Transdermal nitroglycerin is primarily available in two dosage forms: patches and ointment. The patches come in various strengths (0.1 mg/hr to 0.8 mg/hr) and are designed for controlled release over specific periods, while the 2% ointment offers an alternative for patients who may prefer or require a different application method. Proper usage involves applying the patch to clean, dry skin and rotating application sites to avoid irritation. Both forms are used to prevent angina attacks but require careful adherence to dosing instructions to avoid side effects like hypotension or skin reactions.
Key Points Explained:
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Available Dosage Forms
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Patches:
- Strengths: 0.1 mg/hr, 0.2 mg/hr, 0.3 mg/hr, 0.4 mg/hr, 0.6 mg/hr, and 0.8 mg/hr.
- Designed for continuous drug delivery, typically worn for 12–14 hours per day.
- Example: The Nitroglycerin Transdermal Patch is a common option for angina prophylaxis.
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Ointment:
- A 2% formulation applied topically, often used when patches are unsuitable.
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Patches:
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Application Guidelines
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Patches:
- Apply to hairless, clean skin (chest or upper arm).
- Rotate sites to prevent irritation.
- Press firmly to ensure adhesion.
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Ointment:
- Measured doses are applied to skin, usually with a dose-measuring paper.
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Patches:
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Dosing Considerations
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Patches:
- Wear only one patch at a time.
- Replace as directed (e.g., daily or every 72 hours for some matrix patches).
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Ointment:
- Applied in measured amounts, often 1–2 inches, depending on prescription.
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Patches:
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Clinical Use and Precautions
- Prevents angina in coronary artery disease.
- Avoid abrupt discontinuation to prevent rebound angina.
- Side effects include headaches, dizziness, and hypotension.
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Patient Safety Tips
- Wash hands after handling patches/ointment.
- Monitor for severe reactions (e.g., allergic responses or worsening chest pain).
These forms cater to different patient needs while ensuring consistent nitroglycerin delivery, a cornerstone in managing chronic angina. Would a patient’s skin type or lifestyle influence their choice between patches and ointment?
Summary Table:
| Dosage Form | Key Features | Application Tips |
|---|---|---|
| Patches | - Strengths: 0.1–0.8 mg/hr |
- 12–14 hours/day wear time
- Controlled release | - Apply to hairless skin (chest/arm)
- Rotate sites
- Press firmly for adhesion | | Ointment (2%)| - Topical application
- Alternative for patch intolerance | - Use measuring paper
- Apply prescribed amount (e.g., 1–2 inches) |
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