N&PD Moderators: Skorpio
Safe Dose of IV Fentanyl ? (first time)
the_ketaman
Bluelighter
I only read the OP's original post but IMO the only safe environment to IV fentanyl in is a doctors surgery, so he will know how to deal with it. IV fent at home is a very dangerous practice, with medical vials it might be a lil different but with the patches your playing russian roulette(I know your not doing that im just putting my 2c in).
SpunkySkunk347
Bluelighter
The doctors will know what they are doing. Not only do they have opiate antagonists in case of an adverse reaction but they also have plenty of tools to counter hyperthermia.
Make your condition very clear to them.
Please update us on what happens
DCBAe
Bluelighter
I used to work at a hospital...
IV Fentanyl is the standard in anethesia man... you are pretty safe men.
They predose you on benzos the night before and possibly the morning before too.
And sometimes (rarely) they use ketamine too.
But its pretty much benzos and fentanyl in controlled settings.. (artificial respiration and warm eletric blankets and such things)
Fentanyl is good because of the short half-life and its high potency, it does the trick everytime... Even on street junkies..
DCBAe
Bluelighter
Yeah, i've read that now.
vecktor said:
But i was talking in the sense that what can go wrong they can fix it without much problems at all. Trust the docs, they know what they are doing and its safe..
But sorry, i didn't read them all... I'm doing it now.
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DCBAe
Bluelighter
Unlucky said:
What kind of bad reactions are you talking about? Only hyperthermia?
just one of the many examples out there, I found this one in 2 minutes:
DCBAe said:
A friend of mine is an anesthetist and has had a patent die due to this even though they went through all the procedures, FWIW the mortality rate once it happens is about 5%.
it is kind of worth remembering that for the patent death is final, for the doctor is is perhaps a slight blemish on a career or at worst a lawsuit. Another medical professional I know joked that the death rate fell when doctors went on strike in the US. and there is a bit of truth there. 
Vecktor please no more horror stories Im already on the edge about the whole thing as it is.
DCBAe It wasnt only hyperthermia, what happened was during my recovery in hospital after knee surgery they gave me a one capsule of " Endone " which I belive is Hydrocodene? around 45 mins after ingesting it I started noticing my heart beat doing irregular things and beating rapidly whilst feeling feverish at the same time, then it continued to progress to involuntary twitching and spasms mainly in my thighs and upper jaw, it became so violant the bed I was on began to rattle from the spasms, of course also causing me great pain as I had knee surgery earlier that day. I rang for the nurses but being the weekend new staff had just come in to find me in that state, to my shock though the nurse who attented to me was very neglectful and told me to just wait for it to wear off but I only continued to get worse and overheating to a level I can only compare to the time I OD'd on mdma and a bunch of other stuff.
DCBAe said:
I stripped down to my shorts whilst poring water on me from the jug and fanning myself with a magazine I buzzed the nurse again to help me as I started fearing for my wellbeing, but to my shock she yelled at me saying "your not the only one we have to attend in this ward, u cant keep callin me like that". I seriously thought I was going to die and rang my parents telling them I loved them and not to worry for me 8) .
I was in a state of panic and confusion at the time due to the adverse reaction and the hyperthermia and had I been clear minded I would have dragged myself to the ER downstairs but instead I yelled saying that I needed to cool down!! The stupid nurse then told me to go have a cold shower which I gladly took up immedeately, I stayed under the cold shower for a good 40 minutes or so despite it being winter and a cold day at the time as I recall how warmly everyone else was dressed while I was just in shorts.
I started feeling better in the cold shower but soon as I got out the intense heat wave sweeped over me again so I went back in for another 30 mins or so, eventualy I was able to get out of the shower safely and back to a normal state and the nurse realised her mistake and tried being nice and saying things like your looking much better and that she was sorry that there wasnt anything that could be done for me other than to wait it out, several weeks later I sent a complaint letter to the hospital but nothing was resolved.
That was just from hydrocodene my reactions to other painkillers have been slightly different with respiratory deprssion being more predominent but the overheating aspect is always present for some odd reason
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The emberassing part about the whole thing was.... they were handing out two Endone tablets at a time to the elderly in the ward for their pain without incidence, and here I was a raver with a past history of being able to munch on a smorgasbord of pills without being phased , who was now turned into some whimp who couldnt even handle one measly hydrocdene capsule
unlucky,
temperature regulation seems rather more complex than I had hoped, some things don't fit. I searched for serotonin and hyperthermia and in addition o the standard serotonin syndrome there were some real oddities.
I am assuming that the massive amount of serotonin from MDMA somehow is the root cause, but I cannot figure out how it would persist for so long.
I hope that fentanyl is good for you, I would hate to have no safe effective anaglesics.
good luck, post here to let us know how it went.
Vecktor
apparently Elk suffer from stress induced hyperthermia experiments have been tried using the serotonin antagonist ketanserin to reduce this. not sure where this fits except to note that elk are hotter than humans
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1532-950X.1986.tb00208.x?journalCode=vsu
Thank you once again Vector, the information regarding elk as odd as it may seem is still relevant in my opinion, ive already been a volunteer lab rat in my neurologists's endevour to find treatment for my overheating, one of them involved a finding by a thermoregulatory scientist who used "Carvedilol" (a heart medication) to reverse the hypethermia effects of mdma...
http://www.mdma.net/hyperthermia/carvedilol.html
I even contacted the person who made the discovery and kept in touch for a while with him but eventually it was determined a little too late for me to have the benfits of this medication, Although Im a male Ive also tried Clonidine as an experiment as its used in females for treating hot flashes but without success in me so the elch thing to me makes more sense than you think and worth a try so i wil suggest it to my Neurologist :D
cheers
DCBAe
Bluelighter
Unlucky: Do you think these symptons explain it?
If it is some kind of Serotonin symdrome it can be treated with considering benzodiazepines for myoclonus and resultant hyperthermia and cyproheptadine, propranolol, or methysergide if symptoms persist.
In regards to my experince in hospital with the oxycodone those symptoms youve shown seem familiar in what ive experinced, so do you think perhaps I get seretonin syndrome to the opiates ive had adverse reactions to?
Although the additional effects like respiratory depression and difficulty swallowing and rahes and itching I experinced from tramadol arent present on the list, Im confused on what to think but open to suggestion.
I sincerely want to thank everyone here for taking the time to help me so much
DCBAe
Bluelighter
Unlucky said:
Serotonin usually regulates body temperature, and opiates boosts levels of serotonin, so it maybe related..
Ant the additional effects that like you said"like respiratory depression and difficulty swallowing and rahes and itching I experinced from tramadol arent present on the list" those are typical of opiates, so it only indicates that tramadol was doing some part of his work (mu binding and promoting histamine release that opiates generally do).
Perhaps your right, seretonin syndrome could easly be the primary cause of my adverse reactions, but is there any tests to be sure?
Just to give you a bit more info.. I usualy experience the adverse reactions from the mimal doses of painkilers like one capsule or tablet for eg,
and when the respirtaory depression comes on its quite severe, so bad that I feel like im not getting enough oxygen and forgetting to breathe and when I do breathe its one fast gulp of air like ive ben under water too long, even had to go to ER one time from one 50mg tramadol but your saying this particular effect isnt due to seretonin syndrome its just from the tramadol working?
If I do infact have seretonin syndrome then its possible I could react the same way to it with fentanyl too?
DCBAe
Bluelighter
fentanyl i think causes less serotonin release, but i'm not sure.. but even if it causes it can be dealt with by adding more meds.
The difficult breathing (like forgeting to breath) is typical from opiates, but not typical from 50mg of tramadol, or you have 0 tolerance and are extremly sensative to opiates or you metabolize tramadol into the more powerful M1 more than the geral population.
But i worked in a ER and have seen many ppl (mostly pain patients, not recreational users..) with dificult breathing by using normal or high doses of tramadol. That sympton is quite commom and it tends the really scare the patients like hell, cause they feel they will stop breathing...
I don't think there is a test for SS, just a diagnose based on symptons and cures.
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Ive found out that my fentanyl test tommorow will be done in the hopital recovery room by nurses who will administer one set dose of fentanyl below 1mg directly into a drip and routenly monitor my temperature, I dont think Im going to even get to speak to any Dr's or wether the person deciding the dose to be given to me knows anything about my history, they sounded very casual about it, should I be concerned lol?
<pyridinyl_30>
Bluelighter
One hundred micrograms of IV fentanyl is the usual dose.
1 microgram = 1 x 10^-6 grams = 0.000001 g.
100 micrograms = 0.0001 g = 0.1 mg.
1000 mg = 1 g.
DCBAe
Bluelighter
Unlucky said:
In the recovery room you should be fine, try to relax and let them do the work.
And they should have all your info in the patient file process.
Fentanyl is a very safe opiate when used in an hospital recovery room. Its one of the opiates with fewer action on other receptors and amine levels (like serotonin, histamine..). Its very selective in his opiate work.
Hope that you don't have a reaction.
And maybe you should have your doctor prescrive you a benzo to the night before..
