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Thursday, January 23, 2014

Fentanyl Transdermal Patch Application Sites

English: 2D structure of fentanyl
English: 2D structure of fentanyl (Photo credit: Wikipedia)
We know that fentanyl patches should be applied to dry, noninflamed, non-irradiated, hairless skin. Body hair may be trimmed but not shaved. Be sure to press the patch firmly in place for 60 seconds or more. If problems with adherence, use Tegaderm or Micropore.

Fact or Fiction From Medscape:

Q: Is it true that fentanyl patches infuse more quickly in patients with very little subcutaneous fat?

A: No. The amount of fentanyl absorbed is proportional to the surface area of the patch. The absorption rate does not vary to any clinically significant extent between the chest, abdomen, and thigh.[5] Fentanyl is released from the patch into top layers of the skin (stratum corneum and epidermis), and it accumulates within these layers to form a depot. The drug is released slowly into the systemic circulation via small blood vessels within the dermis. Fat tissue should not impair release, as the drug is released directly from the skin into the blood supply.[2,5]

Furthermore, fentanyl exhibits wide tissue distribution to the lungs, kidneys, heart, spleen, brain, muscles, and body fat -- indicating a high extravascular volume of distribution (3-8 L/kg). It takes about 6 days to reach steady-state plasma concentrations after initiating fentanyl patch therapy.[5]

  • Muijsers BBR, Wagstaff AJ. Transdermal fentanyl: an updated review of its pharmacological properties and therapeutic efficacy in chronic cancer pain control. Drugs. 2001;61:2289-2307. Abstract
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Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia: http://en.wikipedia.org/wiki/Pharmacy#History_of_pharmacy

Journal of Palliative Medicine - Table of Contents

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