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Pünnel LC, Lunter DJ. Film-Forming Systems for Dermal Drug Delivery. Pharmaceutics 2021; 13:pharmaceutics13070932. [PMID: 34201668 PMCID: PMC8308977 DOI: 10.3390/pharmaceutics13070932] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 01/29/2023] Open
Abstract
Film-forming formulations represent a novel form of sustained release dermatic products. They are applied to the skin as a liquid or semi-solid preparation. By evaporation of the volatile solvent on the skin, the polymer contained in the formulation forms a solid film. Various film-forming formulations were tested for their water and abrasion resistance and compared with conventional semi-solid formulations. Penetration and permeation studies of the formulations indicate a potential utility as transdermal therapeutic systems. They can be used as an alternative to patch systems to administer a variety of drugs in a topical way and may provide sustained release characteristics.
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Effective factors on iontophoretic transdermal delivery of memantine and donepezil as model drugs. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Transdermal drug delivery systems for fighting common viral infectious diseases. Drug Deliv Transl Res 2021; 11:1498-1508. [PMID: 34024014 PMCID: PMC8140753 DOI: 10.1007/s13346-021-01004-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 02/08/2023]
Abstract
Transdermal drug delivery systems (TDDS) have many advantages and represent an excellent alternative to oral delivery and hypodermic injections. TDDS are more convenient and less invasive tools for disease and viral infection treatment, prevention, detection, and surveillance. The emerging development of microneedles for TDDS has facilitated improved skin barrier penetration for the delivery of macromolecules or hydrophilic drugs. Microneedle TDDS patches can be fabricated to deliver virus vaccines and potentially provide a viable alternative vaccine modality that offers improved immunogenicity, thermostability, simplicity, safety, and compliance as well as sharp-waste reduction, increased cost-effectiveness, and the capacity for self-administration, which could improve vaccine distribution. These advantages make TDDS-based vaccine delivery an especially well-suited option for treatment of widespread viral infectious diseases including pandemics. Because microneedle-based bioassays employ transdermal extraction of interstitial fluid or blood, they can be used as a minimally invasive approach for surveying disease markers and providing point-of-care (POC) diagnostics. For cutaneous viral infections, TDDS can provide localized treatment with high specificity and less systemic toxicity. In summary, TDDS, especially those that employ microneedles, possess special attributes that can be leveraged to reduce morbidity and mortality from viral infectious diseases. In this regard, they may have considerable positive impact as a modality for improving global health. In this article, we introduce the possible role and summarize the current literature regarding TDDS applications for fighting common cutaneous or systemic viral infectious diseases, including herpes simplex, varicella or herpes zoster, warts, influenza, measles, and COVID-19.
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Mechanistic study of transdermal delivery of macromolecules assisted by ionic liquids. J Control Release 2019; 311-312:162-169. [DOI: 10.1016/j.jconrel.2019.08.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/23/2019] [Accepted: 08/25/2019] [Indexed: 02/06/2023]
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Banerjee A, Ibsen K, Iwao Y, Zakrewsky M, Mitragotri S. Transdermal Protein Delivery Using Choline and Geranate (CAGE) Deep Eutectic Solvent. Adv Healthc Mater 2017; 6. [PMID: 28337858 DOI: 10.1002/adhm.201601411] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/21/2017] [Indexed: 12/20/2022]
Abstract
Transdermal delivery of peptides and other biological macromolecules is limited due to skin's inherent low permeability. Here, the authors report the use of a deep eutectic solvent, choline and geranate (CAGE), to enhance topical delivery of proteins such as bovine serum albumin (BSA, molecular weight: ≈66 kDa), ovalbumin (OVA, molecular weight: ≈45 kDa) and insulin (INS, molecular weight: 5.8 kDa). CAGE enhances permeation of BSA, OVA, and insulin into porcine skin ex vivo, penetrating deep into the epidermis and dermis. Studies using tritium-labeled BSA and fluorescein isothiocyanate labeled insulin show significantly enhanced delivery of proteins into and across porcine skin, penetrating the skin in a time-dependent manner. Fourier transform IR spectra of porcine stratum corneum (SC) samples before and after incubation in CAGE show a reduction in peak area attributed to SC lipid content, suggesting lipid extraction from the SC. Circular dichroism confirms that CAGE does not affect insulin's secondary conformation. In vivo studies in rats show that topical application of 10 U insulin dispersed in CAGE (25 U kg-1 insulin dose) leads to a highly significant 40% drop in blood glucose levels in 4 h that is relatively sustained for 12 h. Taken together, these studies demonstrate that CAGE is a promising vehicle for transdermal delivery of therapeutic proteins; specifically, as a noninvasive delivery alternative to injectable insulin for the treatment of diabetes.
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Affiliation(s)
- Amrita Banerjee
- Department of Chemical Engineering and Center for Bioengineering University of California Santa Barbara Santa Barbara CA 93106 USA
| | - Kelly Ibsen
- Department of Chemical Engineering and Center for Bioengineering University of California Santa Barbara Santa Barbara CA 93106 USA
| | - Yasunori Iwao
- Department of Pharmaceutical Engineering School of Pharmaceutical Sciences University of Shizuoka Shizuoka 422‐8526 Japan
| | - Michael Zakrewsky
- Department of Chemical Engineering and Center for Bioengineering University of California Santa Barbara Santa Barbara CA 93106 USA
| | - Samir Mitragotri
- Department of Chemical Engineering and Center for Bioengineering University of California Santa Barbara Santa Barbara CA 93106 USA
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Sugrue D, Bogner R, Ehret MJ. Methylphenidate and dexmethylphenidate formulations for children with attention-deficit/hyperactivity disorder. Am J Health Syst Pharm 2015; 71:1163-70. [PMID: 24973373 DOI: 10.2146/ajhp130638] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Current literature on the safety and efficacy of various intermediate- and long-acting preparations of methylphenidate and dexmethylphenidate for pediatric attention-deficit/hyperactivity disorder (ADHD) is reviewed. SUMMARY The efficacy of methylphenidate in controlling ADHD symptoms is firmly established. Given the drug's relatively short half-life in pediatric patients (about 2.5 hours), a number of intermediate- and long-acting products have been developed; these extended-release methylphenidate products provide the same efficacy as immediate-release (IR) formulations, with the convenience of less frequent dosing. Intermediate-acting methylphenidate preparations have effects lasting as long as 8 hours, but peak concentrations are not attained for up to 5 hours, and many patients may require twice-daily dosing. Long-acting methylphenidate products developed to address these challenges include a controlled-release tablet and bimodal-delivery capsules containing mixtures of IR and extended-release beads (durations of effect, 8-12 hours). Options for patients with difficulty swallowing tablets or capsules include a once-daily transdermal delivery system and a once-daily liquid formulation. Dexmethylphenidate (the more pharmacologically active d-isomer of racemic methylphenidate) can provide efficacy comparable to that of IR methylphenidate at half the dose; an extended-release form of dexmethylphenidate can provide less fluctuation in peak and trough concentrations than the IR form. Methylphenidate and dexmethylphenidate products in capsule form can be opened and sprinkled on applesauce. CONCLUSION The various formulations of IR and intermediate- and extended-release methylphenidate and dexmethylphenidate can be useful options in satisfying patients' individual needs in the management of ADHD. All are equally efficacious in controlling ADHD symptoms.
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Affiliation(s)
- David Sugrue
- David Sugrue, B.S., is a 2015 Pharm.D. candidate; Robin Bogner, M.S., Ph.D., is Associate Professor of Pharmaceutics; and Megan J. Ehret, Pharm.D., M.S., BCPP, is Associate Professor of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs
| | - Robin Bogner
- David Sugrue, B.S., is a 2015 Pharm.D. candidate; Robin Bogner, M.S., Ph.D., is Associate Professor of Pharmaceutics; and Megan J. Ehret, Pharm.D., M.S., BCPP, is Associate Professor of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs
| | - Megan J Ehret
- David Sugrue, B.S., is a 2015 Pharm.D. candidate; Robin Bogner, M.S., Ph.D., is Associate Professor of Pharmaceutics; and Megan J. Ehret, Pharm.D., M.S., BCPP, is Associate Professor of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs.
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Kochhar JS, Quek TC, Soon WJ, Choi J, Zou S, Kang L. Effect of Microneedle Geometry and Supporting Substrate on Microneedle Array Penetration into Skin. J Pharm Sci 2013; 102:4100-8. [DOI: 10.1002/jps.23724] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/09/2013] [Accepted: 08/15/2013] [Indexed: 11/08/2022]
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Abstract
Hypertension is a chronic disease with one of the highest chances of causing death, and long-term treatment is required. The antihypertensive drugs used in the treatment are generally administered orally. The limitations of the oral route make transdermal delivery of drugs more attractive. The transdermal route offers numerous advantages including avoidance of systemic first-pass metabolism and high patient compliance. The transdermal therapeutic systems, popularly known as ‘patches’, deliver drugs across the skin with a constant release rate. However, skin is a unique membrane having excellent barrier properties. Either chemical enhancers or physical methods such as iontophoresis and electroporation have been used to provide effective plasma drug concentrations. This review article focuses on the approaches to enhance skin permeability of antihypertensive drugs for the optimization of transdermal therapeutic systems of these drugs and the research studies intended for the optimization of transdermal dosage forms of antihypertensive drugs are summarized.
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Abstract
Methotrexate has been reported as an immunosuppressant and an antimetabolite widely used in the treatment of rheumatoid arthritis and psoriasis. However, it causes various toxicities and has low bioavailability when taken orally, thus, it is desirable that the drug be delivered transdermally. The water solubility and charged structure of methotrexate, however, limits its use via the transdermal route mainly due to the highly organized microstructure of the stratum corneum. Hence, various technologies, such as chemical enhancers, iontophoresis, electroporation, ultrasound and microneedles, either alone or in combination, are being explored to enhance its permeability by disrupting the barrier property of the skin. The present article discusses the past, present and future of transdermal delivery of methotrexate.
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Multicomponent chemical enhancer formulations for transdermal drug delivery: More is not always better. J Control Release 2010; 144:175-80. [DOI: 10.1016/j.jconrel.2010.02.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 02/03/2010] [Accepted: 02/08/2010] [Indexed: 11/22/2022]
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Hans G, Robert D. Transdermal buprenorphine - a critical appraisal of its role in pain management. J Pain Res 2009; 2:117-34. [PMID: 21197300 PMCID: PMC3004620 DOI: 10.2147/jpr.s6503] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This paper reviews the current clinical data for the role of transdermal buprenorphine (BUP TDS) in the treatment of diverse acute and chronic pain syndromes. Literature searches were carried out using PubMed (1988 to June 2009). The published findings seem to support hypotheses regarding the rather unique analgesic mechanisms of buprenorphine as compared with pure μ-opioids like morphine and fentanyl. However, the exact mechanism of this analgesic efficacy still remains largely unknown despite recent advances in preclinical pharmacological studies. Such assessments have demonstrated the sustained antihyperalgesic effect of buprenorphine in diverse animal pain models. These findings are supported in a growing number of clinical studies of oral, intrathecal, intravenous, and Bup TDS. This review paper focuses almost entirely on the clinical experience concerning the transdermal administration of buprenorphine, although preclinical aspects are also addressed in order to provide a complete picture of the unique pharmacological properties of this analgesic drug. Mounting evidence indicates the appropriateness of Bup TDS in the treatment of diverse acute and chronic pain syndromes which have been less or not responsive to other opioids. Additionally, BUP TDS seems to hold great promise for other difficult-to-treat (pain) conditions, such as patients in the intensive care setting. However, its use is somewhat tempered by the occurrence of local skin reactions which have been shown to be often therapy resistant. Further studies are certainly warranted to identify even more precisely the clinical syndromes that are most sensitive to buprenorphine treatment, and to compare buprenorphine to other opioids in head-to-head trials of acute and chronic pain conditions.
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Warshaw EM, Paller AS, Fowler JF, Zirwas MJ. Practical management of cutaneous reactions to the methylphenidate transdermal system: recommendations from a dermatology expert panel consensus meeting. Clin Ther 2009; 30:326-37. [PMID: 18343271 DOI: 10.1016/j.clinthera.2008.01.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychostimulants remain the most-used medications for attention-deficit/hyperactivity disorder (ADHD). The methylphenidate transdermal system (MTS) is the first stimulant patch dosage formulation to be approved by the US Food and Drug Administration for the treatment of the symptoms of ADHD in children aged 6 to 12 years. The MTS patch is approved to be applied once daily to the hip and worn for 9 hours. While cutaneous reactions may occur with any formulation of medication, they are more likely with transdermal administration. OBJECTIVE The purpose of this commentary was to describe the types of cutaneous reactions that have been reported with transdermal systems in general, review the cutaneous adverse events seen in clinical trials with the MTS specifically, and provide practical management suggestions for prevention and treatment of these potential cutaneous reactions. METHODS In September 2007, a group of child psychiatrists, pediatricians, developmental pediatricians, and pediatric neurologists who treat ADHD and have had experience in their practices with MTS convened to discuss cutaneous reactions in relation to its use. Information collected from this meeting and from the clinical trials database of the sponsor was reviewed by a panel of 3 dermatologic clinical experts in contact dermatitis and 1 pediatric dermatologist. The panel's recommendations form the basis for this report. CONCLUSIONS Mild to moderate erythema is a common cutaneous effect with MTS use, and is generally not a cause for discontinuation if seen in isolation. Irritant contact dermatitis is relatively common and can be reduced and treated by alternating patch application sites, moisturizing, gentle skin care, and application of topical corticosteroids at the previous patch sites if needed. Allergic contact dermatitis (ACD) and allergic contact urticaria are rare when MTS is worn as directed in the prescribing information. MTS should be discontinued if ACD is suspected.
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Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
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Chavez B, Sopko MA, Ehret MJ, Paulino RE, Goldberg KR, Angstadt K, Bogart GT. An update on central nervous system stimulant formulations in children and adolescents with attention-deficit/hyperactivity disorder. Ann Pharmacother 2009; 43:1084-95. [PMID: 19470858 DOI: 10.1345/aph.1l523] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review recent literature on the different stimulant preparations regarding efficacy and safety in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and describe advantages and disadvantages of the many available dosage formulations. DATA SOURCES Literature retrieval was performed through PubMed/MEDLINE (2005-December 2008) using the terms methylphenidate, amphetamines, central nervous system stimulants, and attention-deficit/hyperactivity disorder. In addition, reference citations from publications identified were reviewed and drug manufacturers were contacted for any possible additional references. STUDY SELECTION AND DATA EXTRACTION Double-blind clinical trials found using the search criteria listed above were included for review. Open-label studies and studies prior to 2005 were included if no double-blind trials were published for that formulation within the time period reviewed. DATA SYNTHESIS The literature reviewed here demonstrates the efficacy and safety of stimulant medications in children and adolescents with ADHD. However, there are 19 different formulations of stimulants, leading to confusion and errors in prescribing and dispensing of these drugs. Knowing and understanding the advantages and disadvantages of the different formulations can lead to individualized treatment. Formulations like Concerta, Focalin-XR, Adderall-XR, and Vyvanse provide the convenience of once-daily dosing. Each of these provides varying amount of stimulants at different times of the day. Vyvanse has a unique delivery system that may lower the risk of patients abusing their medication. Daytrana gives patients more control over their dosing by being able to choose when the patch is removed; it is also a feasible alternative for children who cannot swallow pills. For patients who cannot swallow tablets or capsules, the capsules of Focalin-XR, Adderall-XR, Metadate-CD, and Ritalin-LA can be opened and sprinkled on applesauce. CONCLUSIONS Stimulants are effective medications to treat the symptoms of ADHD. The multiple available dosage forms allow for individualization of treatment.
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Affiliation(s)
- Benjamin Chavez
- Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, State University of New Jersey, Piscataway, NJ 07740, USA.
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Narasimha Sathyanarayana Murthy NS, Boguda VA, Payasada K. Electret Enhances Transdermal Drug Permeation. Biol Pharm Bull 2008; 31:99-102. [DOI: 10.1248/bpb.31.99] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Macgregor JM, Rush JE, Rozanski EA, Boothe DM, Belmonte AA, Freeman LM. Comparison of pharmacodynamic variables following oral versus transdermal administration of atenolol to healthy cats. Am J Vet Res 2008; 69:39-44. [PMID: 18167085 DOI: 10.2460/ajvr.69.1.39] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- John M Macgregor
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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Arnold LE, Lindsay RL, López FA, Jacob SE, Biederman J, Findling RL, Ramadan Y. Treating attention-deficit/hyperactivity disorder with a stimulant transdermal patch: the clinical art. Pediatrics 2007; 120:1100-6. [PMID: 17974748 DOI: 10.1542/peds.2007-0542] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Stimulant medications (amphetamine and methylphenidate) are the best-documented treatments for attention-deficit/hyperactivity disorder, but their short pharmacokinetic and behavioral half-lives have historically produced irksome time-course effects. New drug-delivery systems designed to eliminate the need for frequent dosing include the methylphenidate transdermal system, in which the matrix acts as both the drug reservoir and the skin adhesive. The methylphenidate transdermal system patch, in contrast to long-acting oral preparations, requires a paradigmatic shift in clinical thinking, as well as refinement of clinical management skills. For dosing with the methylphenidate transdermal system patch, clinicians must think in terms of a retrievable form of drug delivery (in milligrams per hour) rather than a fixed nonretrievable dose (in milligrams per dose or milligrams per day). Clinicians and patients can determine the optimal clinical dose by controlling 2 variables: (1) patch size (controlling milligrams per hour) and (2) duration of patch wear. The new paradigm is worth learning, because the patch offers several advantages over oral preparations for some patients, chiefly individualized control over effect duration (determined by when the patch is applied in the morning and removed in the afternoon/evening). Taking full advantage of this treatment option requires educating the patient and parents regarding practical elements of daily use. These elements include patch-site selection, application techniques, management of wear time to optimize the daily time course of clinical benefits, and skin hygiene. This article summarizes clinical principles that physicians may find useful in managing this new addition to the attention-deficit/hyperactivity disorder treatment armamentarium.
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Affiliation(s)
- L Eugene Arnold
- Department of Psychiatry, Ohio State University, Columbus, Ohio, USA.
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Batheja P, Priya B, Thakur R, Rashmi T, Michniak B, Bozena M. Transdermal iontophoresis. Expert Opin Drug Deliv 2006; 3:127-38. [PMID: 16370945 DOI: 10.1517/17425247.3.1.127] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Iontophoresis is a technique used to enhance the transdermal delivery of compounds through the skin via the application of a small electric current. By the process of electromigration and electro-osmosis, iontophoresis increases the permeation of charged and neutral compounds, and offers the option for programmed drug delivery. Interest in this field of research has led to the successful delivery of both low (lidocaine) and high molecular drugs, such as peptides (e.g., luteinising hormone releasing hormone, nafarelin and insulin). Combinations of iontophoresis with chemical enhancers, electroporation and sonophoresis have been tested in order to further increase transdermal drug permeation and decrease possible side effects. In addition, rapid progress in the fields of microelectronics, nanotechnology and miniaturisation of devices is leading the way to more sophisticated iontophoretic devices, allowing improved designs with better control of drug delivery. Recent successful designing of the fentanyl E-TRANS iontophoretic system have provided encouraging results. This review will discuss basic concepts, principles and applications of this delivery technique.
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Affiliation(s)
- Priya Batheja
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers-The State University of New Jersey, 145 Bevier Road, Piscataway, NJ 08854, USA
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Neuman DL, Farrar JE, Moresi JM, Vogelsang GB, Higman MA. Toxic absorption of pimecrolimus in a patient with severe acute graft-versus-host disease. Bone Marrow Transplant 2005; 36:919-20. [PMID: 16151424 DOI: 10.1038/sj.bmt.1705146] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Haas CE, Lin L, Cloen D, Kufel T, Moon R, Frerichs V. Omeprazole Absorption from a Compounded Transdermal Formulation in Healthy Volunteers. J Am Pharm Assoc (2003) 2005; 45:473-8. [PMID: 16128503 DOI: 10.1331/1544345054475603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the plasma concentration versus time profile of omeprazole following the administration of a compounded transdermal gel formulation in healthy volunteers. DESIGN Single-dose transdermal pharmacokinetic (PK) study including a comparison with historical data from an oral PK study. SETTING Academic clinical research center. PARTICIPANTS Eight healthy volunteers between 18 and 50 years of age. INTERVENTIONS Omeprazole gel 40 mg (0.8 mL) was applied to the ventral surface of the forearm covering an area of 7 x 15 cm without an occlusive dressing. Blood samples were collected just before application and then at 1, 2, 3, 4, 6, and 8 hours. Plasma concentrations of omeprazole were determined using a validated liquid chromatography tandem mass spectrometry method. MAIN OUTCOME MEASURES PK parameters (maximal plasma concentration [C(max)], the time of C(max), [T(max)], the area under the omeprazole concentration versus time curve from 0 to 8 hours, the elimination rate constant, and the half-life of the elimination phase) following transdermal administration, compared with historical controls who had received an oral omeprazole 40 mg dose during a previous study. RESULTS Of the eight volunteers, five had undetectable plasma omeprazole concentrations throughout the 8-hour study, precluding a complete PK analysis. For the three volunteers with detectable plasma omeprazole concentrations, the values ranged from 0.204 to 0.552 ng/mL. Including values of 0 for the patients with undetectable levels, the mean (+/- SD) C(max) was 0.153 +/- 0.241 ng/mL, and the T(max) in patients with detectable levels occurred at approximately 6 hours. The plasma concentrations following transdermal administration were approximately 1,000-fold lower than those observed with oral dosing. CONCLUSION Transdermal absorption from a single dose of the omeprazole gel formulation used in this study was poor. This transdermal gel formulation is clearly not bioequivalent to the oral capsule.
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Affiliation(s)
- Curtis E Haas
- Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, NY 14260-1200, USA.
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Kalia YN, Naik A, Garrison J, Guy RH. Iontophoretic drug delivery. Adv Drug Deliv Rev 2004; 56:619-58. [PMID: 15019750 DOI: 10.1016/j.addr.2003.10.026] [Citation(s) in RCA: 498] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2003] [Accepted: 10/13/2003] [Indexed: 01/23/2023]
Abstract
The composition and architecture of the stratum corneum render it a formidable barrier to the topical and transdermal administration of therapeutic agents. The physicochemical constraints severely limit the number of molecules that can be considered as realistic candidates for transdermal delivery. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. The principal distinguishing feature is the control afforded by iontophoresis and the ability to individualize therapies. This may become significant as the impact of interindividual variations in protein expression and the effect on drug metabolism and drug efficacy is better understood. In this review we describe the underlying mechanisms that drive iontophoresis and we discuss the impact of key experimental parameters-namely, drug concentration, applied current and pH-on iontophoretic delivery efficiency. We present a comprehensive and critical review of the different therapeutic classes and molecules that have been investigated as potential candidates for iontophoretic delivery. The iontophoretic delivery of peptides and proteins is also discussed. In the final section, we describe the development of the first pre-filled, pre-programmed iontophoretic device, which is scheduled to be commercialized during the course of 2004.
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Weinberger B, Hanna N, Gropper CA, Heck DE, Laskin DL, Laskin JD. Transdermal Xenobiotics in Newborn Skin. ACTA ACUST UNITED AC 2003; 22:51-67. [PMID: 37007905 PMCID: PMC10061589 DOI: 10.1081/cus-120019330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Newborn infants are regularly exposed to a wide variety of topical agents, including treatments for rashes, antimicrobial agents, solvents, and skin barriers or moisturizers. Premature and hospitalized infants are also exposed to topical iodine for antisepsis and to topical analgesic agents. The fact that most of these agents have not been specifically evaluated for use in infants has recently been recognized as a major public health concern. The epidermis of preterm infants is not fully developed, constituting an incomplete barrier to systemic absorption of topical agents. Thus, substances applied to the skin can have adverse systemic effects. Povidone-iodine and steroid creams have been associated with thyroid and hypothalamic-pituitary axis suppression, respectively, in premature infants. Application of topical EMLA (Eutectic Mixture of Local Anesthetics) for analgesia has been implicated in methemoglobinemia in premature infants. Exposure to natural latex in gloves and medical equipment may sensitize infants, leading to the development of airway hyperreactivity and other allergic manifestations. Therefore, it is advisable to limit skin exposure of premature infants to xenobiotics. Further work is required to define safe doses of common agents. In addition, transdermal administration of systemic medications, including methylxanthines, may be practical in premature infants.
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Affiliation(s)
- Barry Weinberger
- Division of Neonatology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Correspondence: Barry Weinberger, M.D., Associate Professor of Pediatrics, Division of Neonatology, St. Peter’s University Hospital, 254 Easton Avenue, New Brunswick, NJ 08903, USA; Fax: 732-249-6306;
| | - Nazeeh Hanna
- Division of Neonatology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Charles A. Gropper
- Department of Dermatology, Mount Sinai School of Medicine, New York, New York, USA
| | - Diane E. Heck
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, New Jersey, USA
| | - Debra L. Laskin
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, New Jersey, USA
| | - Jeffrey D. Laskin
- Department of Environmental and Community Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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Martin DJ, Badwan K, Parker M, Mulhall JP. Transdermal application of verapamil gel to the penile shaft fails to infiltrate the tunica albuginea. J Urol 2002; 168:2483-5. [PMID: 12441945 DOI: 10.1016/s0022-5347(05)64173-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE There currently exists no universally accepted pharmacotherapy for Peyronie's disease. Recently interest has grown in transdermal agents, including verapamil. We evaluated the ability of a commercially available verapamil gel applied to the penile skin to infiltrate the tunica albuginea. MATERIALS AND METHODS In men scheduled to undergo penile prosthesis surgery for erectile dysfunction verapamil gel was applied to the penile shaft the night before and morning of surgery. Urine was obtained at the commencement of the implant operation and tunical samples were excised from each corporeal body intraoperatively. Verapamil quantification was performed in all specimens using high pressure liquid chromatography. RESULTS All patients tolerated verapamil gel application without any adverse events. A mean of 1.1 gm. tunical tissue was excised. Mean verapamil concentration in the urine was 46 ng./ml. No verapamil was detected in any tunical specimens. CONCLUSIONS These data indicate that applying transdermal verapamil gel to the penile shaft results in a small amount of systemic absorption but the gel does not infiltrate the tunica albuginea. Based on these findings the use of transdermal verapamil for Peyronie's disease has no scientific basis.
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Affiliation(s)
- David J Martin
- Department of Urology, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois, USA
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Abstract
For more than two decades, researchers have attempted to find a way to use the skin as a portal of entry for drugs in order to overcome problems associated with traditional modes of drug administration. This has been a complicated task due to the highly effective barrier properties of the skin. In order to deliver drugs through the skin, most compounds require various degrees of permeation enhancement. Classic enhancement methods focused primarily on chemical enhancement or modulation of interactions between the drug and the vehicle. More recent research makes use of innovative vesicular carriers, electrically assisted delivery and various microinvasive methods, some incorporating technologies from other fields. These new and exciting methods for drug delivery are already increasing the number and quality of dermal and transdermal therapies. This review discusses the different types of permeation enhancement, both classic and innovative, and summarises the current strengths and shortcomings in the field with an emphasis on those that have led to products on the market or in the pipeline.
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Affiliation(s)
- Elka Touitou
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, PO Box 12065, Jerusalem, 91120, Israel.
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25
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Dittrich R, Parker L, Rosen JB, Shangold G, Creasy GW, Fisher AC. Transdermal contraception: evaluation of three transdermal norelgestromin/ethinyl estradiol doses in a randomized, multicenter, dose-response study. Am J Obstet Gynecol 2002; 186:15-20. [PMID: 11810078 DOI: 10.1067/mob.2002.118844] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective of this study was to identify the dose for a contraceptive patch that provides a predetermined level of ovulation suppression and cycle control and that is well tolerated. STUDY DESIGN In this randomized study, 610 subjects received 10-, 15-, or 20-cm(2) patch dose sizes (20-cm(2), Ortho Evra/Evra) (Janssen Pharmaceutica, NV Belgium) or Ortho-Cyclen/Cilest (Janssen Pharmaceutica, NV Belgium) for up to 4 cycles. As with Ortho-Cyclen, patch regimens included 21 dosing days (3 consecutive 7-day patches) followed by 1 dose-free week. RESULTS The patch regimens demonstrated a dose-response for ovulation suppression and cycle control. Presumed ovulation, determined on the basis of serum progesterone concentrations > or = 3 ng/mL in cycles 1 and 3, occurred in 6.2% (Ortho Evra) and 7.2% (Ortho-Cyclen) of subjects. At cycle 3, breakthrough bleeding/spotting was reported by 10.5% and 15.0% of subjects, respectively. Compliance with each patch was superior to that with Ortho-Cyclen (all P <.001). All regimens had safety profiles typical of oral contraceptives. CONCLUSION The 20-cm(2) patch (Ortho Evra) provided ovulation suppression, cycle control, and safety similar to that of Ortho-Cyclen, with significantly better compliance.
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Affiliation(s)
- Richard Dittrich
- Partners in Women's Health, Methodist Hospital, Philadelphia, PA, USA
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26
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Affiliation(s)
- A Spray
- Washington University, St. Louis, Missouri, USA
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27
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Curdy C, Kalia YN, Guy RH. Recovery of human skin impedance in vivo after iontophoresis: effect of metal ions. AAPS PHARMSCI 2000; 2:E23. [PMID: 11741239 PMCID: PMC2761134 DOI: 10.1208/ps020323] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The objective of this study was to investigate the effect of the counter-ion (cation) on the recovery of human skin impedance after iontophoresis in vivo. A series of metal chloride aqueous solutions (NaCl, KCl, CaCl2, and MgCl2) was investigated: first at the same concentration (133 mmol/L) and then at the same ionic strength as a NaCl solution at 133 mmol/L. The influence of hydration alone was also examined as a control. The recovery of human skin impedance was followed in the frequency range 1-1,000 Hz, over a 30-minute period after iontophoresis during which 3 impedance spectra were recorded. The results revealed that at t = 30 minutes post-iontophoresis, skin impedance was approximately 3 times greater than the value immediately after the cessation of current passage. However, the results showed that the nature of the cation had no effect on recovery, regardless of whether the ions were at the same concentration or at an equivalent ionic strength. A simple parallel RC-equivalent circuit model for skin was used to determine the resistive (R) and capacitive (C) contributions to skin impedance. An analysis of variance on the calculated R and C values did not show any differences between the electrolytes used at the 2 different ionic strengths.
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Affiliation(s)
- Catherine Curdy
- Centre Interuniversitaire de recherche et d'Enseignement, Pharmapeptides, Campus Universitaire, Parc d'Affaires International, F-74166 Archamps, France
- Faculté des Sciences-Section de Pharmacie. Laboratoire de Pharmacie Galénique, Université de Genève, Ch-1211 Genève 4, Switzerland
- Faculté de Pharmacie, Institut des Sciences Pharmaceutiques et Biologiques, Université Claude Bernard, F-69373 Lyon 1, France
| | - Yogeshvar N. Kalia
- Centre Interuniversitaire de recherche et d'Enseignement, Pharmapeptides, Campus Universitaire, Parc d'Affaires International, F-74166 Archamps, France
- Faculté des Sciences-Section de Pharmacie. Laboratoire de Pharmacie Galénique, Université de Genève, Ch-1211 Genève 4, Switzerland
- Faculté de Pharmacie, Institut des Sciences Pharmaceutiques et Biologiques, Université Claude Bernard, F-69373 Lyon 1, France
| | - Richard H. Guy
- Centre Interuniversitaire de recherche et d'Enseignement, Pharmapeptides, Campus Universitaire, Parc d'Affaires International, F-74166 Archamps, France
- Faculté des Sciences-Section de Pharmacie. Laboratoire de Pharmacie Galénique, Université de Genève, Ch-1211 Genève 4, Switzerland
- Faculté de Pharmacie, Institut des Sciences Pharmaceutiques et Biologiques, Université Claude Bernard, F-69373 Lyon 1, France
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Abstract
THE SKIN ACTS AS A VITAL BARRIER between an individual and the environment by limiting water loss and by protecting against the entry of harmful substances. Various material can pass through the skin barrier, a process called percutaneous absorption. Although the skin’s permeability can lead to harmful effects, it can be beneficial in making the skin a possible route for the delivery of therapeutic drugs. Differences between adult and neonatal skin, especially preterm skin, expose the neonate to a greater potential for percutaneous absorption.1 Neonatal nurses need to be familiar with the characteristics of newborn skin, principles for maintaining skin integrity, and the risks and benefits of percutaneous absorption.
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Affiliation(s)
- M M Benis
- Fletcher Allen Health Care, University of Vermont, Burlington, USA
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Stagni G, O'Donnell D, Liu YJ, Kellogg DL, Shepherd AM. Iontophoretic current and intradermal microdialysis recovery in humans. J Pharmacol Toxicol Methods 1999; 41:49-54. [PMID: 10507758 DOI: 10.1016/s1056-8719(99)00027-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
When microdialysis (MD) is used to study dermal delivery by iontophoresis, the effects of current may alter MD recovery through an increase in temperature, a change of pH, hyperemia, and dermal hydration. The objective of this work is to assess whether these effects of current may cause a measurable change in the retrodialysis of a model compound (sodium fluorescein, Fl). Two linear MD-probes were inserted in the forearm dermis of healthy human volunteers and perfused with Ringer's solution containing Fl. Two identical iontophoresis chambers (IC, filled with NaCl in propylene glycol) were placed over the MD-probes. Each IC included a laser Doppler flowmetry probe to monitor skin blood flow. At one IC, current was applied for two periods of 30 min each, separated by 30 min of no current. No current was applied to the control site. Dialysate samples were collected every 5 min and analyzed for Fl by HPLC. Skin blood flow increased in response to iontophoresis, on average, 570% compared to the control site. However, there was no difference in the recovery of Fl between the current-active site versus the control site, and between the period with applied current versus the period with no current. In conclusion, iontophoretic current did not affect intradermal MD recovery.
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Affiliation(s)
- G Stagni
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, 78284-6205, USA.
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