Fentanyl Transdermal Patch and Fatal Adverse Reactions Essays

Fentanyl Transdermal Patch and Fatal Adverse Reactions Essays Fentanyl Transdermal Patch and Fatal Adverse Reactions Paper Fentanyl Transdermal Patch and Fatal Adverse Reactions Paper The fentanyl transdermal system is used to manage pain. Unlike other pain killers this system manages moderate to severe chronic pain, which other means like opiod combination cannot manage. Safety concerns This system’s safety is only guaranteed if used according to the conditions recommended in the Canadian product monograph. Duragesic is the brand name under which the fentanyl transdermal system has been marked since the year 1992. Two generic products were introduced in July 2006. They are Ran Fentanyl and Ratio-Fentanyl transdermal systems. There have been numerous reports of serious adverse reactions which Health Canada suspects that they are linked to fentanyl transdermal patches. Health Canada is closely monitoring this situation. Fatal outcomes involved opioid-naive adolescents who are suspected to have abused the medication. AR with a fatal outcome linked to fentanyl trandermal patches There were fifty-two AR reports with a fatal outcome being linked to fentanyl transdermal patches. These were submitted to Health Canada from January 1, 1992 to December 31, 2007. : A total of six cases of AR were due to dose initiation and titration. Prescriptions to oploid-naive patients were three, quick titration doses two and one high initiation dose. There was also one case of use concomitant with other central nervous system depressants. The death occurred within twenty-four hours after initiation. CNS depression due to combination of the medication with other CNS depressants was reported as the cause of death. A death was also reported due to interaction between CY3A4 inhibitor and fentanyl transdermal. It occurred less than four days after being initiated during fentanyl transdermal therapy. Six patients died due to patch application by the patients. Four of the patients applied more than the prescribed medication while one patient applied a new patch with the old patches on. Another patient changed the patch daily instead of every three days. There were three fatalities due to caregiver application of the patch. One case was due to the caregiver attempting to reduce dosage by folding the patch in half. Another case was due to the caregiver administering new patch while the old one was on. Still one more case was due to the caregiver pressing on it because it did not stick, thereby leaking fentanyl transdermal and overdosing the patient. One fatality occurred due to a patient using a patch prescribed for another patient. The sixty-four year old man applied the patch prescribed for his wife. The patient became unresponsive, vomited and aspirated. He died five days later due to pneumonia and renal failure. Five fatalities occurred due to accidental overdose. One patient was elderly and underweight. Another died of cardiac arrhythmia as a result of overdose fentanyl and antidepressants. Another had toxic levels of fentanyl after the second dose. The other two cases had limited information and could not be immediately established. Intentional overdose with suicide missions was evident in four of the cases while those of intentional drug abuse of the fentanyl patches were a massive twenty-five (MacMorran, 2008). Health promotion initiatives Health care professionals should therefore follow the directions available in the fentanyl transdermia patches product monographs. It is essential for patients, caregivers and their respective families to be guided on using the product safely. This includes safe storage of the drugs, preventing their accessibility for abuse and to prevent any accidental overdose. Rectification steps Following death reports linked to inappropriate use of the medication, the Canadian product monograph had to be revised in 2005. This was in order to emphasize this safety information. Subsequent advisories followed again in September 2005. A number of publications have followed suit in highlighting safety issues related to the medication use. Health Canada received 105 reports from Jan 1, 1992 to December 31, 2007. According to these reports, the ARs are suspected of being closely associated with fentanyl transdermal patches and one fatal case was reported. Twenty-seven of these reports were received after the last risk communication by Health Canada. The data were analyzed as part of monitoring AR reports. This was to identify any potentially preventable incidents and increase awareness on the product’s safety. In some cases there was no evidence to link the deaths to fentanyl transdermal. This was the case in thirty-three out of the 105 of these reports. In twenty such cases, there was insufficient information in the report for any meaningful evaluation (Raymond et al, 2004). Personal interest held by the advisory The drug advisory has challenged me personally to come up with alternative drugs that can serve the same purpose but are less risky. Proper administration and usage of drugs has also been emphasized. I have been encouraged to handle any drugs carefully. It has brought a very clear realization that people’s lives are at stake and we have to be very careful. Impact of the advisory on a practicing nurse in 2008 The advisory has had a significant impact on the practicing nurse. They have to be very careful not to administer the Fentanyl patch to any more patients unless under prescription and strict following of instructions. This has led to seeking alternative drugs. The altenative drugs have their own short-comings which the patients may not be used to or even aware of. In cases where usage of Fentanyl cannot be abandoned, very strict measures have had to be taken to avoid misuse, overdose and abuse. This has added some extra responsibilities to the nurses. References Canadian Safety Bull. (2006). Fentanyl transdermia: a misunderstood dosage form. 6 (5). Canada Safety Bull (2007). Fentanyl patch linked to another death in Canada. Duragenic (2007). Fentanyl transdermal System: product monograph. Janssen-Ortho Inc: Toronto. MacMorran, M. (2008). Fentanyl transdermia patch and fatal adverse reactions. Canadian Adverse Reaction Newsletter. Raymond, B. et al (2004). Respiratory arrest in adolescents. Duragenic. Canadian Adverse Reaction News. 14 (4): 1-2

Summer Jobs Might be Harder to Find This Summer

Summer Jobs Might be Harder to Find This Summer From lifeguarding at the local pool to mowing lawns, most adults have fond memories of the summer jobs of their youth. But is this generations-old tradition going the way of the dinosaur? A recent report from JPMorgan Chase (JPM) indicates that it may be. Let’s take a closer look at this phenomenon, along with what it means for this year’s crop of employment-seeking teens and young adults. The 411 on Youth EmploymentJPM’s January 2015 report, â€Å"Building Skills Through Summer Jobs: Lessons From the Field,† reveals some unhappy statistics: less than half (46 percent) of young people who sought out summer employment in 2014 ended up landing jobs. This decline was consistent across nearly all industries.But it’s not just lack of jobs that’s the problem. It’s also a decline in youth employment in general. Over the past 12 years, there has been a near 40 percent drop in summer youth employment, with just over a quarter of young adults ho lding paid summer jobs in recent years.The outlook grows even more grim based on findings that economically disadvantaged youth, in particular, are even more impacted by the employment shortage.It’s no surprise that these less-than-optimistic figures led JPM’s Head of Workforce Initiatives Chauncy Lennon to conclude, â€Å"Young people are facing an employment crisis.†More Than a Loss Of JobsWhile the loss of jobs in itself is concerning, another factor is equally unsettling: the loss of skills which would otherwise be acquired on the job. After all, the expression goes that the â€Å"best way to get a job is to have a job.† And with the American workforce already facing a shortage of qualified workers, this decline in opportunities will only further slow the pipeline of trained employees into the workforce.Unfortunately, the situation is something of a vicious cycle. While some of the job cuts may pertain to the replacement of workers by technology and t he hiring of older works, a report from the Federal Reserve Bank of Boston, â€Å"Uncertain Futures: Youth Attachment to the Labor Market in the United States and New England,† yields another reason: a shift toward job openings which require more experience and skill than the typical high schooler brings to the table. But how can they be expected to develop these experiences and skills without a job market willing to take a chance on them?Searching for SolutionsWhile in the past the government has funded skills training programs, growth of these initiatives has stagnated in recent years. According to JPM, the solution is for employers to begin designing summer jobs focused on helping American teens and young adults gain the skills they need to succeed. To that end, JPM is in the process of investing $5 million over the next two years in summer youth programs within several American cities to support the growth of youth talent.But in the meantime what should teens do who are l ooking for work? Lennon recommends the importance of networking - from friends and family members to online job boards. And while finding these jobs may not be as simple a matter as opening up the â€Å"Help Wanted† section of the newspaper, perseverance offers significant payoffs - both for young adults and the economy their talent and experience will fuel.