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Sublimaze: From Painkiller to Plain 'Killer'

Sublimaze is an analgesic supplement to general anesthesia. Usually used with other agents such as short acting barbituates, neuromuscular blocking agents and inhalation anesthetics to produce balanced anesthesia. The active ingrediant in Sublimaze is Fentanyl, a powerful opioid anesthesia.

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  1. Could #Fentanyl Be More Dangerous Than #Heroin or #Oxycodone? #opiates #opioids
    Could #Fentanyl Be More Dangerous Than #Heroin or #Oxycodone? #opiates #opioids
  2. Sublimaze/Fentanyl was one of many products that Dr Paul Janssen synthesised. One of the medical professions most valued and well respected pharmacologists. An amazing man who was responsible for at least 80 of todays most prominent medications, four of which are listed on the World Health Organisations essential medicines list. Here's a little insight into the man and his dedication to his work....

  3. First synthesized in 1960 by Dr Paul Janssen following the inception of Pethidine (Meperidine, Demerol) several years earlier. Janssen developed Fentanyl by assaying analogues of Pethadine for opioid activity. Due to it's widespread use Fentanyl citrate was created, a mixture of Fentanyl and citric acid. This combination was called Sublimaze which was primarily an injectable solution. since this first entry, there have been numerous analogues of Fentanyl, such as, Sufentanil, 3-Methylfentanyl, Alfentanyl, Remifentanil, Lonfentanil, there are possibly over 100 different analogues. In the mid 90's Fentanyl was introduced into palliative care in the form of a Duragesic patch. Over the next decade or so, the Actiq lollypop and the Fentora disolvable tablet for buccal use also appeared, as did a sublingual spray, and numerous other forms. By 2012 Fentanyl became the most commonly used synthetic opioid in clinical practice, By 2013, 1700 kilos per year were being produced and used globally. This use of Fentanyl as a medically overseen intevention is without doubt an asset that is testimony to the benefits of the medication and it's many uses. This article does not set out to diminish this powerful painkillers qualities when administered and used in the right context. That must be clearly understood.
  4. Fentanyl Citrate, a CLASS II Controlled Substance as classified by the Drug Enforcement Agency in the secure area of a local hospital Friday, July10, 2009. Joe Amon / The Denver Post  (Photo By Joe Amon/The Denver Post via Getty Images)
    Fentanyl Citrate, a CLASS II Controlled Substance as classified by the Drug Enforcement Agency in the secure area of a local hospital Friday, July10, 2009. Joe Amon / The Denver Post (Photo By Joe Amon/The Denver Post via Getty Images)
  5. It's medical uses were primarily for pain relief, the injectable formula was commonly used in procedures such as Epidural, Endoscopy, Cardiac Cathetarization, Breakthrough pain in Cancer Patients. Slow release patches were usually used for longer lasting chronic pain. This form of slow release usually takes from 48 to 72 hours to absorb into the bloodstream, and provides long lasting pain relief. Dosage however is reliant on a number of variables, body temperature, body weight, body mass, skin type, where the patch is placed, different brands can also produce different rates of absorbsion. Hence the high risk attached to the medication. There have been high numbers of incidents internally where over-dosing, under-dosing and other mishaps have resulted from a slight miscalculation in dosing, diagnoses, etc, said without blame and with full acceptance that it is not an easy task to get right even in the clinical setting, Outside the clinical environment it is a regular disaster and statistical data is showing us that it is a disater of epic proportion.
  6. Four dead of morphine patches
    Four dead of morphine patches
  7. In Paliative care there is definately a need for this powerful medication, but it's use should be limited and monitored closely. It is usually used on individuals who are already stabalised on opioid medication when break through pain occurs or when there is a period of painful swallowing or being unable to swallow for numerous reasons. also people with renal failure, or to curb the negative effects of other opioids such as morphine, hydromorphone or Oxycodone.
  8. Pediatric PAIN Management… No IV… No Problem... Think Intranasal (IN) Fentanyl or Ketamine C linical...
  9. Intranasal Fentanyl, the dangers of codeine, triage-initiated pain protocols and more on this podcast...
  10. Fentanyl is also available in intranasal form. This method, observed in clinical tests on out of hospital patients, was proven to be effective as a slow release, and effectively the safest when prescribed for home use. is used in both emergency and palliative care and is the route of administration that produces the least side effects.
  11. This shit will fuck you up. Haven't done it and probably won't ever.
#lolipops#thatfuckyouup#fentanyl#intenseshit#canthandleit
    This shit will fuck you up. Haven't done it and probably won't ever. #lolipops#thatfuckyouup#fentanyl#intenseshit#canthandleit
  12. Finally the last of the more commonly used means of administration, is the lozenge, which normally comes in the form of a lollypop. This is given to the more opioid tolerant individuals. It is ingested into the system in a slow release and has been used on patients with non-cancer related nonmalignant pain. It comes in flavours like wild berry to ease the taste but it also dries the mouth and takes around 15 minutes to dissolve. It works faster and more effectively if sucked rather than swallowed whole.
  13. Publication: The PICHFORK (Pain in Children Fentanyl or Ketamine) Trial: A Randomized Controlled Trial...
  14. Fentanyl is also available for children in the above formats, More often in the form of lozenges. and under close monitoring due to the nature of hte medication and it's potency. This will more often than not be administered as an inpatient rather than outpatient to reduce any risks tha may occur in community setting.
  15. And.... it is also used in veterinary surgeries to sedate cats and dogs and other small animals. Recently a medicine primarily for dogs only called Recuvyra was approved by the FDA. It is used in one infusion to knock the dog out for up to four days following an operation to reduce risk of dog causing further damage while trying to rid itself of the irritation while healing process occurs. It has been known to promote severe bouts of dysphoria in animals, (and also in humans). Recuvyra is also available in Europe. Below there is a link to Recuvyra Training.
  16. So Fentanyl when closely monitored and kept in a sucure medical environment is quite a drug and a welcome addition to any medical inventory, it has it's risks as do all substances, but in general it is a wonder drug when it comes to pain relief from the most extreme pains.
  17. However, the popularity of this substance and it's painkilling qualities has attracted quite a market outside of the medical / pharmaceutical business. The interest increased folowing the introduction of abuse proof Oxcodone medication. In 2010 prescription overdoses in USA accounted for 41% of all overdose situations, Oxycontin, Vicodin, Percocet were the main medications found to be behind the majority of the deaths. This surge in prescription medication abuse and fatalities resulted in major Pharmaceutical company Purdue Pharma looking into a solution to reduce the risks, and in the process, increase profit, an added bonus that I'm sure they didn't factor into the process. They introduced a form of Oxycontin that was harder to crush and impossible to inject. This was researched after a three year period and showed a dramatic reduction in Oxycontin abuse, but an almost as dramatic rise in other opioid related medication abuse. Research is now underway to look at ways of introducing this abuse proof chemical compound into other opioid medications to significantly reduce the risks universally with all opioid medications. This effectively removes further risks of pharmaceutical companies being held accountable to a degree, a lesson that was learnt by Purue Pharma in 2007 when they met with a $634 million pound court settlement bill for failing to notify hte general public of the addictive potential of Oxycontin which was first highlighted as a risk in 2000, when it started appearing in rural areas in Australia. Firstly in Appalachia, by 2007 it was showing up in a high percentage of the nations sample of users in Australia, 51% admitted to using it and 27% admitted to injecting it. In 2001 a survey in USA found that 957,000 people aged from 12 and up had used Oxycontin non-medically with many stating it was their 'gateway' drug, unfortunately the warning on the side of the packaging 'Do not crush as this has the potential for rapid release' was quite a selling point that drew people in.
  18. OxyContin Poster Children 15 Years Later
  19. The most effective solution for withdrawals to oxycodone has been found to be Buprenorphine alongside effective psychosocial interventions and appropriate multi disciplinary approach. A fact that may make you think about taking opioid pain relievers in the first place is that the actual relief given from any medication of this type is 30% which is minimal with regards to the pain you might have. So in effect, we take them looking for immediate and full pain relief which isn't going to happen.....so we take more......and more.... which leads to excessive use to achieve relief and enhances the chances of addiction in the long term.
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