Platelet Reactivity With Fentanyl, Morphine, or no Narcotic

Spectrum Health - Lakeland

Status and phase: Terminated; Phase 2

Conditions: Platelet Reactivity; Fentanyl

Treatments: Drug: Fentanyl; Drug: Morphine

Study type: Interventional

Funder types: Other

Identifiers

NCT05367336

EGME#04-2021

Details and patient eligibility

About

The goal is to determine whether fentanyl and morphine have similar effects in reducing aspirin's effect upon platelets in emergency department patients with chest discomfort. Morphine has been shown to worsen outcomes in heart attack patients due to reduction of oral anti-platelet agent effectiveness and so many providers have switches to using fentanyl. However, it is largely unknown whether fentanyl has similar effects.

Full description

Patients presenting to the emergency department with chest discomfort who are being administered aspirin will be offered enrollment in this study. At the time of their zero and two hour troponin we will also draw platelet aggregration studies to determine the effects of aspirin upon platelets. Narcotic medicines slow the absorption of aspirin. Morphine has therefore been shown to decrease the effectiveness of aspirin. Many providers therefore use fentanyl instead, however little is known about the effects of fentanyl upon aspirin. We will therefore compare the platelet reactivity of patients receiving morphine, fentanyl, or no narcotics

Enrollment: 21 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adult Emergency Department patients undergoing 0 and 2 hour troponin testing
• administered aspirin within 30 minutes of the initial blood draw.
• patient presented via private vehicle
• provide informed consent
• over the age of 18

Exclusion criteria

• Patients not expected to get a 2 hour troponin;
• patients already on aspirin, clopidogrel, or stronger anti-coagulants;
• patients who arrived via EMS (Emergency Medical Services) given it can be difficult to find the run reports to determine whether patient received fentanyl in the pre-hospital period;
• pregnant patients;
• patients on chronic narcotics;
• patients already once enrolled in this study,
• inability to provide consent in English

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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21 participants in 3 patient groups

Control

No Intervention group

Description:

not receiving any narcotics

Morphine

Experimental group

Description:

the second group will be those receiving morphine

Treatment:

Drug: Morphine

Fentanyl

Experimental group

Description:

the 3rd group will be those receiving fentanyl

Treatment:

Drug: Fentanyl