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Dual Physiologically Based Pharmacokinetic Model of Liposomal and Nonliposomal Amphotericin B Disposition. Pharm Res 2013; 31:35-45. [DOI: 10.1007/s11095-013-1127-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 06/14/2013] [Indexed: 11/26/2022]
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Saraghi M, Hersh EV. Three newly approved analgesics: an update. Anesth Prog 2013; 60:178-87. [PMID: 24423420 PMCID: PMC3891458 DOI: 10.2344/0003-3006-60.4.178] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 08/29/2013] [Indexed: 11/11/2022] Open
Abstract
Abstract Since 2008, three new analgesic entities, tapentadol immediate release (Nucynta) diclofenac potassium soft gelatin capsules (Zipsor), and bupivacaine liposome injectable suspension (EXPAREL) were granted US Food and Drug Administration (FDA) approval to treat acute pain. Tapentadol immediate-release is a both a mu-opioid agonist and a norepinephrine reuptake inhibitor, and is indicated for the treatment of moderate to severe pain. Diclofenac potassium soft gelatin capsules are a novel formulation of diclofenac potassium, which is a nonsteroidal anti-inflammatory drug (NSAID), and its putative mechanism of action is through inhibition of cyclooxygenase enzymes. This novel formulation of diclofenac allows for improved absorption at lower doses. Liposomal bupivacaine is a new formulation of bupivacaine intended for single-dose infiltration at the surgical site for postoperative analgesia. Bupivacaine is slowly released from this liposomal vehicle and can provide prolonged analgesia at the surgical site. By utilizing NSAIDs and local anesthetics to decrease the transmission of afferent pain signals, less opioid analgesics are needed to achieve analgesia. Since drug-related adverse events are frequently dose related, lower doses from different drug classes may be employed to reduce the incidence of adverse effects, while producing synergistic analgesia as part of a multimodal analgesic approach to acute pain.
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Affiliation(s)
- Mana Saraghi
- Department of Periodontics, Division of Pediatric Dentistry, Department of Oral & Maxiollofacial Surgery/Pharmacology, University of Pennsylvania School of Dental Medicine
| | - Elliot V. Hersh
- Department of Oral & Maxillofacial Surgery, Pharmacology Director, Division of Pharmacology, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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de Paula E, Cereda CMS, Fraceto LF, de Araújo DR, Franz-Montan M, Tofoli GR, Ranali J, Volpato MC, Groppo FC. Micro and nanosystems for delivering local anesthetics. Expert Opin Drug Deliv 2012; 9:1505-24. [DOI: 10.1517/17425247.2012.738664] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Many attempts have been made to increase the duration of local anesthetic action. One avenue of investigation has focused on encapsulating local anesthetics within carrier molecules to increase their residence time at the site of action. This article aims to review the literature surrounding the recently approved formulation of bupivacaine, which consists of bupivacaine loaded in multivesicular liposomes. This preparation increases the duration of local anesthetic action by slow release from the liposome and delays the peak plasma concentration when compared to plain bupivacaine administration. Liposomal bupivacaine has been approved by the US Food and Drug Administration for local infiltration for pain relief after bunionectomy and hemorrhoidectomy. Studies have shown it to be an effective tool for postoperative pain relief with opioid sparing effects and it has also been found to have an acceptable adverse effect profile. Its kinetics are favorable even in patients with moderate hepatic impairment, and it has been found not to delay wound healing after orthopedic surgery. More studies are needed to establish its safety and efficacy for use via intrathecal, epidural, or perineural routes. In conclusion, liposomal bupivacaine is effective for treating postoperative pain when used via local infiltration when compared to placebo with a prolonged duration of action, predictable kinetics, and an acceptable side effect profile. However, more adequately powered trials are needed to establish its superiority over plain bupivacaine.
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Affiliation(s)
- Praveen Chahar
- Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Prolonged analgesia from Bupisome and Bupigel formulations: From design and fabrication to improved stability. J Control Release 2012; 160:346-52. [DOI: 10.1016/j.jconrel.2011.12.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 12/18/2011] [Accepted: 12/21/2012] [Indexed: 11/23/2022]
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56
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Tofoli GR, Cereda CMS, Araújo DR, Franz-Montan M, Groppo FC, Quaglio D, Pedrazzoli Junior J, Calafatti SA, Barros FAP, de Paula E. Pharmacokinetic study of liposome-encapsulated and plain mepivacaine formulations injected intra-orally in volunteers. J Pharm Pharmacol 2011; 64:397-403. [DOI: 10.1111/j.2042-7158.2011.01425.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Objectives
The pharmacokinetics of commercial and liposome-encapsulated mepivacaine (MVC) injected intra-orally in healthy volunteers was studied.
Methods
In this double blind, randomized cross-over study, 15 volunteers received, at four different sessions, 1.8 ml of the following formulations: 2% MVC with 1 : 100 000 epinephrine (MVC2%EPI), 3% MVC (MVC3%), 2% and 3% liposome-encapsulated MVC (MVC2%LUV and MVC3%LUV). Blood samples were collected pre dose (0 min) and at 15, 30, 45, 60, 90, 120, 180, 240, 300, 360 min after injections. Liquid chromatography-tandem mass spectrometry was used to quantify plasma MVC concentrations.
Results
Pharmacokinetic analysis showed that the maximum plasma concentration (Cmax) and the areas under the curves (AUC0–360 and AUC0–∞) after MVC2%LUV and MVC2%EPI injections were smaller (P < 0.05) than the equivalent figures for MVC3% and MVC3%LUV. The time to maximum plasma concentration (Tmax) and the half-life of elimination (t½beta) obtained after the treatment with MVC2%LUV, MVC2%EPI, MVC3% and MVC3%LUV presented no statistically significant differences (P > 0.05). Cmax, AUC0–360 and AUC0-∞ after injection of the 2% formulations (MVC2%LUV and MVC2%EPI) did not exhibit statistically significant differences (P > 0.05). The pharmacokinetics of MVC2%LUV were comparable to the pharmacokinetics of MVC2%EPI.
Conclusion
The liposomal formulation of 2% MVC exhibits similar systemic absorption to the local anesthetic with vasoconstrictor.
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Affiliation(s)
| | - Cíntia M S Cereda
- Department of Biochemistry, State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil
| | | | - Michelle Franz-Montan
- Department of Biochemistry, State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil
| | - Francisco Carlos Groppo
- Piracicaba Dental School, Department of Physiological Sciences, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Daiane Quaglio
- CORE, Laboratory of Clinical Analysis, Bragança Paulista, São Paulo, Brazil
| | | | | | | | - Eneida de Paula
- Department of Biochemistry, State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil
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Shen Y, Ji Y, Xu S, Chen DQ, Tu J. Multivesicular liposome formulations for the sustained delivery of ropivacaine hydrochloride: preparation, characterization, and pharmacokinetics. Drug Deliv 2011; 18:361-6. [PMID: 21428705 DOI: 10.3109/10717544.2011.557788] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of the present study was to design a depot delivery system of ropivacaine hydrochloride using multivesicular liposomes (RP-MVLs) to overcome the limitations of conventional therapies and to investigate it's in vivo effectiveness for sustained delivery. RP-MVLs were prepared by the multiple emulsion method. Appearance, particle size, encapsulation efficiency, zeta potential, and initial stability of RP-MVL were also studied. The in vitro release of RP-MVLs formulations was found to be in a sustained manner. Three batches of RP-MVLs were prepared and the release profile in vitro fitted to a first-order equation. RP-MVLs releasing mechanism was also studied and it was indicated that the drug released from MVLs by diffusion and erosion. Following subcutaneous administration to rats, the time to reach maximum (T(max)) of RP-MVLs formulations was significantly (p < 0.01) later than that of RH solution. The concentrations of RP-MVLs have steadily changed in the low level, which significantly (p < 0.01) lower than RH solution. T(1/2) and MRT were significantly prolonged (p < 0.01). Besides, AUC was also increased significantly (p < 0.01). The increase in AUC and decrease in C(max) reflects that the MVL formulations could reduce the toxic complications and limitations of conventional injected formation therapies.
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Affiliation(s)
- Yan Shen
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing, PR China
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Schroeder A, Turjeman K, Schroeder JE, Leibergall M, Barenholz Y. Using liposomes to target infection and inflammation induced by foreign body injuries or medical implants. Expert Opin Drug Deliv 2010; 7:1175-89. [DOI: 10.1517/17425247.2010.517519] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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