspnea caused by lung metastasis of ureteral cancer.Case: An 86-year-old female was scheduled to start opioids for dyspnea caused by exacerbation of lung metastasis from ureteral cancer. Morphine hydrochloride was not chosen due to renal dysfunction, and oxycodone hydrochloride extended-release tablet was initiated. However, one day after starting medication, the patient refused to take the tablet because of vomiting. Given the difficulties in using morphine hydrochloride and oxycodone hydrochloride extended-release tablet, fentanyl citrate patch 0.5 mg/day was started for the purpose of improving dyspnea. The dose was eventually increased to 1.0 mg/day. Dyspnea improved and she was discharged.Conclusion: This case suggested the possibility that use of fentanyl citrate patch may be effective for dyspnea. Fentanyl citrate patch may provide one option when other drugs such as morphine hydrochloride and oxycodone hydrochloride cannot be used. However, since this is a report of a single case, further verification is required to clarify the effectiveness of fentanyl citrate patch for dyspnea.
ABSTRACT
<b>Objective: </b>From September 2009, the Department of Pharmacy of Kitasato University Kitasato Institute Hospital started operation room services, and the pharmacist in charge also responds to the inquiries from the operation room staff (doctors and nurses) concerning pharmaceutical compounds. In the present study, we collected the inquiries and analyzed their contents in order to understand the information of pharmaceutical compounds required by the operation room staff.<br><b>Methods: </b>The inquiries from operation room staff received between October 2009 and March 2012 were collected and the contents were analyzed.<br><b>Results: </b>A total of 625 inquiries (mean, 20.8 inquiries per month) were received. Regarding the contents of inquiry, the most frequent inquiry was on “the presence or absence of the stock” (70.7%), followed by “drug information” (17.0%), “handling of controlled substances” (5.9%), and “handling of non-controlled substances” (4.2%). For “the presence or absence of the stock,” the most common pharmaceutical compounds inquired were antibacterial agents, anesthetics, and infusion fluids. For “drug information,” the contents were diverse, ranging from drug efficacy to operation method, whether compounds are included in hospital drug list, in-hospital preparations, and drug selection. For “handling of non-controlled substances,” the most frequent inquiries were associated with the expiration date after unsealing.<br><b>Conclusion: </b>The most frequent inquiry from the operation room staff was on “the presence or absence of the stock,” and the common subject of inquiry was presumably pharmaceutical compounds frequently used at the time of surgery. The analysis showed that the operation room requires a wide range of information.