A method of systemic drug administration where an active therapeutic agent, such as a hormone, is delivered across the skin barrier and into the bloodstream for systemic circulation. This non-invasive route bypasses the gastrointestinal tract and the hepatic first-pass metabolism, offering a steady, sustained release of the compound. It is a common and clinically advantageous method for administering bioidentical hormones.
Origin
The concept of using the skin for drug delivery dates back centuries, but modern transdermal patches and gels were scientifically developed and commercialized in the late 20th century. This innovation was driven by the need to improve bioavailability and reduce the side effects associated with oral administration of certain drugs. It is a key pharmaceutical engineering advancement.
Mechanism
The drug is formulated to penetrate the stratum corneum, the outermost layer of the skin, typically through passive diffusion down a concentration gradient. Once in the deeper layers of the epidermis and dermis, the drug is absorbed into the local capillaries and then enters the systemic circulation. This mechanism maintains relatively stable plasma concentrations, avoiding the sharp peaks and troughs seen with some oral dosing.
Oral hormone therapy's cardiovascular impact is a conditional reality, shaped by the specific formulation, delivery route, and timing of its initiation.
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