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Can Fentanyl Cause Breathlessness In Elderly?
Question: i am a 73 old lady that has a difficult breathing problem.. it is most difficult laying in bed , but can be very difficult standing up also.i have been to the ER three times and they say it could be congestive heart failure, and send me home after the lab work. they dont known what going on.it comes on really quick and i get on a breathing machine that helps for a while but comes right back again. is there some thing that i can do to help the breathing so i can get some sleep. theres been a lot of sleepless nights. theres one more thing that i take for pain, from a fracture in my back , and it is fentanyl 12mcg/hr patch. it says in the side affects it could cause deadly breathing problems.coud it be that patch thats causing my breathing problem. thank you very much for a response to this question. XXXXXXX XXXXXXX
Brief Answer:
Yes it can be heart related, stop fentanyl and if possible do upload labs
Detailed Answer:
Hello XXXXXXX I am Dr Mody and I would be addressing your concern.
Breathlessness that occur in supine position is very commonly heart related, as while sleeping more blood from your legs gets accumulated in the lungs, which would decrease the available lungs for exchange of oxygen causing breathlessness.
Important investigation that will help us find if this is the cause are 2d echo and of available blood investigation like Nt pro Bnp.
Fentanyl is surely known to cause respiratory depression and breathing difficulties, and it's more potent at older age group as you, so if possible try avoiding it. You may discuss with your physician about the alternative.
Also if you can give me the details like are you obese, have hypertension, diabetes and previous heart problem, do you usually have swelling in the legs.
Also you mentioned that various lab tests were done, so if you can upload them I would be able to help you better in terms of further investigation and management .
Also it is better to make an accurate diagnosis, before we discuss the treatment.
Regards Dr Priyank Mody
Yes it can be heart related, stop fentanyl and if possible do upload labs
Detailed Answer:
Hello XXXXXXX I am Dr Mody and I would be addressing your concern.
Breathlessness that occur in supine position is very commonly heart related, as while sleeping more blood from your legs gets accumulated in the lungs, which would decrease the available lungs for exchange of oxygen causing breathlessness.
Important investigation that will help us find if this is the cause are 2d echo and of available blood investigation like Nt pro Bnp.
Fentanyl is surely known to cause respiratory depression and breathing difficulties, and it's more potent at older age group as you, so if possible try avoiding it. You may discuss with your physician about the alternative.
Also if you can give me the details like are you obese, have hypertension, diabetes and previous heart problem, do you usually have swelling in the legs.
Also you mentioned that various lab tests were done, so if you can upload them I would be able to help you better in terms of further investigation and management .
Also it is better to make an accurate diagnosis, before we discuss the treatment.
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Prasad
I have no lab work as of recently.i am not obese,weigh about 124 lb.had congestive heart failure about 25 years ago.dont have diabetes. I take meds for high blood pressure.i need to know do i stop the fentanyl all at once or slowly ween my self from the patches.thank you for a response. XXXXXXX XXXXXXX
Brief Answer:
I will recommend cardiac evaluation like 2d echo, ekg and sos stress tes
Detailed Answer:
Hello,
Thank you for the clarification.
If you are taking fentanyl for even more than 3 days , it would be better if you taper it and stop to avoid withdrawal symptoms. However as fentanyl is short acting it will be tapered off in a short time.
How to taper off and which medicine to substitute would be better judged by your local doctor.
Now coming back to congestive heart failure. What was the cause at that time and what has been the heart pumping ever post that episode.
I will strongly recommend you to get a 2d echo, ekg and based on that any further cardiac evaluation to plan upon the medication you should take as even fluctuations in the blood pressure may cause breathlessness you describe plus the heart of such patients even if normal pumping have impaired relaxation which may cause heart failure like symptoms.
I would be more than happy to guide you on the treatment after review of the above reports.
As I have stressed previously to recommend you any treatment I should be sure of the diagnosis.
Regards Dr XXXXXXX mody
I will recommend cardiac evaluation like 2d echo, ekg and sos stress tes
Detailed Answer:
Hello,
Thank you for the clarification.
If you are taking fentanyl for even more than 3 days , it would be better if you taper it and stop to avoid withdrawal symptoms. However as fentanyl is short acting it will be tapered off in a short time.
How to taper off and which medicine to substitute would be better judged by your local doctor.
Now coming back to congestive heart failure. What was the cause at that time and what has been the heart pumping ever post that episode.
I will strongly recommend you to get a 2d echo, ekg and based on that any further cardiac evaluation to plan upon the medication you should take as even fluctuations in the blood pressure may cause breathlessness you describe plus the heart of such patients even if normal pumping have impaired relaxation which may cause heart failure like symptoms.
I would be more than happy to guide you on the treatment after review of the above reports.
As I have stressed previously to recommend you any treatment I should be sure of the diagnosis.
Regards Dr XXXXXXX mody
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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