A pharmacokinetic crossover study to compare the absorption characteristics of three transdermal nicotine patches

Fant, Reginald V.; Henningfield, Jack E.; Shiffman, Saul; Strahs, Kenneth R.; Reitberg, Donald P.

doi:10.1016/s0091-3057(00)00399-3

Cited by 73 publications

(41 citation statements)

References 8 publications

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“…Nicotine levels rise gradually and then plateau for most of the day as the patch diffuses nicotine through the skin and into the bloodstream at a constant rate. 46,58,63,64 Nicotine patches are the preferred method of NRT because of the ease of use and high concentrations of nicotine delivered. The nicotine patch is available in several formulations that vary in strength and duration of action.…”

Section: Pharmacotherapymentioning

confidence: 99%

Tobacco Cessation in Primary Care: Maximizing Intervention Strategies

Anczak¹,

Nogler²

2003

Clinical Medicine & Research

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The most effective preventive intervention that a clinician can provide for tobacco-using patients against heart disease, cancer, cerebrovascular disease and chronic obstructive pulmonary disease is an empathic, personalized smoking cessation intervention program with extended assistance and follow-up. The goal of the intervention must be complete smoking cessation. Reduction provides no direct health benefits to the individual smoker. Interventions are readily available, but underutilized, in part due to lack of clinician training and organizational support.The present article summarizes the current guidelines for smoking cessation interventions as a framework from which to start. The guidelines incorporate the Transtheoretical Model of patient behavioral change and the "Five A's": Ask, Advise, Assess, Assist and Arrange. Pharmacotherapeutic tools, including nicotine replacement therapies (nicotine gums, patches, nasal sprays, inhalers and new therapies) and non-nicotine therapies (bupropion, clonidine, nortriptyline and other antidepressants and anxiolytics) are considered. Adherence validation methods, new approaches to tobacco and addiction treatment that appear in the recent research literature are reviewed.Beyond this framework, specific categories of tobacco users (including smokeless tobacco users), cultural and ethnic minorities, adolescents using snuff and bidis, women, Medicaid recipients, and users of multiple forms of tobacco require special consideration.With this framework and the modifications that may be required for specific categories of patients, practicing clinicians can incorporate into daily practice a successful tobacco cessation intervention program with quit rates approaching 20%.

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Section: Pharmacotherapymentioning

confidence: 99%

Tobacco Cessation in Primary Care: Maximizing Intervention Strategies

Anczak¹,

Nogler²

2003

Clinical Medicine & Research

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“…Thus, pharmacological aids have become central in smoking cessation treatment, and nicotine replacement therapy (NRT) has proven to be one of the reference treatments [5]. Several forms of NRT (gums, patches, nasal sprays) produce similar overall beneficial results, increasing the cessation rate by approximately two-fold compared with a placebo [6]. Although gums have been shown to reduce acute withdrawal symptoms and to serve as a temporary substitute for cigarettes, they are often associated with adverse side effects such as nausea and irritation of the mouth and throat [7].…”

Section: Introductionmentioning

confidence: 99%

Effects of smoking on the pharmacokinetics and pharmacodynamics of a nicotine patch

Yun¹,

Seo²,

Choi³

et al. 2008

Biopharm & Drug Disp

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The effect of smoking on the pharmacokinetics and pharmacodynamics of a nicotine transdermal delivery system, administered as a single dose or multiple doses, was examined in smokers (n=12) and nonsmokers (n=12). The study was a two-period, parallel trial. In the first period, a single dose of the Nicotinell TTS 20 patch was administered, followed by a 1-week washout period. Then, in the second period, multiple doses of the Nicotinell TTS 20 patch were administered over 4 days. Regarding the pharmacokinetics of nicotine, the AUC(36 h) and AUC(tau) of smokers were about 20% and 40% greater, respectively, than those of nonsmokers. Significant differences in heart rate were observed between smokers and nonsmokers at 10, 12, 16 and 24 h, and significant differences in systolic blood pressure were seen between smokers and nonsmokers at 12, 30 and 36 h in the single-dose study. With multiple doses, significant differences in systolic and diastolic blood pressures were detected between smokers and nonsmokers only at 72.5 and 82 h. Here, it is demonstrated for the first time that the pharmacokinetic and hemodynamic effects of a nicotine patch are significantly different between smokers and nonsmokers.

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“…The rates of nicotine delivery and plasma nicotine concentrations vary among the different transdermal systems (Fig. 3) (Fant et al, 2000). In all cases, there is an initial lag time of about 1 h before nicotine appears in the bloodstream, and there is continued systemic absorption (about 10% of the total dose) after the patch is removed, the latter due to residual nicotine in the skin.…”

mentioning

confidence: 99%