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Transdermal opioid toxicity — GPhC CRA MCQ

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HardCNS TherapeuticsTransdermal opioid toxicityGPhC CRA

A care home asks about a prescription for buprenorphine 10micrograms/hour patches, apply one patch every 7 days. The resident still has a patch from hospital dated 5 days ago and is drowsy with respiratory rate 9/min. What is the most appropriate action?

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Correct answer: E — Do not apply a new patch and seek urgent clinical review for possible opioid toxicity

Drowsiness and low respiratory rate suggest opioid toxicity. A new patch should not be applied while the patient may already be over-opioidised, and urgent medical advice is needed. Cutting patches is unsafe and can alter drug delivery. Heat can increase transdermal opioid absorption and worsen toxicity.

Reference: BNF; NICE CKS Palliative care