general information about opioid analgesic patch preparations:
the patient should be warned that they may experience more breakthrough pain than usual in the first 1 to 3 days. Breakthrough analgesia should be provided rather than changing the patch strength at this point
laxatives may need to be reduced and titrated to need
replace the patches at the same time of day as indicated on the product information
vary the site of application with each change
apply to clean, dry, undamaged, non-hairy, flat areas of skin
never apply heat over the patch as this will increase absorption. Excessive heat should be avoided e.g. sauna, infrared radiation
dispose of patches by folding in half, sticky side together and putting in safe disposal unit e.g sharps box
check that patches stick well. Sweating, crinkling and lifting at edges can make pain control inadequate
patients can shower or swim, but often a vapour-permeable film dressing needs to be placed over the patch to aid adhesion
Reference:
(1) West Midlands Palliative Care Physicians (2007). Palliative care - guidelines for the use of drugs in symptom control.
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