troublesome side effects of oral morphine, hydromorphone, or oxycodone.When using the transdermal patch, patients must be careful to minimize or avoid external heat sources (direct sunlight, heating pads, etc. ), which can trigger the release of too much medication and cause potentially deadly complications. Combat medicine
USAF Pararescue combat medics in Afghanistan used fentanyl lozenges in the form of lollipops on combat casualties from IED blasts and other trauma. The stick is taped to a finger and the lozenge put in the cheek of the person. When enough fentanyl has been absorbed, the (sedated) person generally lets the lollipop fall from the mouth, indicating sufficient analgesia and somewhat reducing the likelihood of overdose and associated risks. Dyspnea
Fentanyl can also be used for patients in whom morphine is not tolerated, or whose breathlessness is refractory to morphine. Fentanyl is especially useful for concomitant treatment in palliative care settings where pain and shortness of breath are severe and need to be treated with high strength opioids. Other
Some routes of administration such as nasal sprays and inhalers generally result in a faster onset of high blood levels, which can provide more immediate analgesia but also more severe side effects, especially in overdose. The much higher cost of some of these appliances may not be justified by marginal benefit compared with buccal or oral options.
Cenegermin, sold under the brand name Oxervate, also known as recombinant human nerve growth factor (rhNGF), is a recombinant form of human nerve growth factor (NGF). In July 2017, it was approved in the European Union as an eye drop formulation for the treatment of moderate or severe neurotrophic keratitis in adults.As a recombinant form of NGF, cenegermin is a peripherally selective agonist of the TrkA and LNGFR (p75NTR) which must be administered parenterally.The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication. History
It was developed by Anabasis Pharma, Dompé Farmaceutici, and Ospedale San Raffaele. Research
In addition to neurotrophic keratitis, cenegermin is also under development for the treatment of dry eyes, retinitis pigmentosa, and glaucoma. References
Further reading
Sheha H, Tighe S, Hashem O, Hayashida Y (October 2019). "Update On Cenegermin Eye Drops In The Treatment Of Neurotrophic Keratitis". Clin Ophthalmol. 13: 1973–1980. doi:10.2147/OPTH.S185184. PMC 6789413. PMID 31631965. External links
"Cenegermin". Drug Information Portal. U.S. National Library of Medicine.