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Alghanem S, Dziurkowska E, Ordyniec-Kwaśnica I, Sznitowska M. Intraoral medical devices for sustained drug delivery. Clin Oral Investig 2023; 27:7157-7169. [PMID: 37982874 PMCID: PMC10713785 DOI: 10.1007/s00784-023-05377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/05/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES The oral cavity constitutes an attractive organ for the local and systemic application of drug substances. Oromucosal tablets, gels, or sprays are examples of the formulations applied. Due to the elution through the saliva, the residence time of the formulation at the application site is relatively short. Medical devices placed in the oral cavity, with a reservoir for an active substance, play an important role in solving this problem. MATERIALS AND METHODS In this review, we discuss the devices described in the literature that are designed to be used in the oral cavity, highlighting the advantages, disadvantages, and clinical applications of each of them. RESULTS Among the intraoral medical devices, special types are personalized 3D-printed devices, iontophoretic devices, and microneedle patches. CONCLUSION We anticipate that with the development of 3D printing and new polymers, the technology of flexible and comfortable devices for prolonged drug delivery in the oral cavity will develop intensively. CLINICAL RELEVANCE The presented review is therefore a useful summary of the current technological state, when in fact none of the existing devices has been widely accepted clinically.
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Affiliation(s)
- Suhail Alghanem
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland
| | - Ewelina Dziurkowska
- Department of Analytical Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland.
| | - Iwona Ordyniec-Kwaśnica
- Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdansk, Str. E. Orzeszkowej 18, 80-208, Gdansk, Poland
| | - Małgorzata Sznitowska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland
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Wanasathop A, Nimmansophon P, Murawsky M, Krishnan DG, Li SK. Iontophoresis on Porcine and Human Gingiva. Pharm Res 2023; 40:1977-1987. [PMID: 37258949 PMCID: PMC10524680 DOI: 10.1007/s11095-023-03535-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/12/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE Iontophoresis is a noninvasive method that enhances drug delivery using an electric field. This method can improve drug delivery to the tissues in the oral cavity. The effects of iontophoresis on gingival drug delivery have not been investigated. The objectives of this study were to (a) determine the flux enhancement of model permeants across porcine and human gingiva during iontophoresis, (b) examine the transport mechanisms of gingival iontophoresis, and (c) evaluate the potential of iontophoretically enhanced delivery for three model drugs lidocaine, ketorolac, and chlorhexidine. METHODS Passive and iontophoretic fluxes were determined with porcine and human gingiva using a modified Franz diffusion cell and model drugs and permeants. To investigate the transport mechanisms of iontophoresis, the enhancement from the direct-field effect was determined by positively and negatively charged model permeants. The electroosmosis enhancement effect was determined with neutral permeants of different molecular weight. The alteration of the gingival barrier due to electropermeabilization was evaluated using electrical resistance measurements. RESULTS Significant flux enhancement was observed during gingival iontophoresis. The direct-field effect was the major mechanism governing the iontophoretic transport of the charged permeants. Electroosmosis was from anode to cathode. The effective pore radius of the iontophoretic transport pathways in the porcine gingiva was ~0.68 nm. Irreversible electropermeabilization was observed after 2 and 4 h of iontophoresis under the conditions studied. CONCLUSION Iontophoresis could enhance drug delivery and reduce transport lag time, showing promise for gingival drug delivery.
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Affiliation(s)
- Apipa Wanasathop
- Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, 231 Albert Sabin Way, MSB # 3005, Cincinnati, OH, 45267-0514, USA
| | - Patcharawan Nimmansophon
- Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, 231 Albert Sabin Way, MSB # 3005, Cincinnati, OH, 45267-0514, USA
| | - Michael Murawsky
- Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, 231 Albert Sabin Way, MSB # 3005, Cincinnati, OH, 45267-0514, USA
| | - Deepak G Krishnan
- Division of Oral and Maxillofacial Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - S Kevin Li
- Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, 231 Albert Sabin Way, MSB # 3005, Cincinnati, OH, 45267-0514, USA.
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Tharmatt A, Malhotra D, Sharma H, Bedi N. Pharmaceutical Perspective in Wearable Drug Delivery Systems. Assay Drug Dev Technol 2021; 19:386-401. [PMID: 34339259 DOI: 10.1089/adt.2021.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Humans have been dealing with health problems for millions of years. Normal health services need well-trained personnel and high-cost diagnostic tests, which forces patients to go to hospitals if medical treatment is required. To address this, prototype testing has been carried out into the wearable drug delivery health care perspectives. Researchers have devised a wide variety of formulations for the treatment of various diseases at home by performing real-time monitoring of different routes of drug administration such as ocular, transdermal, intraoral, intracochlear, and several more. A comprehensive review of the different types of wearable drug delivery systems with respect to their manufacturing, mechanism of action and specifications has been done. In the pharmaceutical context, these devices are technologically well-equipped interfaces for diverse physicochemical signals. Above mentioned information with a broader perspective has also been discussed in this article. Several wearable drug delivery systems have been introduced in the market in recent years. But a lot of testing needs to be conducted to address the numerous obstacles before the wearable devices are successfully launched in the market.
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Affiliation(s)
- Abhay Tharmatt
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Danish Malhotra
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Hamayal Sharma
- Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Pilani, India
| | - Neena Bedi
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
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Iontophoretic Drug Delivery in the Oral Cavity. Pharmaceutics 2018; 10:pharmaceutics10030121. [PMID: 30087247 PMCID: PMC6161066 DOI: 10.3390/pharmaceutics10030121] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/25/2018] [Accepted: 07/27/2018] [Indexed: 11/28/2022] Open
Abstract
Iontophoresis is a noninvasive method to enhance systemic and local drug delivery by the application of an electric field. For systemic drug delivery in the oral cavity, iontophoresis was studied primarily for transbuccal delivery. Significant enhancement of drug delivery was observed in buccal iontophoresis compared to passive transport for different drugs. For local drug delivery in the oral cavity, iontophoresis could enhance drug penetration into the enamel, dentin, and other oral tissues for the treatment of oral diseases. Iontophoresis was evaluated in dentistry such as to produce local anesthesia and treat tooth decalcification and hypersensitivity, but this technology has not been fully utilized. The most common drugs in these evaluations were fluoride and lidocaine. In general, there is limited knowledge of the mechanisms of iontophoresis in the oral tissues. In vivo animal and human studies have suggested that iontophoresis is safe in the oral cavity under the conditions investigated. The present review covers the topics of iontophoretic drug delivery in the oral cavity for both systemic and local treatments. The anatomy and diseases in the oral cavity for iontophoretic drug delivery are also briefly reviewed, and the challenges for this drug delivery method are discussed.
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Strang J, McDonald R, Alqurshi A, Royall P, Taylor D, Forbes B. Naloxone without the needle - systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal. Drug Alcohol Depend 2016; 163:16-23. [PMID: 26996745 DOI: 10.1016/j.drugalcdep.2016.02.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/24/2016] [Accepted: 02/28/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Deaths from opioid overdose can be prevented through administration of the antagonist naloxone, which has been licensed for injection since the 1970s. To support wider availability of naloxone in community settings, novel non-injectable naloxone formulations are being developed, suitable for emergency use by non-medical personnel. OBJECTIVES 1) Identify candidate routes of injection-free naloxone administration potentially suitable for emergency overdose reversal; 2) consider pathways for developing and evaluating novel naloxone formulations. METHODS A three-stage analysis of candidate routes of administration was conducted: 1) assessment of all 112 routes of administration identified by FDA against exclusion criteria. 2) Scrutiny of empirical data for identified candidate routes, searching PubMed and WHO International Clinical Trials Registry Platform using search terms "naloxone AND [route of administration]". 3) Examination of routes for feasibility and against the inclusion criteria. RESULTS Only three routes of administration met inclusion criteria: nasal, sublingual and buccal. Products are currently in development and being studied. Pharmacokinetic data exist only for nasal naloxone, for which product development is more advanced, and one concentrated nasal spray was granted licence in the US in 2015. However, buccal naloxone may also be viable and may have different characteristics. CONCLUSION After 40 years of injection-based naloxone treatment, non-injectable routes are finally being developed. Nasal naloxone has recently been approved and will soon be field-tested, buccal naloxone holds promise, and it is unclear what sublingual naloxone will contribute. Development and approval of reliable non-injectable formulations will facilitate wider naloxone provision across the community internationally.
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Affiliation(s)
- John Strang
- National Addiction Centre, Addictions Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 4 Windsor Walk, Denmark Hill, London SE5 8BB, UK.
| | - Rebecca McDonald
- National Addiction Centre, Addictions Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 4 Windsor Walk, Denmark Hill, London SE5 8BB, UK.
| | - Abdulmalik Alqurshi
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK.
| | - Paul Royall
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK.
| | - David Taylor
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK; Pharmacy Department, South London and Maudsley NHS Foundation Trust (SLaM), Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK.
| | - Ben Forbes
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK.
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Scaturro AL, De Caro V, Campisi G, Giannola LI. Potential transbuccal delivery of l-DOPA methylester prodrug: stability in the environment of the oral cavity and ability to cross the mucosal tissue. Drug Deliv 2014; 23:2355-2362. [PMID: 25533875 DOI: 10.3109/10717544.2014.987332] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anna Lisa Scaturro
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF), University of Palermo, Palermo, Italy and
| | - Viviana De Caro
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF), University of Palermo, Palermo, Italy and
| | - Giuseppina Campisi
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), University of Palermo, Palermo, Italy
| | - Libero Italo Giannola
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF), University of Palermo, Palermo, Italy and
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Abstract
This paper is the thirty-sixth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2013 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia; stress and social status; tolerance and dependence; learning and memory; eating and drinking; alcohol and drugs of abuse; sexual activity and hormones, pregnancy, development and endocrinology; mental illness and mood; seizures and neurologic disorders; electrical-related activity and neurophysiology; general activity and locomotion; gastrointestinal, renal and hepatic functions; cardiovascular responses; respiration and thermoregulation; and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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Sattar M, Sayed OM, Lane ME. Oral transmucosal drug delivery--current status and future prospects. Int J Pharm 2014; 471:498-506. [PMID: 24879936 DOI: 10.1016/j.ijpharm.2014.05.043] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 05/14/2014] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Abstract
Oral transmucosal drug delivery (OTDD) dosage forms have been available since the 1980s. In contrast to the number of actives currently delivered locally to the oral cavity, the number delivered as buccal or sublingual formulations remains relatively low. This is surprising in view of the advantages associated with OTDD, compared with conventional oral drug delivery. This review examines a number of aspects related to OTDD including the anatomy of the oral cavity, models currently used to study OTDD, as well as commercially available formulations and emerging technologies. The limitations of current methodologies to study OTDD are considered as well as recent publications and new approaches which have advanced our understanding of this route of drug delivery.
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Affiliation(s)
- Mohammed Sattar
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1 N 1AX, United Kingdom; Department of Pharmaceutics, College of Pharmacy, University of Basrah, Basrah, Iraq
| | - Ossama M Sayed
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1 N 1AX, United Kingdom; Pharmaceutics Department, Faculty of Pharmacy, Beni Suef University, P.O. Box 62514, Egypt
| | - Majella E Lane
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1 N 1AX, United Kingdom.
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Overcoming hurdles in iontophoretic drug delivery: is skin the only barrier? Ther Deliv 2014; 5:493-6. [DOI: 10.4155/tde.14.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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