Patch Down the Hatch

A 42-year-old man presented with somnolence. Initial vital signs include: heart rate 54 bpm, blood pressure 92/68 mm/Hg, temperature 37°C, respiratory rate 6, pulse oximetry 90% on room air. Physical examination is remarkable for depressed level of consciousness, miosis, and bradypnea. His mental status and respiratory rate temporarily improved with the administration of 0.04 mg naloxone. He reports swallowing several “patches” in a suicide attempt.   What are examples of medications available as a transdermal patch? Compare the dose of drug delivered and the patch content. Popular transdermal patches are listed below. Others include diclofenac, buprenorphine, hormone patches (estrogen, contraceptive, testosterone), methylphenidate, and rivastigmine. It is important to consider the potentially significant quantity of drug contained in transdermal patches even after being used.   How do patches deliver the drug? The patches are designed to deliver small quantities of the drug over a long period of time into the outer layers of skin, then absorbed into the deeper layers and then to the bloodstream, which circulates it throughout the body. Several types of transdermal delivery systems are available. For example, fentanyl patches are available as a reservoir system and matrix system (Figure 1).                                  Figure 1: Reservoir system (left) and Matrix system (right). Derived from Duragesic and Mylan package inserts. What...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs