Transdermal patch, nicotine concentration

Transdermal nicotine is available in a variety of formulations and dosing schedules (e.g., 15 mg/l6 hours 7, 14, and 21 mg/24 hours and 11 and 22 mg/ 24 hours) (Cinciprinni and McClure 1998). Peak nicotine concentrations for the various systems are reached 2-6 hours after application, and steady state conditions occur 2—3 days after continued patch use (Henningfield 1995). The highest-dose patch (i.e., 21 or 22 mg/24 hours or 15 mg/l6 hours) delivers approximately 0.9 mg of nicotine per hour transdermally (Henningfield... 

Blood concentrations of nicotine in individuals who smoked cigarettes, chewed nicotine gum or received nicotine by transdermal patch. 

Transdermal patches registered at present are patches containing active substances such as buprenorphine, estradiol, fentanyl, glyceryl trinitrate, nicotine, oxybutynine, rivastigmine, rotigotine and scopolamine. These transdermal patches are used in the treatment of a variety of diseases. They release the active substance during a period of 24 up to 72 h, depending on the type of patch used and the active substance. After application of the patch plasma concentration slowly rises until a steady concentration is reached. 

Dehvery via a transdermal patch provides a sustained plasma nicotine concentration, typically lower than venous blood concentrations after tobacco smoking (Figure 122.2). On the other hand, a nasal spray and a vapor inhaler provide immediate 10-fold higher arterial blood concentrations immediately following inhalation compared to venous concentrations after a nicotine patch application. 

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)... 

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 ]. 

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