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DOI: 10.1055/a-1546-4686
Überdosis durch ein Pflaster
Overdose from a patch
Zusammenfassung
Anamnese und klinischer Befund Wir berichten über eine 89-jährige Patientin, für die aufgrund einer Bewusstseinsstörung der Notarzt alarmiert wurde. Sie war soporös und zeigte eine deutliche generalisierte Muskelrigidität. Fremdanamnestisch war der fehlerhafte Gebrauch eines Fentanyl-Pflasters zu eruieren.
Therapie und Verlauf Durch die Antidot-Gabe von Naloxon kam es zu einer Restitution. Die Notwendigkeit einer repetitiven Gabe bestätigte die Verdachtsdiagnose.
Folgerung Die Gabe von Fentanyl über die Haut in Form transdermaler therapeutischer Systeme (TTS) erfreut sich seit Jahren einer zunehmenden Beliebtheit. Bei unsachgemäßer Verabreichung treten Intoxikationen mit den führenden Symptomen Bewusstseinsminderung und Atemdepression auf. Dieser Fallbericht ergänzt das Spektrum um den Rigor der quergestreiften Skelettmuskulatur, der sonst im Zusammenhang mit der intravenösen Applikation beschrieben wird.
Abstract
History and clinical findings We present the case of an 89-year-old patient with impaired consciousness for whom the emergency services were called. She was soporose and showed a pronounced generalized muscle rigidity. Due to a third-party history the incorrect use of a fentanyl patch was found out to be at cause.
Treatment and clinical course The antidote administration of naloxone led to restoration. The need for repetitive administration confirmed the clinical hypothesis.
Conclusion The application of fentanyl via the skin in the form of transdermal therapeutic systems (TTS) has become more popular over the years. Incorrect administration causes intoxication with the leading symptoms of loss of consciousness and respiratory depression. This case report extends the spectrum of symptoms to include skeletal muscle rigidity otherwise only described in connection with intravenous administration, especially in anaesthetic settings.
Publication History
Article published online:
14 September 2021
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