Nicotine patches, transdermal

Stapleton JA, Russell MAH, Feyerabend C, Wiseman SM, Gustavsson G, Sawe U and Wiseman D (1995). Dose effects and predictors of outcome in a randomised trial of transdermal nicotine patches in general practice. Addiction, 90, 31 42. 

Fant RV, Henningfleld JE, Shiffman S, Strahs KR, Reitberg DP (2000) A pharmacokinetic crossover study to compare the absorption characteristics of three transdermal nicotine patches. Pharmacol Biochem Behav 67(3) 479 82... 

Lawrence and colleagues (2002) explored the neural substrates of nicotine effects on sustained attention using the rapid visual information processing (RVIP) task. Smokers (n = 15) received either placebo or 21-mg transdermal nicotine patch prior to testing. Matched nonsmokers (n = 14) were tested under similar conditions, but did not receive a nicotine patch. Relative to the placebo condition, the smokers in the nicotine condition demonstrated improved task performance and increased neural activity in the parietal and occipital cortices, the thalamus and caudate, and decreased activity in left frontal, anterior and posterior cingulate, insula, and left parahippocampal regions (see Fig. 3). As noted by the authors, previous studies... 

Salin-Pascual RJ, Rosas M, Jimenez-Genchi A, Rivera-Meza BL, Delgado-Parra V (1996) Antidepressant effect of transdermal nicotine patches in nonsmoking patients with major depression. J Clin Psychiatry 57 387-389... 

F%.1 Venous blood concentrations in nanograms of nicotine per miUimeter of blood as a function of time for various nicotine delivery systems. Data on the cigarette delivering about 1 mg nicotine (filled square), oral snuff delivering 3.6 mg (filled circle), and 4 mg nicotine gum (star) are from those published by Benowitz et al. (1988). Data on 1 mg nicotine nasal spray (filled triangle) are from Schneider et al. (1996). Data on 21 mg transdermal nicotine patch (open square) are from Benowitz (1993). Data on the 4 mg nicotine lozenge (open circle) are from Choi et al. (2003)... 

Currently approved NRT products include the transdermal nicotine patch and several acute NRT products, including nicotine gum, lozenge, sublingual tablet, vapor inhaler, and nasal spray. The single-dose nicotine plasma curves for transdermal patch, gum, nasal spray, lozenge, as well oral snuff and a cigarette, are illustrated in Fig. 1 (note for the sake of simphcity, the curve for sublingual tablet is not illustrated, but because of the route of nicotine delivery, the plasma curve is qualitatively similar to nicotine gum). 

Tiffany ST, Cox LS, Elash CA (2000) Effects of transdermal nicotine patches on abstinence-induced and cue- elicited craving in cigarette smokers, J Consult Clin Psychol 68 233-240 Tonnesen P (1988) Dose and nicotine dependence as determinants of nicotine gum efficacy. Prog Clin Biol Res 261 129-144... 

Tourette s syndrome. Administration of nicotine (either 2 mg nicotine gum or 7 mg transdermal nicotine patch) potentiated the therapeutic properties of neuroleptics in treating patients with Tourette s syndrome, and a single patch may be effective for a variable number of days. These findings suggest that transdermal nicotine could serve as an effective adjunct to neuroleptic therapy . 

Local skin reactions to transdermal nicotine patches have been reported (31). Other local adverse effects, including erythema with edema, erosions, and systemic skin reactions have also been described (32). 

Saenghirunvattana S. Trial of transdermal nicotine patch in smoking cessation. J Med Assoc Thai 1995 78(9) 466-8. 

Tonnesen P, Norregaard J, Simonsen K, Sawe U. A doubleblind trial of a 16-hour transdermal nicotine patch in smoking cessation. N Engl J Med 1991 325(5) 311-15. 

Sivyer G, Gardiner J, Hibbins G, Saunders R. Smoking cessation study involving a transdermal nicotine patch. Outcome achieved in a workplace setting and in general practice. Drug Invest 1994 7 244-53. 

The review was limited to randomized trials in which NRT was compared to placebo or no treatment, or where different doses of NRT were compared. The main outcome measure was abstinence from smoking after at least 6 months of follow-up. For each trial, researchers used the most rigorous deflnition of abstinence, and confirmation with biochemical markers where available. The review includes 110 studies, 96 of which included a placebo or non-nicotine control arm. These studies were used in the primary analysis. In this group there were 51 trials of nicotine gum, 34 of transdermal nicotine patch, 4 of intranasal nicotine spray, 4 of inhaled nicotine, and 3 of an oral tablet. Five trials compared combinations of two forms of nicotine therapy with only one form (patch with gum to patch alone patch with gum to gum alone patch with nasal spray to patch alone patch with inhaler to inhaler alone and patch with inhaler to either one alone). ... 

The AHRQ guidelines recommend use of NRT in the forms of transdermal nicotine patches, nicotine gum, nicotine sprays, and nicotine inhalers. The use of NRT is relatively safe, but it is not recommended for all smokers. Although cardiovascular disease is not an independent risk factor for acute myocardial events, NRT should... 

C. Transdermal nicotine patches deliver an average of 5-22 mg of nicotine over the 16-24 hours of intended application, depending on the brand and size. Transdermal patches may produce intoxication in light smokers or in non-smokers, particularly children to whom a used patch inadvertently sticks. Ingestion of a discarded patch may also potentially produce poisoning. 

A 22-year-old woman in good health was anaesthetised for surgery with nitrous oxide/oxygen and isoflurane. Twenty minutes after induction she was given an injeetion of 0.2 units of vasopressin into the eervix. Within seeonds she developed severe hypotension and bradycardia, and over the next 30 minutes blood pressures as low as 70/35 mmHg and heart rates as low as 38 bpm were recorded. She was treated with atropine and adrenaline (epinephrine), and eventually made a full recovery. This patient was wearing a transdermal nicotine patch. ... 

Drag overdose A fatal case of poisoning with tramadol and nicotine has been reported in a 46-year-old man, who had attached 25 transdermal nicotine patches to his thorax and abdomen and in whom tramadol was detected in femoral venous blood post-mortem (concentration 6.6 mg/1) [49 ]. 

Another recent study revealed that the pre-operative application of a 7 mg nicotine patch resulted in a significant (31%) reduction in opioid consumption in non-smoking patients undergoing radical retropubic prostatectomy [4]. Peri-operative administration of a high-dose transdermal nicotine patch (21 mg/24 hours) for 3 days did not improve post-operative pain control or decrease the analgesic requirement after... 

Transdermal nicotine patch for postoperative pain management a pilot dose-ranging study. Anesth Analg 2008 107(3) 1005-1010. 

Turan A, White PF, Koyuncu O, Karamanliodlu B, Kaya G, Apfel CC. Transdermal nicotine patch failed to improve post-operative pain management. Anesth A flfe 2008 107(3) 1011-1017. 

Stein PK, Rottman JN, Kleiger R. Effect of 21 mg transdermal nicotine patches and smoking cessation on heart rate variability. Am J Cardiol 1996 77 701-705. 

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