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Daily. Med - LIDOCAINE- lidocaine patch. Application Site Reactions. During or immediately after treatment with lidocaine patch 5%, the skin at the site of application may develop blisters, bruising, burning sensation, depigmentation, dermatitis, discoloration, edema, erythema, exfoliation, irritation, papules, petechia, pruritus, vesicles, or may be the locus of abnormal sensation. These reactions are generally mild and transient, resolving spontaneously within a few minutes to hours. Allergic Reactions. Allergic and anaphylactoid reactions associated with lidocaine, although rare, can occur. They are characterized by angioedema, bronchospasm, dermatitis, dyspnea, hypersensitivity, laryngospasm, pruritus, shock, and urticaria. The EMLA patch--a new type of local anaesthetic application for dermal analgesia. The skin application of EMLA cream under a Tegaderm dressing was compared in children with a new combined dressing/local anaesthetic patch. This page includes the following topics and synonyms: Local Skin Anesthesia, Local Anesthesia, Infiltrative Anesthesia, Mepivacaine, Carbocaine, Bupivicaine, Marcaine, Prilocaine, Citanest, Etidocaine, Duranest. Principles of Office Anesthesia: Part II. Thick layer (1 to 2 g per 10 cm 2) applied to intact skin with covering patch of. A randomized, controlled trial of a eutectic mixture of local anesthetic. If they occur, they should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value. Other Adverse Events. Due to the nature and limitation of spontaneous reports in postmarketing surveillance, causality has not been established for additional reported adverse events including: Asthenia, confusion, disorientation, dizziness, headache, hyperesthesia, hypoesthesia, lightheadedness, metallic taste, nausea, nervousness, pain exacerbated, paresthesia, somnolence, taste alteration, vomiting, visual disturbances such as blurred vision, flushing, tinnitus, and tremor. Systemic (Dose- Related) Reactions. Systemic adverse reactions following appropriate use of lidocaine patch 5% are unlikely, due to the small dose absorbed (see CLINICAL PHARMACOLOGY, Pharmacokinetics). Systemic adverse effects of lidocaine are similar in nature to those observed with other amide local anesthetic agents, including CNS excitation and/or depression (light- headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest). Excitatory CNS reactions may be brief or not occur at all, in which case the first manifestation may be drowsiness merging into unconsciousness. Cardiovascular manifestations may include bradycardia, hypotension and cardiovascular collapse leading to arrest. To report SUSPECTED ADVERSE REACTIONS, contact Actavis at 1- 8. FDA at 1- 8. 00- FDA- 1. Patent US7. 88. 34. Transdermal local anesthetic patch with injection port. CROSS- REFERENCE TO RELATED APPLICATIONThis application claims priority to U. S. 6. 1/1. 32,1. 34, filed Jun. BACKGROUNDAn overarching fear of needles and needle sticks exists throughout the world. This fear knows no bounds of age, sex, or race. For many, this phobia makes visits to the doctor and dentist intolerable and often times a last resort. This ultimately results in missed doctor's and dentist's visits and inadequate healthcare treatment of various illnesses, diseases and for routine vaccinations. For people with this phobia coupled with chronic diseases such as, for example, insulin dependent diabetes, treatment is a daunting task. These patients face the daily task of sticking their finger with a lancet to draw blood to test blood sugar. For a noncompliant patient, this complicates diagnosis and treatment of the condition, and even for the most compliant patient, the task of repeatedly sticking their finger with a lancet is extremely painful. In addition, for a compliant patient each day the patient must administer medication or insulin via an injection. After administering their medication, proper sterile techniques require one to sterilize the injection site and place a bandage where the injection took place. Anesthesia, Local Definition Local or regional anesthesia involves the injection or application of an anesthetic drug to a specific area of the body, as opposed to the entire body and brain as occurs during general anesthesia. Consumer information about the drug lidocaine (Lidoderm. Common side effects of lidocaine patches include: local burning, bruising. PREPARATIONS: Lidocaine patch: 5%. This process is tedious and mundane. Many people fail to follow proper sterile techniques, and as a result, the injection site may become infected. Find the Local Anesthesia in Pediatric Dentistry Described herein are transdermal delivery devices composed of at least one re-sealable injection port and at least one local anesthetic reservoir. The device effectively delivers anesthetic to the skin of the subject prior to. Topical patch (lidocaine 5%), marketed since 1999 in the US by Endo Pharmaceuticals as 'Lidoderm'. Adverse drug reactions (ADRs) are rare when lidocaine is used as a local anesthetic and is administered correctly. For those people who do follow this protocol, the skin is often damaged due to the constant application and removal of bandage adhesives. Thus, it would be desirable for the subject to have a patch containing a local anesthetic to numb the injection site, an antiseptic or antimicrobial agent to prevent injection site infection, and either a single use or multi- use injection port to allow for a pain free injection for as many days as needed. SUMMARYDescribed herein are transdermal delivery devices composed of at least one re- sealable injection port and at least one local anesthetic reservoir. The device effectively delivers anesthetic to the skin of the subject prior to puncturing the skin by syringes, needle sticks, or other instruments intended to be inserted into the skin. In addition, the transdermal delivery device may include a single use patch that does not include a local anesthetic refill port. The advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the aspects described below. The advantages described below will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims. It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive. BRIEF DESCRIPTION OF THE DRAWINGSThe accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects described below. FIG. 1 shows the top view of a transdermal delivery device with a single injection port, two resealable refill ports, and an anesthetic reservoir. FIG. 2 shows the cross- sectional view of a transdermal delivery device with a single injection port, two resealable refill ports, and an anesthetic reservoir. FIG. 3 shows the top view of a transdermal delivery device with multiple injection ports, two resealable refill ports, and an anesthetic reservoir. FIG. 4 shows a transdermal delivery device with a replaceable button with and an injection port having multiple adjacent resealable injection regions. FIG. 5 shows a transdermal delivery device with multiple resealable injection ports surrounded by two anesthetic reservoirs without local anesthetic refill ports. FIG. 6 shows a transdermal delivery device with a single resealable injection port surrounded by an anesthetic reservoir without a local anesthetic refill port. DETAILED DESCRIPTIONBefore the present compounds, compositions, and/or methods are disclosed and described, it is to be understood that the aspects described below are not limited to specific compositions, compounds, synthetic methods, or uses as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular aspects only and is not intended to be limiting. In this specification and in the claims that follow, reference will be made to a number of terms that shall be defined to have the following meanings: It must be noted that, as used in the specification and the appended claims, the singular forms . Thus, for example, reference to . For example, the phrase . The therapeutic amount of local anesthetic compounds is referred to as concentration of the active compound and the volume administered. Described herein are transdermal delivery devices that deliver a local anesthetic to an injection or lancing site. The delivery device includes at least one resealable injection port and at least one local anesthetic reservoir. Each component of the delivery device is described in detail below and in the figures. The term injection port includes a resealable injection port which may be injected with a needle or pierced by a lancet. The resealable injection port is generally composed of a polymeric, non- allergenic, non- reacting, inert material that permits a medical device such as a syringe or needle to readily pass through the material. During injection, the polymeric material forms a seal around the medical device. Upon removal of the medical device, the polymeric material substantially if not completely closes the hole produced by the medical device. Thus, the resealable injection port can maintain a sterile environment during injection and post- injection. The polymeric material used to make the resealable injection port can be composed of a variety of different materials such as, for example, silicon, non- allergic rubberized material, or other medically safe synthetic or semi- synthetic plastics. The number of injection ports can vary, as will be demonstrated below. The delivery device also contains one or more local anesthetic reservoirs for holding the local anesthetic. The local anesthetic is generally positioned near the resealable injection port so that the skin at or near the injection site is exposed to the anesthetic and block the nerves of the skin, for a painless entry of a needle or lancet. The local anesthetic can be any topical anesthetic known in the art. In one aspect, the local anesthetic includes ester based or an amide based local anesthetics or any combination thereof. Examples of amide based local anesthetics include, but are not limited to, articaine, bupicaine, dibucaine, lidocaine, mepivacaine, prilocaine, and ropivacaine. Examples of ester based local anesthetics include, but are not limited to, benzocaine, chloroprocaine, proparacaine, and tetracaine. In one aspect, the local anesthetic is a combination of both lidocaine and prilocaine. The lidocaine and prilocaine are present at least in a 2: 1 ratio by weight, a 1: 1 ratio by weight, or any combination thereof. In other aspects, lidocaine and prilocaine may be present in the amount of 3: 1, 4: 1, 5: 1, 6: 1, 7: 1, 8: 1, 9: 1, 1. In addition, any of the local anesthetics mentioned above can be used in combination and are present at least in a 2: 1, 3: 1, 4: 1, 5: 1, 6: 1, 7: 1, 8: 1, 9: 1, 1. Even up to 2: 9. 8, 5: 9. The anesthetic can be mixed with carriers such as lipophilic vehicles in order to enhance the absorption of the anesthetic by the skin. The local anesthetic may be fast- acting or short- acting. For example, one may feel a . However, this numbing sensation may only last a matter of minutes or hours. In another aspect, the local anesthetic may be long acting. In this aspect, one may feel a . The selection and amount of the local anesthetic can vary depending upon the size of the delivery device as well as the number and position of resealable injection ports present in the device and how long the patch will be used. The shape and size of the transdermal delivery device can vary depending upon the application, which is demonstrated in the figures. In certain aspects, the shape of the device is a circle, a square, a rectangle, an oval, an oblong shape, a triangle, a star, or a square depending upon where on the subject the device is applied. In general, the device has an adhesive that permits the attachment of the device to the skin of the subject. For example, the transdermal delivery device may be placed onto a finger (like a band aid), the abdomen, thigh, calf, arm, shoulder, or any other regions of exposed skin on the subject. Adhesives typically used in bandages and the like can be used herein. The devices described herein can contain one or more optional therapeutic agents. The location of the optional therapeutic agents in the device can vary depending upon the design of the device. In one aspect, the optional therapeutic agent can be an antiseptic agent, a therapeutic pharmacological, a biologic, a nutriceutical, hormones, antibiotics, nicotine, antifungal agents, antiviral agents, or any pain relieving agent not excluding narcotics. By preventing bacterial, viral, and fungal growth, antiseptic agents maintain sterility either before, during, or post injection. 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Or tried topical anti-inflammatories? Alpharma announced availability of FLECTOR Patch (diclofenac epolamine topical patch) 1.3%, the first and only anti-inflammatory pain relief patch in US. Flector Dosage and Administration. DICLOFENAC is a non-steroidal anti-inflammatory drug (NSAID). It is used to treat pain from bruises, sprains, or strains. Alternatives to NSAIDs, pros and consby Marianna Rakovitsky, RPh. Recently, I have talked about the concerns with the use of NSAIDs and their effects on the heart. NSAIDs are usually very effective in controlling pain especially muscle and bone pain, but they also carry a potential risk of side effects such as stomach and kidney problems, increased risk of bleeding and adverse effects on cardiovascular system. Flector Tissugel is the sole locally active antiinflammatory patch. Flector Tissugel adhesive patch. The diclofenac epolamine topical patch is an analgesic (pain killing) drug to be worn on the skin. The diclofenac patch is available with a prescription under the. Learn about missing a dose, what happens if you overdose, and what to avoid when taking Flector Patch (Diclofenac Epolamine Topical Patch). In this post I will talk about common topical treatments as one of the strategies to manage pain. According to the recommendations of American Heart Association the non- pharmacological methods should be the first line of treatment for pain. Such strategies as appropriate exercise, physical therapy, application of cold and heat may be suggested. Some of the pros and cons of using the common ingredients found in these products are described in this post. Capsaicin. Capsaicin is an ingredient that is derived from pepper and is often used as a cream or patch to relieve pain. It is thought to alleviate pain by stimulating the release of substance P. Although in the beginning this may lead to burning sensation, after continued use Capsaicin starts to relieve pain as substance P gets depleted. The most common side effect of Capsaicin is the burning sensation that should diminish with continued use. Capsaicin may be used to relieve self limiting pain due to muscle strains and sprains. Pros: Usually does not cause systemic side effects, available without prescription. Cons: Questionable effectiveness when used for osteoarthritis (lack of clinical trials comparing Capsaicin to NSAIDS). Not covered by most insurance plans. Important: Wash your hands thoroughly after applying capsaicin, avoid contact with the eyes and mucous membranes. Do not use in children, if you are pregnant or breastfeeding unless recommended by a physician. Do not use if the condition worsens, irritation develops or for more than 7 days without consulting a doctor. Stop using if you develop severe burning sensation. If swallowed, get medical help or contact a Poison Control Center immediately. Methyl salicylate. Methyl salicylate is an ingredient found in common over the counter creams that are used for pain such as Bengay and Icy. Hot. Methyl salicylate is thought to work as a rubefacient, which means that it is believed to relieve pain by producing a counterirritant effect. Pros: Available over the counter, relatively inexpensive. Cons: Lack of evidence that the products containing methyl salicylate are effective. Important : Watch out for the amount of product containing methyl salicylate that is being used. Exposure of large areas of the skin and multiple daily applications may lead to salicylate overdose that in rare cases may be fatal. Also do not use the products that contain methyl salicylate with aspirin or salsalate without consulting a doctor first as this combination may increase the risk of salicylate overdose. An application of creams that contain methyl salicylate over a large body area may be equivalent to taking 2 tablets of regular strength Aspirin. Also ask your doctor before using topical products containing methyl salicylate with NSAIDs, Coumadin (Warfarin) or other prescription drugs to avoid a potential for interaction and increased risk of bleeding. To avoid the risk of an overdose do not use these creams with a heating pad, do not tightly bandage. Keep away from children. If swallowed, get medical help or contact a Poison Control Center immediately. Do not use if the condition worsens, irritation develops or for more than 7 days without consulting a doctor. Keep away from the eyes and mucous membranes. Do not apply to wounded, damaged or irritated skin. Do not use in children under 1. Do not use these products if you are allergic to aspirin or salicylates. Topical NSAIDSBrand names: Voltaren gel, Solaraze, Pennsaid, Flector. Patch. Generic: Diclofenac. Pros: Effectivness approaches that of oral NSAIDS when used as directed. One study has found that when Voltaren gel is applied the concentration of diclofenac (an active ingredient) in blood is generally 5 to 1. Lower risk of GI side effects. Even though these drugs have been only recently approved in the US they have a long history of use in other countries. Cons: Carry the same warning and potential to increase the risk of the same side effects as oral NSAIDs including: increased risk of heart attacks and stokes, increased risk of gastrointestinal bleeding, potential to cause kidney and liver problems, increased risk of high blood pressure and heart failure as well as other reactions that may be caused by diclofenac (active ingredient) in a form of a tablet. May increase the risk of photosensitivity. Available only by prescription. Expensive, some insurances don’t cover them or require prior authorization. Use only as prescribed, do not share these medications with family and friends. Avoid in children or if you are pregnant or nursing. Do not use heating pads over the area treated with these products, do not tightly bandage. Do not use these products if you are allergic to diclofenac, aspirin, salicylates, or NSAIDs. Diclofenac has a potential to cause serious life threatening hypersensitivity reactions including Stevens- Johnson syndrome and toxic epidermal necrolysis (TEN). Stop using the product if irritation or skin reactions develop. Please report any rash, itching, hive , swelling of the face, lips, throat or tongue to your doctor or seek emergency medical help. Periodic monitoring of blood pressure, blood counts, kidney functions and liver functions by a physician may be recommended in patients that are on long term therapy with topical NSAIDs. Do not use Flector Patch in a bath or shower. Keep all the topical products containing NSAIDs away from children. If swallowed, get medical help or contact a Poison Control Center immediately. Dispose used Flector Patch properly away from the reach of children and pets as significant amount of the medication remains in the patch after use. Lidocaine. Lidocaine is a topical anesthetic. Lidocaine is available as various creams, gels, ointments and as a patch (Lidoderm). Lidoderm patch is approved for post- herpetic neuralgia (nerve pain after shingles) . There is limited evidence available that Lidoderm may have some effectiveness in other type of pain such as back pain. Pros: Limited risk of systemic side effects. Cons: Very limited data supporting the use for conditions other than post- herpetic neuralgia. Slight but real possibility of lidocaine overdose. Possiblity of local skin reactions such as rash or irritation. Available only by prescription, possible problems with insurance coverage, need for prior authorization from the doctor. Important to know: Apply exactly as directed by physician to the intact skin, do not share Lidoderm patches with others. Applying more patches than prescribed by the doctor, applying the patches for a longer period of time or applying the patch to broken or irritated skin may increase the risk of an overdose. Make sure to tell the doctor all the medications that you are using including any topical anesthetic creams and heart medications to avoid the potential for drug interactions and the possibility of lidocaine overdose. Keep away from the pets and children, never store Lidoderm patches outside of sealed envelope. Discard the unused patches properly by folding the patch so that adhesive sticks to itself away from children and pets as the majority of lidocaine remains in the patch after use. Contact the poison control center or seek emergency medical help immediately if swallowing is suspected. Wash the hands thoroughly after application, avoid contact with the eyes or mucous membranes. Do not apply heat sources such as heat pads or hot water bottles over the patch as this may increase the risk of lidocaine overdose. Stop using the patch and contact your doctor if dizziness, drowsiness, nervousness, euphoria, blurred vision, double vision, vomiting, confusion, tremors, convulsions, sensation of heat or cold, ringing in the ears develop as these may be the signs of lidocaine overdose. As a class of medications NSAIDs are very effective in providing pain relief. However as with any medications there is a risk for adverse effects. Sometimes to find a balance between the most effective pain control and minimizing the possible undesirable effects you have to work closely with your doctor to find the most appropriate drug or combination of drugs that is right for you. In this post I described most common ingredients found in the topical drugs that are used for pain. These medications represent one of the options that you may want to discuss with your doctor in more details based on your unique situation. Marianna Rakovitsky is a pharmacist who blogs at the Healthialist Blog. Submit a guest post and be heard on social media’s leading physician voice. |
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