ABH gel is not absorbed from the skin of normal volunteers

Journal of Pain and Symptom Management
Thomas SmithGwendolyn Parker

Abstract

Lorazepam (Ativan(®)), diphenhydramine (Benadryl(®)), haloperidol (Haldol(®)) (ABH) topical gel is currently widely used for nausea in hospice because of perceived efficacy and low cost and has been suggested for cancer chemotherapy. However, there are no studies of absorption, a prerequisite for effectiveness. We completed this study to establish whether ABH gel drugs are absorbed, as a prerequisite to effectiveness. Ten healthy volunteers, aged 25 to 58 years (mean 37 years), two African Americans and eight Caucasian Americans, applied the standard 1.0 mL dose (2mg of lorazepam, 25mg of diphenhydramine, and 2mg of haloperidol in a pluronic lecithin organogel), rubbed on the volar surface of the wrists by the subject. Blood samples were obtained at 0, 30, 60, 90, 120, 180, and 240 minutes. Plasma concentrations were analyzed by liquid chromatography-tandem mass spectrometry using deuterated internal standards for each drug. No lorazepam or haloperidol was detected in any sample from any of the 10 volunteers down to a level of 0.05 ng/mL. Diphenhydramine was found in multiple plasma samples at concentrations >0.05 ng/mL in three patients, with the highest concentration of 0.30 ng/mL in one person at 240 minutes. Overall, five o...Continue Reading

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Citations

Nov 26, 2015·Drug Development and Industrial Pharmacy·Hashem AlsaabSai Hs Boddu
Feb 26, 2013·Journal of Pain and Symptom Management·Daniel FischbergUNKNOWN HPM Choosing Wisely Task Force
Apr 23, 2014·AACN Advanced Critical Care·Jonathan G LeungMegan Leloux
Apr 29, 2015·Clinics in Geriatric Medicine·Thomas J Smith
Apr 25, 2015·The Annals of Pharmacotherapy·Bonnie M KaminskySally K Guthrie
Jan 19, 2018·The American Journal of Hospice & Palliative Care·Bryce KayhartJonathan G Leung
Dec 15, 2017·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Kathryn PaezBrad Macy
Jan 15, 2021·Current Treatment Options in Oncology·Janet Hardy, Mellar P Davis

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