Transdermal Flashcards
Does the nitroglycerin transdermal system relieve acute attacks?
No, nitroglycerin transdermal systems are only indicated for prevention of angina pectoris.
The drug is evenly distributed, can be cut in half, contains a release liner, and is released from the adhesive in which transdermal system
Adhesive matrix
What’s the trade name for ranolazine?
Ranexa
What type of matrix are contained in Minitran and Nitro-Dur?
Adhesive matrix
How often is Minitran given?
Qday
Which transdermal system can’t be cut in half and haas rate controlling membrane?
Reservoir
How often should ranolazine (Ranexa) be given?
Bid
How often should Nitro-Dur and Minitran be given?
Wear for 12 hours then take off for 12 hours
What’s the term for painful intercourse?
Dyspareunia
What’s the term for inflammation of the vagina of thinning and shrinking of tissues?
Atrophic vaginitis
What’s the BBW for estradiol transdermal systems such as Menostar, Climara, Vivelle-Dot, Alora, and Minivelle?
Increased risk of CVD, dementia, and endometrial cancers
Which estradiol transdermal patch is indicated for osteoporosis only?
Menostar
Which type of matrix are the estradiol transdermal systems?
Adhesive
Which are the strengths for Minivelle?
0.0375, 0.05, 0.075, 0.1 mg/24 hours
Which estradiol transdermal comes in a strength of 0.014 mg/24 hours
Menostar
How often is Climara given?
Qweek
How often are Vivelle Dot and Alora given?
Twice weekly
How often is Menostar given?
Qweekly 0.014 mg/24 hours
What are the indications for estradiol transdermal systems?
- Vasomotor symptoms
- Vaginal atrophy
- Osteoporosis
How often are Minivelle, Alora, and Vivelle-Dot given?
Twice weekly
Which estradiol topical emulsion contains soybean oil?
Estrasorb
How often is Estrasorb (estradiol) given?
2 packets every morning 0.05 mg/2 packets; place one packet on the leg for 3 minutes, one packet on right leg for 3 minutes, rub the excess on the buttocks
What’s the trade for estradiol 0.021 mg/spray transdermal spray?
Evamist
Where do you spray Evamist?
Spray on the inside of the arm
How often should Evamist be given?
One spray daily
Which estradiol products are indicated for vasomotor symptoms only?
- Estrasorb-left and right leg then buttocks
- Evamist-forearm
- Divigel-upper thigh
How often is Divigel given?
Daily
What’s the trade for ethinyl estradiol + norelgestromin?
Ortho Evra-given weekly-adhesive matrix-apply 1 patch for 3 weeks then go patch free for one week repeat
How often is Activella given?
Qday
What are the trade names for estradiol + norethindrone?
CombiPatch, Activella
What’s the trade name for estradiol and levonorgestrel?
Climara Pro
What’s the trade for the conjugated equine estrogens?
Premarin Vaginal Creams
What’s the trade for the 10 mcg vaginal tablet?
Vagifem
What’s the trade for the 0.1 mg/g vaginal cream?
Estrace
What’s the maintenance dose for Estrace?
1-3x a week
What’s the dosing interval for Femring?
0.05 and 0.1 mg/24 hours every three months
Which are indicated for VM, VA, and O?
Activella-comes in 0.5 mg/0.1 mg tablet as well as 1 mg/0.5 mg tablet
How often is CombiPatch given?
Twice weekly
How often is Activella given?
Qday
What’s the trade for the 0.625 mg/g vaginal cream?
Premarin Vaginal Cream
What’s the initial dose for Vagifem?
1 tablet qday for 2 weeks then a maintenance dose of 1 tablet twice weekly
Which are indicated for VA only?
Vagifem, Premarin Vaginal Cream
Which estradiol must be refrigerated?
CombiPatch
What are Climara Pro’s indication?
Indicated for VM and O
What percent is estradiol topical gel?
0.1% in 0.25, 0.5, 1 gram packets of gel
What’s the dosing interval for Estrace?
Initial: give daily for 2 weeks then after / weeks give half a dose daily daily for 2 weeks
Maintenance: 1-3x weeks
Which estradiol products contain alcohol USP?
Evamist, Divigel
How much testosterone do men produce daily?
5 mg/day
What are the synthetic derivatives of testosterone?
Anabolic steroids
What drugs do testosterone transdermal systems interact with?
They decrease anticoagulant and insulin requirements
What control level are anabolic steroids?
CIII
How often should testosterone transdermals be given?
All are given daily-Androderm, AndroGel, Testim, Fortesta, Axiron
What testosterone transdermal patch comes in strengths of 2 mg/24 hours and 4 mg/24 hours?
Androderm
Which testosterone transdermal is a reservoir patch?
Androderm
Which testosterone transdermal comes in 5 gram single dose packets? 50 mg testosterone= 5 mg absorbed
Testim
What single dose packet sizes does AndroGel come in?
2.5 grams, 5 gram= 25 mg, 50 mg testosterone-2.5 mg, 5 mg absorbed via the shoulder
What % metered dose pump does AndroGel come in?
1%, 1.62%
With a 1% AndroGel testosterone pump, how many milligrams are absorbed via the shoulder?
5 mg absorbed via the shoulder; 1 pump=12.5 mg x 4 pumps= 50 mg with 5 mg absorbed
What’s the metered dose pump that includes alcohol USP used as a topical solution?
Axiron-give daily-ALL testosterone transdermals are DAILY
Which testosterone metered dose pump is applied as two pumps to each thigh to minimize secondary exposure?
Fortesta
How often is Kapvay given?
Bid (maintenance)
What is. Kapvay indicated for?
ADHD
How often is Catapres given?
Qweek it comes in 0.1, 0.2, 0.3 mg/24 hours
What is Catapres indicated for?
Hypertension
What strengths does Kapvay come in?
0.1 mg, 0.2 mg ER tablet
What’s the precaution with fentanyl transdermal system?
All may be fatal to children so discard appropriately
How often is Duragesic given?
q72h
Which fentanyl transdermal is given for chronic pain?
Duragesic-note 12 hour onset
What strengths does fentanyl come in?
12.5, 25, 50, 75, 100 mcg/hr
How often is Actiq given?
q4h-Rub on side of cheek for 15 minutes
What’s the trade for the transmucosal lozenge on a stick
Actiq
How often is Onsolis given?
q2h
How often is the sublingual fentanyl tablet given?
Abstral
What’s the trade for the fentanyl nasal spray?
Lazanda-1 spray in 1 nostril
Which fentanyl product should be placed in a child resistant container?
Lazanda
What’s the trade for the fentanyl but cal tablet?
Fentora
What’s the trade for the fentanyl sublingual tablet?
Abstral given q2h
How long can a scopolamine patch be left on?
3 days-note: place behind ear for 4 hours
If a scopolamine patch is used for surgery, when should it be placed behind the ear?
The evening before surgery
What strength does scopolamine come in?
5 mcg/hr
What’s the trade for scopolamine patch?
Transderm-Scop
Which transdermal patch is indicated for pain associated with post herpetic neuropathy?
Lidoderm-lidocaine
What’s the trade for the 5 % lidocaine transdermal patch?
Lidoderm
How often and how long should Lidoderm be applied?
Apply up to 3 patches a day at the same time; put one on for 12 hours, then remove for 12 hours
What’s the trade for zoster vaccine?
Zostavax
What’s the trade for varicella vaccine?
Varivax
What are the indications for Neurontin?
- PHN
2. Partial seizures
What are the indications for Lyrica?
- PHN
- Partial seizures
- DPN
- Fibromyalgia
What’s the trade for mirabegron?
Myrbetriq
What’s the trade for fesoteridone?
Toviaz
What’s the trade for solifenacin?
Vesicant
What’s the trade for darifenacin?
Enablex
What’s the trade for the ER trospium capsule?
Sanctura XR
What’s the trade for the IR trospium tablet?
Sanctura
How should trospium be taken?
Take on an empty stomach
What’s the 10% topical oxybutynin gel?
Gelnique
What’s the trade for the IR oxybutynin tablet?
Ditropan
What’s the trade for the ER oxybutynin tablet?
Ditropan XL
What’s the trade for the oxybutynin transdermal 3.9 mg/24 hours adhesive?
Oxytrol
How often should Oxytrol be given?
Twice weekly
Which class is Myrbetriq a part of?
Beta 3 agonist
Where is Gelnique applied?
The abdomen
How often is Gelnique given?
Qday
How often should Daytrana be given?
Qday
What’s the indication for methylphenidate and what class?
ADHD; Controlled II
What strength does Daytrana come in?
10, 15, 20, 30 mg/9 hours
Where do you apply Daytrana and for how long?
Wear on the hip for 2 hours before needed, then take off 9 hours later.
What’s the trade for granisetron?
Sancuso
How often should Sancuso be given?
Qweek-3.1 mg/24 hours
What are Zelapar and Eldepryl indicated for?
AntiParkinson’s agent
What’s the generic for Emsam, Eldepryl, and Zelapar?
Selegiline
What’s the trade for ODT selegiline?
Zelapar
What’s the indication for Emsam?
MAOI depressant
What’s a drug interaction with Emsam?
Tyramine 9 mg, 12 mg; avoid pseudoephedrine and phenylephrine
What strengths does Emsam come in?
6, 9, 12 mg/24 hours
How often should Sancuso be given?
Qweek
How often should Emsam given?
Qday
What’s the trade for aprepitant?
Emend
What’s the trade for ondansetron?
Zofran
What’s the trade for dolasetron?
Anzemet
What’s the trade for palonosetron?
Aloxi
Which antiemetic is indicated for N/V patients receiving chemotherapy for 5 straight days?
Sancuso-granisetron
How soon should Sancuso be applied to upper arm before treatment?
24 hours and also taken off 24 hours after last treatment
What’s the trade for galantamine?
Razadyne
What’s the trade for donepezil?
Aricept
What’s the trade for Exelon?
rivastigmine?
Where should Exelon Patch be applied?
In the middle of the back
How often should Exelon Patch be applied?
Qday; it comes in strengths of 4.6,9.5/24 hours
What’s the dosing interval for Exelon Patch?
4.6 mg x 1 month, then increase to 9.5 mg as maintenance dose
How often should Butrans be given?
Weekly
What’s the trade for parenteral buprenorphine?
Buprenex
What’s the sublingual buprenorphine tablet?
buprenorphine
What’s the indication for Buprenex?
Addiction
What’s the trade for diclofenac epolamine?
Flector Patch
How often should Flector Patch be given?
Bid
Which COX enzyme does Flector Patch inhibit?
COX-2
What are the indications for Flector Patch?
- Strains-stretched muscle
2. Sprains-stretched ligaments
What’s a drug interaction with Flector Patch?
Aspirin
What’s the trade for galantamine?
Razadyne
How often should Butrans be given?
Qweek comes in 5, 10, 20 mcg/hour
Which strength of buprenorphine are used in opioid tolerant patients?
10 and 20 mcg/hour
What’s the dosing interval for Exelon Patch?
4.6 mg x 1 month; then increase to 9.5 mg as maintenance dose
What category is Zyban?
Aminoketone antidepressant
What’s the dosing interval for Zyban?
Take 1 tablet for 3 days then bid for 12 weeks
How often should Zyban be started before trying to quit?
Give one week to reach therapeutic levels
What’s the dosing interval for Chantix?
Take 0.5 mg qday for 3 days, then 0.5 mg bid for 4 days, then 1 mg bid for 12 weeks
What’s Chantix mechanism of action?
Nicotine receptor agonist; varenicline binds to its receptor and produces nicotine-like effects and inhibits nicotine
What’s the DI for Nicoderm CQ?
Daily
What are the strengths of Nicoderm CQ?
7 mg, 14 mg, 21 mg/24 hour adhesive matrix
What’s the DI for Nicoderm CQ based off of?
Cigarettes smoked per day
>10 cigarettes: 21 mg-6 weeks, 14 mg and 7 mg-2 weeks
<10 cigarettes: 14 mg-6 weeks, 7 mg-2 weeks
Where should Nicoderm CQ be applied?
Upper part of arm; remove after 24 hours (do not reuse this site for 7 days) and apply new patch to different site-fold patch in half to discard
What’s the max daily dose for Nicotrol Inhaler?
Max daily dose/day 16 cartridges= 4 mg cartridge; contains enough nicotine for 20 minutes of active puffing; transmucosal so do. to inhale into lungs
Trade for cromolyn sodium?
Nasalcrom
Class for Nasalcrom?
Mast Cell Stabilizers
Trade for desmopessin acetate?
DDAVP, Stimate
Which class is DDAVP and Stimate?
desmopessin acetate
Trade for ipratropium bromide?
Atrovent Nasal Spray
Which class is Atrovent Nasal spray?
Anticholinergics
Which class is Astelin, Astepro?
Antihistamines
Which condition are Miacalcin, Fortical indicated for?
calcitonin
Which class is Omnaris, Nasonex, Veramyst, Flonase, Rhinocort Aqua, Nasacort AQ?
Corticosteroids
What’s the trade for triamcinolone?
Nasacort AQ
Trade for ciclesonide?
Alvesco
Term for rate of diffusion through the skin?
Flux
How do you apply a transdermal patch?
Place patch in the middle of the palm and press down on area firmly for 10 seconds to get contact with edges
How often should Minitran or Nitro-Dur be given?
Qday or daily
Can you take Minitran or Nitro-Dur for an acute attack?
No, it’s for prevention of angina pectoris
What’s the rate of Minitran?
0.1 mg/hr
How long do you wear Minitran?
12 hours then give 12 hour break
Side effect of Minitran?
Headache
How often should Ranexa be given?
Twice daily; comes in 500 mg, 1000 mg strength
What category is Ranexa?
Vasodilator
Name of the estrogen hormone indicated for hormone replacement therapy in post-menopausal women?
Estradiol
Which estradiol transdermal system is indicated for osteoporosis only?
Menostar
What BBW do estradiol transdermals have in pre-menopausal women?
Endometrial cancer
What BBW do estradiol transdermals have in post-menopausal women?
CVD and dementia
Strengths of Climara?
- 025 mg/24 hour
- 0375 mg/24 hour
- 05 mg/24 hour
- 06 mg/24 hour
- 075 mg/24 hour
- 1 mg/24 hour
Strengths of Vivelle-Dot?
- 025 mg/hr
- 0375 mg/hr
- 05 mg/hr
- 075 mg/hr
- 1 mg/24 hour
Basically one less than Climara…there’s no 0.06 mg/hr
Strengths for Alora?
- 025 mg/24 hour
- 05 mg/24 hour
- 075 mg/24 hour
- 1 mg/24 hour
Strength of Menostar?
0.014 mg/24 hour
When is Estrasorb given?
In the morning
When is Evamist given?
Daily or qday
What is Estrasorb indicated for?
Vasomotor symptoms only
Which estradiol should you not use in allergic to peanuts?
Estrasorb
How often should Evamist be given?
Daily
What’s the indication for Evamist?
Vasomotor symptoms
Strength of Evamist?
0.021 mg/spray
Indications for CombiPatch?
VM, VA
Dosing interval for CombiPatch?
Twice weekly
Dosing interval for Climara Pro?
Qweek
Indication for Climara Pro?
VM, O
Term for a synthetic progesterone?
Progestin
CombiPatch should it be kept at room temp or refrigerated?
Refrigerated
Max pieces of Nicolette DS?
20
Max pieces of Nicorette?
30 pieces
Precaution with Nicorette?
Do not swallow
How is Nicorette absorbed?
Buccal mucosa
The rate and extent of Nicotine is dependent on?
pH dependent
What should be avoided when taking Nicorette?
Coffee, soft drinks, fruit juices
How many times should you chew Nicorette?
15 times until peppery taste or tingling subsides then place between cheek and gym until taste is gone….repeat for 30 minutes
Which nicotine lozenge strength must be taken within 30 minutes of waking?
4 mg
Which nicotine lozenge should be taken after 30 minutes of waking?
2 mg
What’s the dosing interval for nicotine lozenges?
Take 1 lozenge either 2 or 4 mg every 1 to 2 hours for 6 weeks then q2-4 hours for 3 weeks then q4-q8 hours every 3 weeks
Nicotrol Inhaler contain nicotine for how many minutes of active puffing?
20 minutes
Nicotine lozenge is dose dependent on?
Time to first cigarette
What type of system is Nicoderm CQ?
Adhesive matrix transdermal system
Where should Nicoderm CQ be applied?
Apply daily to clean, hairless, dry area on upper outer part of arm
Is a person smokes less than 20 cigarettes a day, what’s the DI?
14 mg for 6 weeks
7 mg for 2 weeks
Is a person smokes more than 20 cigarettes a day, what’s the DI?
21 mg for 6 weeks, 14 mg for 2 weeks, 7 mg for 2 weeks
Category for Lidoderm?
Local anesthetics
Does Lidoderm contain percutaneous absorption enhancer?
No; don’t want it to go into systemic circulation
Lidoderm treats?
Pain from PHN, herpes zoster, varicella virus
What age group is Zostavax indicated for?
Patients 50 and older
How often should Oxytrol be taken?
Twice weekly comes in 3.9 mg/24 adhesive matrix
What’s the TC for Oxytrol?
Antispasmodic or Anticholinergic
How often should Gelnique be given?
Daily
How should Sanctura and Sanctura XR be taken?
On an empty stomach
How often should Emsam be given?
Daily
What’s the category for Emsam?
MAOI antidepressant
What’s the trade of the only transdermal patch indicated for depression?
Emsam
Trade for selegiline capsule?
Eldepryl
Trade for selegiline ODT?
Zelapar
What’s the trade for selegiline capsule?
Eldepryl
What are Eldepryl and Zelapar indicated for?
AntiParkinson’s
What adhesive matrix strengths does Ensam come in?
6 mg/24 hr, 9 mg/24 hr, 12 mg/24 hr
What’s the category for Emsam?
MAOI antidepressants
Patient counseling for Sancuso?
Avoid photo toxic reaction by avoiding sun to area patch was applied for 10 days following removal.
How often should Exelon Patch be given?
Daily
What’s the strength for Exelon patch?
4.6 mg/24 hr; 9.5 mg/24 hr
What’s the category for Exelon patch?
Cholinesterase inhibitors
How does Exelon Patch work?
Increases Acetylcholine levels
What dose do patients start on with Exelon patch?
4.6 mg initial for a thought then a maintenance of 9.5 mg per dose
Where should Exelon Patch be applied?
Middle of the back
What’s the category for Razadyne and Aricept?
Cholinesterase inhibitors
What’s the category for Butrans?
Opioid analgesics give it weekly do not reuse same site for 3 weeks
Trade for buprenorphine adhesive matrix?
Butrans in strengths of 5 mcg/hr, 10 mcg/hr, 20 mcg/hr
