What Are Quit-Smoking Patches?

Nicotine patches, indications are to help quit smoking, reduce the addictive behavior and various withdrawal symptoms of nicotine-dependent smokers. The course of treatment should not exceed 3 months. The relevant data show that compared with placebo, short-term use of nicotine transdermal patches is effective. The long-term effect after quitting smoking does not depend on the product, but mainly depends on the patient's perseverance and whether he has received further psychological support treatment.

Nicotine patches, indications are to help quit smoking, reduce the addictive behavior and various withdrawal symptoms of nicotine-dependent smokers. The course of treatment should not exceed 3 months. The relevant data show that compared with placebo, short-term use of nicotine transdermal patches is effective. The long-term effect after quitting smoking does not depend on the product, but mainly depends on the patient's perseverance and whether he has received further psychological support treatment.

Drug Name

Nicotine patch

Drug type

OTC A, external medicine

Nicotine patch ingredients

nicotine.

Nicotine patch properties

This product is a circular pad with a square shape, two masks with gloss. After removing the pad, you can see a uniform, nearly colorless, sticky surface. Below this surface is a light yellow active material layer. The diameters of the films are respectively Approximately 36 mm (10 cm ² : 17.5 mg specification); 51 mm (20 cm ² : 35.0 mg specification) and 62 mm (30 cm ² : 52.5 mg specification).

Nicotine patch specifications

This product is divided into 3 specifications according to the area in contact with the skin:
1. 10 cm2: 17.5mg; that is, quit smoking patch 10, the average rate of active substance release to the skin is 7mg / 24 hours.
2. 20 cm2: 35.0 mg; that is, quit smoking patch 20, the average rate of active substance release to the skin is 14 mg / 24 hours.
3 30 cm2: 52.5mg; that is, quit smoking patch 30, the average rate of active substance release to the skin is 21 mg / 24 hours.
(The patient's choice of the above 3 specifications, see [usage and dosage] for details)

Nicotine Patch Usage and Dosage

From the use of this product, patients should be required to stop smoking completely.
This product is suitable for adults over 18 years of age.
Take this product once a day, and apply it for 24 hours.
Since the nicotine content per square centimeter of this product is constant, the therapeutic dose can only be determined based on the skin-contacting area of this product. To avoid local skin irritation, choose different attachment sites daily. This product is available in 3 dosage specifications, namely 30cm ² : 52.5mg nicotine transdermal patch (quit smoking patch 30), 20cm ² : 35mg nicotine transdermal patch (quit smoking patch 20) and 10cm ² : 17.5mg Transdermal nicotine patch (quit smoking patch 10). Do not adjust the dose by cutting the film.
For those who smoke more than 20 cigarettes a day, usually use a smoking cessation sticker of 30; For those who smoke a total of less than 20 cigarettes a day, usually use a smoking cessation sticker of 20. Quit smoking patch 10 is used at the end of treatment to reduce the dose.
A larger dose of this product should be used at the beginning of treatment (30 or 20 quit stickers), and then gradually reduce the dose according to the course of treatment. The dose can also be adjusted based on the efficacy of the patient after a period of use.
For a large number of smokers, the smoking cessation sticker 30 can be used initially, then the smoking cessation sticker 20 is replaced, and finally the smoking cessation sticker 10 is used. The duration of each phase is approximately 4 weeks.
For moderate smokers, use a smoking cessation sticker for about 8 weeks and then switch to a smoking cessation sticker for about 4 weeks.
During treatment, patients should be prevented from ingesting more nicotine than they were when they smoked.
Usage: After removing the protective aluminum foil, paste this product on clean, dry and intact skin (there should be no detergent, alcohol or residual ointment on the skin). The application area is preferably the trunk, upper arms or hips. After applying it, press it with your palm for 10 seconds. Should choose to apply different parts daily, at the end of the treatment, if this product can not stop patients from smoking, you should stop using.
Note: This product can also be used as an adjunct to self-treatment, behavioral therapy, or psychotherapy.

Adverse reactions to nicotine patches

In principle, the adverse reactions caused by this product are similar to those caused by smoking. However, smoking can also bring other dangers, such as the harmful effects of carbon monoxide, irritating gases and tar, and the nicotine plasma concentration in the body after using this product is much lower than the concentration when smoking. The response was not obvious. However, if patients continue to smoke while using this product, adverse reactions may occur frequently and are more obvious.
Skin and skin irritation: Burning, edema, erythema, itching, eczema, urticaria and small blisters. Symptoms mostly disappear within 48 hours, and severe erythema can persist for 1-3 weeks. Serious adverse reactions often appear 3-8 weeks after treatment. Once severe or persistent skin irritation occurs, stop using this product and seek medical attention.
Central nervous system headache (approximately 30% of patients), dizziness, nausea, and sleep disturbances.
Occasional, rare: difficulty concentrating, nightmares, fatigue, dry mouth, unconsciousness, migraine, sweating, increased appetite, paresthesia, taste disorders, blurred vision, and tremor.
Occasional cardiovascular system: palpitations, hypertension, hot flushes.
Rare: chest pain, dyspnea, and arrhythmia.
Symptoms may worsen if you already have a cardiovascular disease, such as coronary heart disease (angina pectoris) and / or peripheral arterial occlusive disease (intermittent claudication).
Gastrointestinal tract occasional gastrointestinal upset, vomiting, constipation, diarrhea, bloating and dry mouth.
Other systems are common: occasional flu-like symptoms, rare: motor dysfunction, back pain, joint pain, myalgia.
Very rare: systemic allergic reactions, such as systemic urticaria, angioedema, and allergic reactions.

Nicotine Patch Taboo

1. This product should not be used for non-smokers, children or occasional smokers.
2. Disabled during pregnancy and lactation.
3 People with known or suspected allergies to nicotine or any of this ingredient are contraindicated.
4 Disabled in patients with systemic dermatosis.
5. Instability or worsening angina, acute myocardial infarction, severe arrhythmia are contraindicated.
6. Patients with recent stroke are disabled.

Nicotine patch precautions

1. Nicotine is a toxic substance, and if quickly absorbed, the milligram dose level is potentially fatal.
2. When using this product, patients should be required to stop smoking completely. Patients should be warned that if they continue to smoke while using this product, it will increase the harm caused by smoking, including adverse cardiovascular effects.
3 For patients with the following diseases who need to use this product, carefully consider the above-mentioned side effects that nicotine may cause:
-Stable angina pectoris-after acute myocardial infarction-occlusive peripheral arterial disease-cerebrovascular disease-heart failure-abnormal kidney or liver function-diabetes-uncontrolled hypertension-hyperthyroidism-peptic ulcer-chromaffin cells Tumor 4. Allergic reactions: Clinical studies have found that a small number of patients may develop contact allergies after using this product. In such patients, contact allergies may recur when using other nicotine-containing products, including tobacco.
5. Intermittent use: There is no sufficient data on the effect of intermittent use of this product. However, if you experience long-term insomnia after using this product, you can remove it after applying for 16 hours (that is, do not use it at night).
6. It has been reported that patients with a known history of muscle weakness (such as myasthenia gravis, myasthenic syndrome) have worsened symptoms after using this product.
7. In patients with severe or persistent skin reactions, treatment should be discontinued.
8. Quitting smoking can lead to behavior changes. There is no data to show that the proper dosage of nicotine transdermal patches can affect the driving and mechanical control of the user.

Nicotine patches for pregnant and lactating women

Banned for pregnant and lactating women.

Nicotine patches for children

Nicotine is a highly toxic substance that can be tolerated by adults during treatment can cause severe symptoms of poisoning in children. In other words, children's misuse of this product can be fatal if not noticed in time. Therefore, this product must be kept out of the reach of children.
In order to protect children, this product is sealed in a small bag that children cannot tear. Before use, cut the small bag with scissors. At the same time, care should be taken not to damage the nicotine transdermal patch.
After use, the transdermal patch still contains nicotine, so it should be handled properly so that it is not accessible to children.

Nicotine patches for the elderly

no effect.

Nicotine patch drug interactions

The enzyme-induced phenomenon found in smokers is not caused by nicotine, but by tar compounds in tobacco smoke. This means that after stopping smoking, although the nicotine can be replaced by this product, the metabolism of the body and the pharmacological effects of the combined drug will still change (normalize). Smoking can lower the serum concentration of certain drugs such as antipyrine, estrogen, norazepam, lidocaine, oxazepam, warfarin, phenacetin, caffeine, theophylline, imipramine And pentazocine.
The effects of smoking include reducing the analgesic effect of propaphene, reducing the diuretic effect of furosemide, altering the pharmacodynamic response to propranolol, and reducing the cure rate of H2-receptor antagonists for ulcer disease. Both smoking and nicotine can increase cortisol and catecholamine levels in the circulation. The doses of nifedipine, adrenergic agonists and blockers may also need to be adjusted appropriately.
After quitting smoking, the above phenomenon may disappear even if some nicotine in the body is replaced by this product. Therefore, when patients who are receiving the above medicines stop smoking, it may be necessary to appropriately adjust the dose of the combined drug. Because nicotine has multiple pharmacological effects on the sympathetic and parasympathetic nervous systems, the effects of beta-blockers may be affected in different forms.

Nicotine patch overdose

The simultaneous use of several nicotine transdermal patches can cause severe nicotine overdose.
The symptoms and signs of overdose are the same as those of acute nicotine poisoning. Symptoms for non-smokers include: paleness, sweating, nausea, salivation, vomiting, diarrhea, headache, dizziness, hearing and vision loss, tremor, unconsciousness, muscle weakness, convulsions, collapse, lack of neurological response, and respiratory failure.
Lethal doses can cause peripheral or central respiratory paralysis in patients, and in rare cases heart failure, which can lead to convulsions and death.
If the patient shows symptoms of overdose, this product should be removed immediately. Rinse skin surface with water and wipe dry (not suitable for soap). Because nicotine can deposit on the skin, nicotine can still enter the bloodstream through the skin within hours of removing this product.
Other treatments for acute nicotine poisoning include artificial respiration in patients with respiratory paralysis, maintaining normal body temperature, and timely treatment of hypotension and heart failure.

Pharmacological effects of nicotine patches

Pharmacological effects < br This product is a smoking cessation drug. The main pharmacological effect of its active ingredient, nicotine, is to stimulate the sympathetic and parasympathetic nervous systems, thereby generating corresponding cardiovascular effects, such as increasing blood pressure and increasing heart rate. Can produce cholinergic effects, thereby stimulating the central nervous system, relaxing skeletal muscles, promoting gastrointestinal motility and secretion of digestive juices.
Ex-smokers who use nicotine transdermal patches (20 cm ² ) overnight without eating can cause a slight increase in average heart rate (increased 6 times / minute), a slight increase in systolic blood pressure, and a decrease in stroke output. The patient still had this change in heart rate and stroke volume after repeated use of the nicotine transdermal patch for 10 days, indicating that the patient was not fully tolerant of the effects of nicotine. However, its effect is weaker than smoking, and the skin temperature and blood flow of patients using this product have not changed compared with the placebo control group.
The following withdrawal symptoms often occur after quitting smoking: such as smoking addiction, irritability, depression, anger, anxiety, stress, anxiety, hunger, weight gain, difficulty concentrating and sleep disturbance. In a placebo-controlled double-blind clinical trial, it was found that in the first few weeks or months of smoking cessation, if this product is used for replacement therapy, whether or not psychotherapy is used at the same time, the success rate of smoking cessation is significantly increased and can be significantly reduced Withdrawal symptoms occur.
Toxicology research <br As tobacco smoke contains many other toxic components (such as carbon monoxide, irritating gases and tars), the toxicity of nicotine is not directly equivalent to the toxicity of smoking.
Due to the increased tolerance, long-term smokers can tolerate high doses of nicotine. The slower absorption process of nicotine after absorption through the skin also helps patients gradually develop tolerance to its toxic effects. Due to the slow release of nicotine from this product and first-pass metabolism, the nicotine in this product will not be quickly distributed throughout the body, which is different from chewing and swallowing nicotine.
Acute toxicity In adults, the acute lethal dose of oral nicotine is 40-60 mg. This dose is equivalent to the total nicotine content of 4-6 cigarettes or 1 cigar. Tobacco products in children will show the following symptoms: vomiting, anxiety, nausea, diarrhea, paleness, weakness, sluggishness, and twitching of the limbs.
Long-term effects Desensitization occurs as a result of long-term smoking, that is, long-term smokers can tolerate acute and higher doses of nicotine. The symptoms of chronic overdose are similar to acute nicotine poisoning.

Nicotine Patch Pharmacokinetics

Like absorption from the respiratory tract, nicotine is quickly absorbed through the skin and mucous membranes and is widely distributed in body tissues. In this product, nicotine exists as a free base.
After using this product, the body can continuously absorb nicotine through the skin.
Distribution of healthy smoking cessators (is using a patch for smoking cessation treatment) After a single use of this product, the absorption process of nicotine manifests as a lag time of 1-2 hours before progressive plasma concentrations increase, and 8-10 after use Plasma concentrations were reached by the hour. Using a 30cm ² nicotine transdermal patch, the peak plasma concentration can reach 12.3ng / ml.
Intravenous injection of nicotine has a clearance half-life of 2 hours. However, if this product is used, the plasma concentration will decrease more slowly than expected after the film is removed. This is because 10% of the nicotine still enters the skin after the product is removed blood circulation system.
Compared with intravenous injection, 76.8% of the nicotine released by this product can be used by the system. Pharmacokinetic parameters, especially the area under the drug-time curve, have a linear relationship with dose. Repeatedly using 20cm2 and 30cm2 nicotine transdermal patches, the mean values of the lowest and highest plasma concentrations at steady state were 20cm2: 7.1ng / ml, 12.0ng / ml; 30cm2: 10.3ng / ml, 17.7ng / ml.
Its plasma concentration is in the same range as that of a moderate smoker (ie, one cigarette per hour).
Nicotine is widely distributed in the body, and its volume of distribution is close to 180L. It can pass through the blood-brain barrier and the placenta, and can also be found in breast milk. Nicotine plasma protein binding rate is less than 5%, which is negligible. Total nicotine clearance is 0.92 to 2.43 L / min.
Metabolic nicotine is primarily eliminated by metabolism in the liver. The main metabolites are cotinine and nicotine-1'-N-oxide. Neither metabolite has pharmacological activity.
The half-life of nicotine clearance is about 2 hours, and the plasma clearance rate is 0.92-2.43L / min.
Only a small amount of nicotine is excreted from the kidneys in their original form.
Nicotine removed from the kidney in its original form accounts for about 5-10% of the total, and is pH-dependent, negligible under alkaline conditions. The accumulation effect is very slight.

Nicotine Patch Storage

Store below 25 ° C. If the period of use indicated under "EXP" on the box is exceeded, it cannot be used further.

Nicotine Patch Packaging

Each product is individually packaged in a small bag.
The pouch consists of the following layers:-paper layer-glue layer-aluminum foil-adhesive paint-polyacrylonitrile.
7 tablets / box; 28 tablets / box.

Nicotine patch expiration date

24 months.

Nicotine patch implementation standards

Import drug registration standard JX20050127. ^[1]