Pharmacology Book

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Patch Delivered Medication

Aka: Patch Delivered Medication, Transdermal Drug, Medication Patch, Topical Medication
  1. Precautions: Transdermal Patch
    1. Patch is heat sensitive
      1. Increases absorption and decreases duration
      2. Affected by fever, Sun Exposure, heating pads, saunas
      3. Could dangerously increase levels (e.g. Fentanyl)
    2. Avoid cutting patches unless specifically allowed
      1. Patches with evenly distributed medication may be cut (e.g. Lidoderm)
      2. Avoid cutting patches with drug reservoir (e.g. Androderm, Nicoderm CQ)
      3. Avoid cutting patches for which exact dosing must be maintained (e.g. Fentanyl)
    3. Remove patches before entering MRI
      1. Many patches have a metallic backing
    4. Patch disposal
      1. FDA recommends Flushing some patches with diversion potential (e.g. Fentanyl)
      2. Take-Back programs may accept patches for disposal
      3. Other patches may be folded in half (adherent sides together) and discarded
  2. Precautions: Water Exposure
    1. Apply Topical Medications and patches after bath, shower or swimming
    2. Wait at least 15-30 minutes or until medication dries prior to any water exposure
    3. Avoid reapplying medications after water exposure (if already applied prior to water exposure)
    4. Applying medication to moist skin may increase absorption (risk of adverse effects)
    5. Heat may affect topicals as well as patches (see above)
    6. Some patches may allow for water exposure, but the patch adhesive may be reduced
      1. May require medical tape along edges or across the surface to keep secured to skin
      2. Apply patch in regions that are less easily rubbed off
  3. References
    1. (2017) Presc Lett 24(7)
    2. (2021) Presc Lett 28(8): 46-7

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