TY - CHAP M1 - Book, Section TI - Transdermal Toxicology A1 - Nelson, Lewis S. A2 - Nelson, Lewis S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Smith, Silas W. A2 - Goldfrank, Lewis R. A2 - Hoffman, Robert S. Y1 - 2019 N1 - T2 - Goldfrank's Toxicologic Emergencies, 11e AB - Applying a xenobiotic to the skin to treat a systemic medical condition is not new. Ointments and other salves have been applied topically for thousands of years for the treatment of local and systemic diseases. During World War I, dynamite workers used nitroglycerin applied to their hatbands to prevent angina when they were away from work and no longer exposed to organic nitrates.36 Mustard seed plaster for chest congestion, releasing allyl isothiocyanate, and topical elemental mercurials for syphilis are other examples of such use in the beginning of the 20th century.28 Over the past 30 years, an increasing number of medications have been formulated in transdermal delivery systems, or patches, to allow for systemic delivery of a xenobiotic. The first commercially available patch delivered scopolamine for motion sickness (1979), which was followed by nitroglycerin for chronic angina (1981) and then fentanyl for chronic pain management (1990). In the United States, the nicotine patch remains the most widely used transdermal patch, because of both the significant need for smoking cessation and its nonprescription availability. Certain medicinal xenobiotics, such as testosterone, can be administered without a patch, as a spray or gel.22 Further, xenobiotics are absorbed transdermally, as occurs with nicotine following direct exposure to moist tobacco leaf in patients with “green tobacco sickness” or following direct contact with organic phosphorus compound spraying.3 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1163022285 ER -