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Transdermal drug delivery system exposure outcomes
R J Roberge1, E P Krenzelok, R Mrvos
1Department of Emergency Medicine, Western Pennsylvania Hospital, Pittsburgh 15224, USA.
The Journal of Emergency Medicine
|March 4, 2000
Summary
Transdermal drug delivery system exposures are rare but lead to significant healthcare use. Clonidine and fentanyl exposures, along with oral routes, increased hospital admissions and intensive care unit stays.
Area of Science:
- Toxicology
- Pharmacology
- Public Health
Background:
- Transdermal drug delivery systems (TDDS) are widely used for medication administration.
- Limited data exist on the clinical outcomes following accidental or intentional TDDS exposures.
- Poison control centers receive infrequent reports of TDDS exposures.
Purpose of the Study:
- To analyze the characteristics and medical outcomes of TDDS exposures reported to a regional poison information system.
- To identify factors associated with hospital admission and intensive care unit (ICU) stays in TDDS exposure cases.
Main Methods:
- Retrospective study of 61 TDDS exposure cases over a 5-year period.
- Data collected from a Regional Poison Information System.
- Analysis of exposure routes, management, and patient outcomes, including hospital admission and ICU care.
Main Results:
- Most exposures (72%) were managed with telephone consultation.
- 18% of evaluated patients required hospital admission, with 13% admitted to ICUs.
- Clonidine and fentanyl exposures, oral routes, and drug abuse correlated with hospital admission.
- Clonidine exposure was linked to ICU admission.
Conclusions:
- TDDS exposures, though infrequent, are associated with substantial healthcare utilization.
- Specific agents (clonidine, fentanyl) and exposure routes (oral) necessitate careful medical evaluation.
- Poison control centers play a role in managing TDDS exposures, but significant cases require advanced medical care.