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Plasma concentrations of fentanyl with subcutaneous infusion in palliative care patients
journal contribution
posted on 2023-05-16, 09:51 authored by Miller, RS, Gregory PetersonGregory Peterson, Abbott, F, Maddocks, I, Parker, D, Stuart McLeanStuart McLeanPlasma concentrations of fentanyl were measured by g.c. in 20 patients (median age: 75 years and range: 54-86 years; eight females) in palliative care receiving the drug by continuous s.c. infusion (median rate: 1200 micrograms day-1 and range: 100-5000 micrograms day-1). 2. The infusion rate was significantly related to the duration of therapy (Spearman rho = 0.56, P < 0.05). The total steady-state plasma concentrations of fentanyl ranged between 0.1 and 9 ng ml-1, with a median of 1 ng ml-1. The unbound fraction of fentanyl in the plasma ranged from 17.8 to 44.4%, with a median value of 33.6%. Infusion rates and both total and unbound plasma concentrations of fentanyl were correlated (Spearman rho = 0.92, P < 0.05 in each case). Even with standardization for dosage, there was an eightfold variation in total plasma concentrations and 3.5-fold variation in unbound plasma concentrations of fentanyl. 3. There is considerable inter-patient variability in the pharmacokinetics of fentanyl with s.c. infusion in the palliative care setting, which necessitates careful titration of dosage according to individual clinical response.
History
Publication title
British Journal of Clinical PharmacologyVolume
40Issue
6Pagination
553 - 556ISSN
0306-5251Department/School
School of Pharmacy and PharmacologyPublisher
Wiley-Blackwell Publishing Ltd.Place of publication
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