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We report successful management of such a case utilizing whole bowel irrigation along with intravenous push and continuous infusion naloxone. Despite numerous case reports describing oral ingestion of fentanyl patches, information on the management of such intoxication is lacking. The patient was treated with whole bowel irrigation and continuous intravenous naloxone infusion for approximately 48 hours without complications. Initial vital signs showed the patient to be afebrile and normotensive with a heart rate of 63, respiratory rate of 16, and oxygen saturation of 100% on 2 liters nasal cannula after administration of 2 milligrams of intravenous naloxone.
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In the ED, the patient was obtunded, dizzy and drowsy. The patient chewed and ingested two illegally purchased transdermal fentanyl patches. A 32-year-old man was brought to the emergency department (ED) via emergency medical services for toxic ingestion and suicide attempt. In this report, we describe a case of transbuccal and gastrointestinal ingestion of fentanyl patches and the management of such ingestion. Fentanyl is available as a transdermal system for the treatment of chronic pain in opioid-tolerant patients however, it carries a black box warning due to both the potency of the product and the potential for abuse.