A 60-year-old woman stabilized on a transdermal fentanyl patch develops high fever from pneumonia. Which complication should the treating physician anticipate?

• A Increased fentanyl release from the patch causing respiratory depression ✓
• B Accelerated hepatic clearance causing acute withdrawal
• C Patch detachment due to sweat leading to loss of analgesia only
• D Conversion of the patch reservoir into a toxic metabolite under heat

Explanation

Fentanyl release from the transdermal matrix is temperature dependent. Fever or external heat sources such as hot water bags increase skin permeability and drug release, raising serum concentrations and risking fatal respiratory depression. Clearance is not increased enough to cause withdrawal, and sweating may reduce adhesion but the dominant danger is enhanced delivery, not loss of analgesia.

Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.