A patient with stable angina uses a nitroglycerin transdermal patch, and efforts are being made to prevent drug tolerance. Which statement made by the patient best demonstrates an understanding of the transdermal patch? "I will apply my patch
a. at 8:00 AM and remove it at 8:00 PM."
b. at 8:00 PM and remove it when I wake up."
c. at 7:00 AM and remove it at 8:00 PM."
d. as soon as I remove my old one."
ANS: A
Tolerance develops if patches are used continuously (24 hours a day). A daily "patch free" interval of 10 to 12 hours is recommended. This can be accomplished by applying a new patch each morning, leaving it in place for 12 to 14 hours, and then removing it in the evening.
It is more effective to be using the patch during awake hours plus answer 2 does not specify what time the patient will be waking up so the time may be too short or too long for the patch to be in place.
Application of the patch at 7:00 AM and removal at 8:00 PM does not allow a long enough interval between applications.
This answer is incorrect because one the patch is removed there must be a "patch free" interval of time of at least 10 to 12 hours.
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