Mr. Ralston, age 63, is taking a long-awaited vacation with his wife of 30 years. They...

Mr. Ralston, age 63, is taking a long-awaited vacation with his wife of 30 years. They are going on a cruise for their anniversary. Mr. Ralston has a history of angina and is taking Nitro-Dur (transdermal patch) for chest pain. He asks about using Viagra (sildenafil) on his vacation.

Mr. Ralston has been using the transdermal patch for several years. What is his probable dosage?

a. 15 – 30 mg q 8 hours

b. 4 mg PO tid

c. 0.6 mg/hr

d. 1 inch of 0.4% ointment

Solutions

Expert Solution

Answer: c. 0.6 mg/hr

Why?

Nitro-Dur contains nitroglycerine drug used for treating angina.

Transdermal patches releasing rates of the drug are described in terms of drug delivered per 24 hours. For example, 2.5mg/24 hours mean 0.1 mg of the drug will release in 1 hour.

As mentioned in the above-asked question, Mr. Raslton has a chronic history of angina.

For chronic angina patients, dosage in transdermal patch form, one transdermal patch applied topically to intact skin. The release rates of the drug given in this form are in the range of 0.1 to 0.8 mg/hour.

Why not option D?

d. 1 inch of 0.4% ointment

Topical forms are available in 2% based ointments not 0.4% based. The ointment is applied in a thin layer topically to the skin for every 8 hours while awake and at bedtime covering approximately 1-3 inches of skin. So, it can't be the right option.

Why not option A and B?

15 – 30 mg of drug is supplied in a 2% based ointment form, not in a transdermal patch. So, option A can't be the right answer.

Option B suggests to us of oral dosage in the form of extended-release capsules containing 2.5 to 6.5 mg drug given PO 3 to 4 times daily. As the question is asked about the transdermal patch, this can't be the right answer.

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Nightingale answered 1 year ago

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