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Taguchi T, Yamaguchi S, Terahara T, Okawa K, Inakura H. Systemically Acting Diclofenac Sodium Patch for Control of Low Back Pain: A Randomized, Double-Blind, Placebo-Controlled Study in Japan. Pain Ther 2023; 12:529-542. [PMID: 36725795 PMCID: PMC10036709 DOI: 10.1007/s40122-023-00478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used for pain disorders such as low back pain and exist in multiple formulations; however, no systemically acting transdermal formulations are available for low back pain. Transdermal formulations can be safely administered even to patients with trouble swallowing or at risk of aspiration, and without regard to the effect of food on drug absorption. Unlike locally acting formulations, systemically acting transdermal formulations need not be applied at the target site, so dosing is simple and the burden is not on one area of the skin. A patch with the systemically acting NSAID diclofenac sodium is approved in Japan for treatment of cancer-related pain, and we hypothesized that it would be useful for controlling low back pain. METHODS This randomized, double-blind, placebo-controlled study aimed to evaluate the efficacy and safety of diclofenac sodium patch in Japanese patients with low back pain. Eligible patients were randomized to receive diclofenac sodium patch 75 mg or 150 mg or placebo once daily for 2 weeks. The primary endpoint was pain intensity assessed on a visual analog scale (VAS). RESULTS Primary analysis of the primary endpoint showed that both doses of the diclofenac sodium patch (150 mg and 75 mg) were superior to placebo in terms of absolute change from baseline in mean 3-day VAS score after 2 weeks' treatment; the mean difference between the active and placebo treatments in this variable was -5.67 [95% confidence interval (CI) -9.34 to -2.00] mm in the 150 mg group and -5.68 (95% CI -9.34 to -2.01) mm in the 75 mg group. Most adverse events were mild. No serious adverse events occurred. CONCLUSION In Japanese patients, diclofenac sodium patch is effective for the relief of low back pain and is well tolerated. TRIAL REGISTRATION JPRN number, JPRN-JapicCTI-205134.
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Affiliation(s)
| | - Shigeki Yamaguchi
- Department of Anesthesia and Pain Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Takaaki Terahara
- Hisamitsu Pharmaceutical Co., Inc., 2-4-1, Marunouchi, Chiyoda-ku, Tokyo, 100-6330, Japan
| | - Koji Okawa
- Hisamitsu Pharmaceutical Co., Inc., 2-4-1, Marunouchi, Chiyoda-ku, Tokyo, 100-6330, Japan
| | - Hiroshi Inakura
- Hisamitsu Pharmaceutical Co., Inc., 2-4-1, Marunouchi, Chiyoda-ku, Tokyo, 100-6330, Japan.
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Ma J, Wang Y, Lu R. Mechanism and Application of Chitosan and Its Derivatives in Promoting Permeation in Transdermal Drug Delivery Systems: A Review. Pharmaceuticals (Basel) 2022; 15:ph15040459. [PMID: 35455456 PMCID: PMC9033127 DOI: 10.3390/ph15040459] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 01/15/2023] Open
Abstract
The mechanisms and applications of chitosan and its derivatives in transdermal drug delivery to promote drug permeation were reviewed in this paper. Specifically, we summarized the permeation-promoting mechanisms of chitosan and several of its derivatives, including changing the structure of stratum corneum proteins, acting on the tight junction of granular layers, affecting intercellular lipids, and increasing the water content of stratum corneum. These mechanisms are the reason why chitosan and its derivatives can increase the transdermal permeation of drugs. In addition, various transdermal preparations containing chitosan and its derivatives were summarized, and their respective advantages were expounded, including nanoparticles, emulsions, transdermal microneedles, nanocapsules, transdermal patches, transdermal membranes, hydrogels, liposomes, and nano-stents. The purpose of this review is to provide a theoretical basis for the further and wider application of chitosan in transdermal drug delivery systems. In the future, research results of chitosan and its derivatives in transdermal drug delivery need more support from in vivo experiments, as well as good correlation between in vitro and in vivo experiments. In conclusion, the excellent permeability-promoting property, good biocompatibility, and biodegradability of chitosan and its derivatives make them ideal materials for local transdermal drug delivery.
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Ma K, Jiang W, Wang YX, Wang L, Lv Y, Liu JF, Liu RG, Liu H, Xiao LZ, Du DP, Lu LJ, Yang XQ, Xia LJ, Huang D, Fu ZJ, Peng BG, Liu YQ. Expert consensus of the Chinese Association for the Study of Pain on pain treatment with the transdermal patch. World J Clin Cases 2021; 9:2110-2122. [PMID: 33850930 PMCID: PMC8017498 DOI: 10.12998/wjcc.v9.i9.2110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/14/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic pain lasting more than 3 mo, or even several years can lead to disability. Treating chronic pain safely and effectively is a critical challenge faced by clinicians. Because administration of analgesics through oral, intravenous or intramuscular routes is not satisfactory, research toward percutaneous delivery has gained interest. The transdermal patch is one such percutaneous delivery system that can deliver drugs through the skin and capillaries at a certain rate to achieve a systemic or local therapeutic effect in the affected area. It has many advantages including ease of administration and hepatic first pass metabolism avoidance as well as controlling drug delivery, which reduces the dose frequency and side effects. If not required, then the patch can be removed from the skin immediately. The scopolamine patch was the first transdermal patch to be approved for the treatment of motion sickness by the Food and Drug Administration in 1979. From then on, the transdermal patch has been widely used to treat many diseases. To date, no guidelines or consensus are available on the use of analgesic drugs through transdermal delivery. The pain branch of the Chinese Medical Association, after meeting and discussing with experts and based on clinical evidence, developed a consensus for promoting and regulating standard use of transdermal patches containing analgesic drugs.
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Affiliation(s)
- Ke Ma
- Department of Algology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Wei Jiang
- Department of Anesthesiology, Third Medical Center of People’s Liberation Army General Hospital, Beijing 100039, China
| | - Yun-Xia Wang
- Department of Algology, The Third People’s Hospital of Hubei Province, Hubei Zhongshan Hospital, Wuhan 430033, Hubei Province, China
| | - Lin Wang
- Department of Algology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
| | - Yan Lv
- Department of Algology, Xijing Hospital, Air Force Medical University, Xi'an 710032, Shaanxi Province, China
| | - Jin-Feng Liu
- Department of Algology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Rong-Guo Liu
- Department of Algology, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
| | - Hui Liu
- Department of Algology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Li-Zu Xiao
- Department of Algology, Shenzhen Sixth People’s Hospital (Nanshan Hospital), Shenzhen 518000, Guangdong Province, China
| | - Dong-Ping Du
- Department of Algology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
| | - Li-Juan Lu
- Department of Algology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
| | - Xiao-Qiu Yang
- Department of Algology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ling-Jie Xia
- Department of Algology, Henan Provincial People’s Hospital, Zhengzhou 450000, Henan Province, China
| | - Dong Huang
- Department of Algology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Zhi-Jian Fu
- Department of Algology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Bao-Gan Peng
- Department of Orthopedics, The Third Medical Center, General Hospital of the Chinese People’s Liberation Army, Beijing 100039, China
| | - Yan-Qing Liu
- Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
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4
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Characterization of microneedles and microchannels for enhanced transdermal drug delivery. Ther Deliv 2021; 12:77-103. [DOI: 10.4155/tde-2020-0096] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Microneedle (MN)-based technologies are currently one of the most innovative approaches that are being extensively investigated for transdermal delivery of low molecular weight drugs, biotherapeutic agents and vaccines. Extensive research reports, describing the fabrication and applications of different types of MNs, can be readily found in the literature. Effective characterization tools to evaluate the quality and performance of the MNs as well as for determination of the dimensional and kinetic properties of the microchannels created in the skin, are an essential and critical part of MN-based research. This review paper provides a comprehensive account of all such tools and techniques.
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Md S, Karim S, Saker SR, Gie OA, Hooi LC, Yee PH, Kang AWC, Zhe CK, Ian N, Aldawsari HM, Hosny KM, Alhakamy NA. Current Status and Challenges in Rotigotine Delivery. Curr Pharm Des 2020; 26:2222-2232. [PMID: 32175832 DOI: 10.2174/1381612826666200316154300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Abstract
Rotigotine is a non-ergoline, high lipophilic dopamine agonist. It is indicated as the first-line therapy for Parkinson's disease (PD) and Restless Leg Syndrome (RLS). However, the precise mechanism of rotigotine is yet to be known. Rotigotine has similar safety and tolerability to the other oral non-ergolinic dopamine antagonists in clinical trials, which include nausea, dizziness and somnolence. Neupro® was the first marketed transdermal patch formulation having rotigotine. The transdermal delivery system is advantageous as it enables continuous administration of the drug, thus providing steady-state plasma drug concentration for 24-hours. Intranasal administration of rotigotine allows the drug to bypass the blood-brain barrier enabling it to reach the central nervous system within minutes. Rotigotine can also be formulated as an extended-release microsphere for injection. Some challenges remain in other routes of rotigotine administration such as oral, parenteral and pulmonary, whereby resolving these challenges will be beneficial to patients as they are less invasive and comfortable in terms of administration. This review compiles recent work on rotigotine delivery, challenges and its future perspective.
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Affiliation(s)
- Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.,Center of Excellence for Drug Research & Pharmaceutical Industries, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shahid Karim
- Department of Pharmacology, College of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Sanggetha R Saker
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Ooi A Gie
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Lim C Hooi
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Phua H Yee
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Alvin W C Kang
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Chen K Zhe
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Ng Ian
- School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Hibah M Aldawsari
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.,Center of Excellence for Drug Research & Pharmaceutical Industries, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khaled M Hosny
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.,Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni- Suef University, Beni-Suef, Egypt
| | - Nabil A Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.,Center of Excellence for Drug Research & Pharmaceutical Industries, King Abdulaziz University, Jeddah, Saudi Arabia
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6
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Cheng PTM, Hawley P. Experiences with Cutting Matrix Fentanyl Patches as a Method of Dose Titration in Cancer Patients. J Palliat Med 2017; 20:1311-1312. [PMID: 28813614 DOI: 10.1089/jpm.2017.0368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Phoebe Tsz Man Cheng
- 1 Undergraduate Medical Program, University of British Columbia , Vancouver, British Columbia, Canada
| | - Philippa Hawley
- 2 Department of Pain and Symptom Management/Palliative Care Program, Vancouver Centre , BC Cancer Agency (BCCA), Vancouver, British Columbia, Canada .,3 Division of Palliative Care, Department of Medicine, University of British Columbia , Vancouver, British Columbia, Canada
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Chenevas-Paule C, Wolff HM, Ashton M, Schubert M, Dodou K. Development of a Predictive Model for the Stabilizer Concentration Estimation in Microreservoir Transdermal Drug Delivery Systems Using Lipophilic Pressure-Sensitive Adhesives as Matrix/Carrier. J Pharm Sci 2017; 106:1371-1383. [DOI: 10.1016/j.xphs.2017.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/03/2017] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
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Chenevas-Paule C, Wolff HM, Ashton M, Schubert M, Dodou K. Development of a Predictive Model for the Long-Term Stability Assessment of Drug-In-Adhesive Transdermal Films Using Polar Pressure-Sensitive Adhesives as Carrier/Matrix. J Pharm Sci 2017; 106:1293-1301. [PMID: 28088456 DOI: 10.1016/j.xphs.2017.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/10/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
Abstract
Drug crystallization in transdermal drug delivery systems is a critical quality defect. The impact of drug load and hydration on the physical stability of polar (acrylic) drug-in-adhesive (DIA) films was investigated with the objective to identify predictive formulation parameters with respect to drug solubility and long-term stability. Medicated acrylic films were prepared over a range of drug concentrations below and above saturation solubility and were characterized by Fourier transform infrared spectroscopy, differential scanning calorimetry, polarized microscopy, and dynamic vapor sorption (DVS) analysis. Physical stability of medicated films was monitored over 4 months under different storage conditions and was dependent on solubility parameters, Gibbs free energy for drug phase transition from the amorphous to the crystalline state, and relative humidity. DVS data, for assessing H-bonding capacity experimentally, were essential to predict physical stability at different humidities and were used together with Gibbs free energy change and the Hoffman equation to develop a new predictive thermodynamic model to estimate drug solubility and stability in DIA films taking into account relative humidity.
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Affiliation(s)
- Clémence Chenevas-Paule
- Sunderland Pharmacy School, Faculty of Applied Sciences, University of Sunderland, Sunderland SR13SD, UK
| | | | - Mark Ashton
- Sunderland Pharmacy School, Faculty of Applied Sciences, University of Sunderland, Sunderland SR13SD, UK
| | | | - Kalliopi Dodou
- Sunderland Pharmacy School, Faculty of Applied Sciences, University of Sunderland, Sunderland SR13SD, UK.
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10
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Teaching Caregivers to Administer Eye Drops, Transdermal Patches, and Suppositories. Am J Nurs 2017; 117:54-59. [PMID: 28030410 DOI: 10.1097/01.naj.0000511568.58187.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article is the third in a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project supported evidence that family caregivers aren't being given the information they need to manage the complex care regimens of their family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's medications. Each article explains the principles nurses should consider and reinforce with caregivers and is accompanied by a video for the caregiver to watch. The third video can be accessed at http://links.lww.com/AJN/A76.
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Chew ML, Mordenti J, Yeoh T, Ranade G, Qiu R, Fang J, Liang Y, Corrigan B. Minimization of CYP2D6 Polymorphic Differences and Improved Bioavailability via Transdermal Administration: Latrepirdine Example. Pharm Res 2016; 33:1873-80. [PMID: 27072954 DOI: 10.1007/s11095-016-1922-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 04/04/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Transdermal delivery has the potential to offer improved bioavailability by circumventing first-pass gut and hepatic metabolism. This study evaluated the pharmacokinetics of oral immediate release and transdermal latrepirdine in extensive and poor CYP2D6 metabolizers (EM/PM). METHODS Latrepirdine transdermal solution was prepared extemporaneously. The solution was applied with occlusive dressing to upper or middle back for 24 h. Each subject received a single dose of 8.14 mg oral, 5 mg transdermal, and 10 mg transdermal (EMs only) latrepirdine free base in a fixed sequence. RESULTS Twelve EMs and 7 PMs (50-79 years) enrolled and completed the study. Latrepirdine was well tolerated following both routes of administration. Dose-normalized latrepirdine total exposures were approximately 11-fold and 1.5-fold higher in EMs and PMs, respectively following administration of transdermal relative to oral. Differences between EM and PM latrepirdine exposures were decreased, with PMs having 1.9- and 2.7-fold higher peak and total exposures, respectively, following transdermal administration compared to 11- and 20-fold higher exposures, respectively, following oral administration. CONCLUSION Transdermal delivery can potentially mitigate the large intersubject differences observed with compounds metabolized primarily by CYP2D6. Transdermal delivery was readily accomplished in the clinic using an extemporaneously prepared solution [NCT00990613].
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Affiliation(s)
- Marci L Chew
- Pfizer Global Innovative Pharma, 445 Eastern Point Road, Groton, Connecticut, 06340, USA.
| | - Joyce Mordenti
- Formerly Medivation, San Francisco, California, 94105, USA
| | - Thean Yeoh
- Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut, 06340, USA
| | - Gautam Ranade
- Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut, 06340, USA
| | - Ruolun Qiu
- Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut, 06340, USA
| | - Juanzhi Fang
- Formerly Pfizer, Chatham, New Jersey, 07928, USA
| | - Yali Liang
- Pfizer Global Innovative Pharma, 445 Eastern Point Road, Groton, Connecticut, 06340, USA
| | - Brian Corrigan
- Pfizer Global Innovative Pharma, 445 Eastern Point Road, Groton, Connecticut, 06340, USA
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Gadzhanova S, Roughead EE, Pont LG. Safety of opioid patch initiation in Australian residential aged care. Med J Aust 2015; 203:298. [DOI: 10.5694/mja15.00174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 07/30/2015] [Indexed: 11/17/2022]
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13
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van der Maaden K, Sekerdag E, Schipper P, Kersten G, Jiskoot W, Bouwstra J. Layer-by-Layer Assembly of Inactivated Poliovirus and N-Trimethyl Chitosan on pH-Sensitive Microneedles for Dermal Vaccination. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2015; 31:8654-8660. [PMID: 26145437 DOI: 10.1021/acs.langmuir.5b01262] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this work was to coat pH-sensitive microneedle arrays with inactivated polio vaccine (IPV) particles and N-trimethyl chitosan chloride (TMC) via electrostatic interactions, and assess the immunogenicity of the vaccine after topical application of the coated microneedles in rats. The surface of 200 μm long microneedles was first chemically modified with pH-sensitive (pyridine) groups and then coated with negatively charged IPV and a positively charged polymer (TMC). To obtain a sufficient high antigen dose, 10 layers of IPV were alternately coated with TMC. The binding of IPV and TMC onto pH-sensitive microneedles was quantified and visualized by using fluorescently labeled TMC and IPV. The release of IPV and TMC from the microneedles was evaluated in ex vivo human skin by fluorescence and the immunogenicity of (unlabeled) IPV was assessed after topical application of the coated microneedles in rats. pH-sensitive microneedles were homogeneously coated with 10 layers of both IPV and TMC, resulting in 45 D antigen units IPV and 700 ng TMC per microneedle array. Fluorescence microscopy imaging revealed that both IPV and TMC were released into ex vivo human skin upon application of the coated microneedles. Finally, in vivo application of IPV-TMC-coated pH-sensitive microneedles in rats led to the induction of IPV specific antibody responses, illustrating that they are practically applicable. Topical administration of pH-sensitive microneedles coated with polyelectrolyte multinanolayers of antigens and oppositely charged polymers may be a useful approach for microneedle-based vaccination.
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Affiliation(s)
- Koen van der Maaden
- †Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, P.O. Box 2300 RA, 2311 EZ Leiden, The Netherlands
| | - Emine Sekerdag
- †Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, P.O. Box 2300 RA, 2311 EZ Leiden, The Netherlands
| | - Pim Schipper
- †Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, P.O. Box 2300 RA, 2311 EZ Leiden, The Netherlands
| | - Gideon Kersten
- †Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, P.O. Box 2300 RA, 2311 EZ Leiden, The Netherlands
- ‡Institute for Translational Vaccinology (Intravacc), P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Wim Jiskoot
- †Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, P.O. Box 2300 RA, 2311 EZ Leiden, The Netherlands
| | - Joke Bouwstra
- †Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, P.O. Box 2300 RA, 2311 EZ Leiden, The Netherlands
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van der Maaden K, Luttge R, Vos PJ, Bouwstra J, Kersten G, Ploemen I. Microneedle-based drug and vaccine delivery via nanoporous microneedle arrays. Drug Deliv Transl Res 2015; 5:397-406. [PMID: 26044672 PMCID: PMC4529475 DOI: 10.1007/s13346-015-0238-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In the literature, several types of microneedles have been extensively described. However, porous microneedle arrays only received minimal attention. Hence, only little is known about drug delivery via these microneedles. However, porous microneedle arrays may have potential for future microneedle-based drug and vaccine delivery and could be a valuable addition to the other microneedle-based drug delivery approaches. To gain more insight into porous microneedle technologies, the scientific and patent literature is reviewed, and we focus on the possibilities and constraints of porous microneedle technologies for dermal drug delivery. Furthermore, we show preliminary data with commercially available porous microneedles and describe future directions in this field of research.
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15
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Pastore MN, Kalia YN, Horstmann M, Roberts MS. Transdermal patches: history, development and pharmacology. Br J Pharmacol 2015; 172:2179-209. [PMID: 25560046 PMCID: PMC4403087 DOI: 10.1111/bph.13059] [Citation(s) in RCA: 260] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 12/24/2022] Open
Abstract
Transdermal patches are now widely used as cosmetic, topical and transdermal delivery systems. These patches represent a key outcome from the growth in skin science, technology and expertise developed through trial and error, clinical observation and evidence-based studies that date back to the first existing human records. This review begins with the earliest topical therapies and traces topical delivery to the present-day transdermal patches, describing along the way the initial trials, devices and drug delivery systems that underpin current transdermal patches and their actives. This is followed by consideration of the evolution in the various patch designs and their limitations as well as requirements for actives to be used for transdermal delivery. The properties of and issues associated with the use of currently marketed products, such as variability, safety and regulatory aspects, are then described. The review concludes by examining future prospects for transdermal patches and drug delivery systems, such as the combination of active delivery systems with patches, minimally invasive microneedle patches and cutaneous solutions, including metered-dose systems.
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MESH Headings
- Administration, Cutaneous
- Animals
- Chemistry, Pharmaceutical/history
- Drug Carriers
- History, 15th Century
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- History, Ancient
- Humans
- Pharmaceutical Preparations/administration & dosage
- Pharmaceutical Preparations/chemistry
- Pharmaceutical Preparations/history
- Technology, Pharmaceutical/history
- Technology, Pharmaceutical/methods
- Transdermal Patch/history
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Affiliation(s)
- Michael N Pastore
- School of Pharmacy and Medical Sciences, University of South AustraliaAdelaide, SA, Australia
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva & University of LausanneGeneva, Switzerland
| | - Michael Horstmann
- former Acino Pharma AG, now Independent Pharmacist (Transdermalpharma UG)Neuwied, Germany
| | - Michael S Roberts
- School of Pharmacy and Medical Sciences, University of South AustraliaAdelaide, SA, Australia
- Therapeutics Research Centre, School of Medicine, University of Queensland, Princess Alexandra HospitalBrisbane, Qld, Australia
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16
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Snell B, Moles R, Harding AM, Chandler K, Welch S, O'Sullivan G. Letters to the Editor. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2015. [DOI: 10.1002/j.2055-2335.2010.tb00570.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Beverley Snell
- Centre for International Health, Macfarlane Burnet Institute for Medical Research and Public Health; Melbourne Vic. 3001
| | - Rebekah Moles
- Faculty of Pharmacy; The University of Sydney; Sydney NSW 2006
| | - Andrew M Harding
- Maroondah Hospital, Senior Emergency Department Pharmacist (currently), Austin Hospital; Heidelberg Vic. 3084
| | | | - Susan Welch
- Medication Incident Committee St Vincent's Hospital; Darlinghurst NSW 2010
- Faculty of Pharmacy; University of Sydney; Sydney NSW 2006
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El-Say KM, Ahmed TA, Badr-Eldin SM, Fahmy U, Aldawsari H, Ahmed OAA. Enhanced permeation parameters of optimized nanostructured simvastatin transdermal films:ex vivoandin vivoevaluation. Pharm Dev Technol 2014; 20:919-926. [PMID: 25019166 DOI: 10.3109/10837450.2014.938859] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Khalid M El-Say
- a Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , King Abdulaziz University , Jeddah , Saudi Arabia
- b Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , Al-Azhar University , Cairo , Egypt
| | - Tarek A Ahmed
- a Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , King Abdulaziz University , Jeddah , Saudi Arabia
- b Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , Al-Azhar University , Cairo , Egypt
| | - Shaimaa M Badr-Eldin
- a Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , King Abdulaziz University , Jeddah , Saudi Arabia
- c Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , Cairo University , Cairo , Egypt , and
| | - Usama Fahmy
- a Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Hibah Aldawsari
- a Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Osama A A Ahmed
- a Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , King Abdulaziz University , Jeddah , Saudi Arabia
- d Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , Minia University , Minia , Egypt
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Lampert A, Seiberth J, Haefeli WE, Seidling HM. A systematic review of medication administration errors with transdermal patches. Expert Opin Drug Saf 2014; 13:1101-14. [DOI: 10.1517/14740338.2014.926888] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ahmed OAA, Afouna MI, El-Say KM, Abdel-Naim AB, Khedr A, Banjar ZM. Optimization of self-nanoemulsifying systems for the enhancement of in vivo hypoglycemic efficacy of glimepiride transdermal patches. Expert Opin Drug Deliv 2014; 11:1005-13. [PMID: 24702435 DOI: 10.1517/17425247.2014.906402] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To optimize and use of glimepiride (GMD)-loaded self-nanoemulsifying delivery systems (SNEDs) for the preparation of transdermal patches. METHODS Mixture design was utilized to optimize GMD-loaded SNEDs in acidic and aqueous pH media. Optimized GMD-loaded SNEDs were used in the preparation of chitosan (acidic) and hydroxypropyl methyl cellulose (HPMC) (aqueous) films. The prepared optimized formulations were investigated for ex vivo skin permeation, for in vivo hypoglycemic activity and for their pharmacokinetic parameters using animal model. RESULTS The optimized formulations showed flux value of (2.88 and 4.428 μg/cm(2)/h) through rat skin for chitosan and HPMC films, respectively. The pattern of GMD release from both formulations was in favor of Higuchi and approaching zero order models. The n values for Korsmeyer-Peppas equation were characteristic of anomalous (non-Fickian) release mechanism. Moreover, HPMC patches have shown significant reductions (p < 0.05) in blood glucose levels; (213.33 ± 15.19) mg/100 ml from the base-line measurement after 12 h of application. CONCLUSIONS Optimized GMD SNEDs patches were found to improve GMD skin permeability and the essential pharmacokinetic parameters. Further extensive pre/clinical studies are necessary prior to use transdermal GMD as a valuable alternative to peroral dosage forms with improved bioavailability, longer duration of action and more patient convenience.
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Affiliation(s)
- Osama A A Ahmed
- King Abdulaziz University, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , Jeddah-21589 , Saudi Arabia +966 599120686 ; +966 26951696 ; ,
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Wen W, Lynch SY, Munera C, Swanton R, Ripa SR, Maibach H. Application site adverse events associated with the buprenorphine transdermal system: a pooled analysis. Expert Opin Drug Saf 2013; 12:309-19. [PMID: 23506252 DOI: 10.1517/14740338.2013.780025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To characterize the profile of application site reactions (ASRs) for patients treated with the buprenorphine transdermal system (BTDS) in chronic pain studies. METHODS The incidences of ASRs during treatment with BTDS were examined using (a) integrated data from 16 controlled and uncontrolled Phase III chronic pain studies (N = 6566), (b) a subset of integrated data that focused on the double-blind phases of five enriched, placebo-controlled studies (n = 1806) and (c) data from an international postmarketing drug safety database. These data were compared with the ASR data reported in the full prescribing information of other transdermal patches marketed in the US. RESULTS Among the 6566 patients, the overall incidence of ASRs was 23.4%, of which 98.3% were mild to moderate in intensity, none were serious and 4.4% led to treatment discontinuation. Rates of severe and inflammatory ASRs were low. Among the 1806 patients, ASR rates were higher with BTDS (16.6%) than placebo transdermal system (12.7%). Among the 6566 patients, the 1806 patients, and the postmarketing data, the most common ASRs seen were pruritus, erythema and rash. Incidences of most ASRs for other selected transdermal products were 17% or lower. CONCLUSION Incidence rates of ASRs in patients treated with BTDS were low and infrequently led to discontinuation. Severe and inflammatory-type ASRs were not common. The ASR profile of BTDS was comparable with those of other transdermal patches.
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Affiliation(s)
- Warren Wen
- Purdue Pharma LP, One Stamford Forum, 7th Floor, Stamford, CT 06901, USA.
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Tsai CY, Chang CC. Auto-adhesive transdermal drug delivery patches using beetle inspired micropillar structures. J Mater Chem B 2013; 1:5963-5970. [DOI: 10.1039/c3tb20735h] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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van der Maaden K, Jiskoot W, Bouwstra J. Microneedle technologies for (trans)dermal drug and vaccine delivery. J Control Release 2012; 161:645-55. [DOI: 10.1016/j.jconrel.2012.01.042] [Citation(s) in RCA: 421] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 01/23/2012] [Accepted: 01/30/2012] [Indexed: 11/24/2022]
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Tam E, Furlan AD. Transdermal lidocaine and ketamine for neuropathic pain: a study of effectiveness and tolerability. Open Neurol J 2012; 6:58-64. [PMID: 22833771 PMCID: PMC3401865 DOI: 10.2174/1874205x01206010058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 02/21/2012] [Accepted: 03/02/2012] [Indexed: 02/05/2023] Open
Abstract
Background: Acute neuropathic pain is a common disorder. Transdermal cream could be an alternative to oral medications. Objective: To evaluate the effectiveness and tolerability of transdermal Lidocaine and Ketamine for acute neuropathic pain. Study Design: Retrospective chart review Setting: University-affiliated outpatient Physiatry clinic Methods: articipants: neuropathic pain with a prescription of a transdermal cream containing Lidocaine and Ketamine. Ef-fectiveness was evaluated by the number of patients with improvement divided by the total number of patients who re-ceived a prescription of the cream. Results: A total of 854 patient charts were reviewed. Twenty-one patients with symptoms, signs, and/or a documented di-agnosis of neuropathic pain and had been given a prescription of a transdermal preparation containing Lidocaine and Ketamine. Four groups were identified: those with a clearly stated diagnosis of neuropathic pain and prescribed a transdermal compound containing Lidocaine and Ketamine with follow-up (Group A) or without follow-up (Group B), and those with a suggested diagnosis of neuropathic pain with (Group C) or without follow-up (Group D). Effectiveness of the cream was seven out of eight (87%) for Group A and one out of three (33%) for Group C. In total, eight out of 11 patients (73%) benefited from a cream containing Lidocaine and Ketamine. Two patients experienced skin reactions that led to discontin-uation of treatment. Limitations: This is a retrospective chart review without control group. Conclusion: Transdermal cream containing Ketamine and Lidocaine was effective in 73% of patients with acute neuro-pathic pain and may be a good alternative to oral medications.
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Affiliation(s)
- Emily Tam
- Toronto Rehabilitation Institute, (University Health Network) 550 University Av, room 12-020, Toronto, ON, M5G 2A2, Canada
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Abstract
A medication's pharmacokinetic properties can be as important as its efficacy in determining how successful a treatment is. Formulation plays a critical role in absorption, distribution, and elimination of a drug, which in turn can influence the clinical profile of a medication, including onset and duration of action, consistency of plasma levels, ability to cross the blood-brain barrier, and other factors. Advances in drug delivery technology mean that formulation is now an integral component in the development of a drug. Likewise, formulation is one of the factors that may influence selection of a medication to suit the needs of a particular patient. This article briefly reviews the technologies commonly applied in the development of psychotropic medications, with emphasis on the various oral modified-release formulations, and discusses how formulation can be used to optimize the efficacy and tolerability of psychotropic drugs.
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Durand C, Alhammad A, Willett KC. Practical considerations for optimal transdermal drug delivery. Am J Health Syst Pharm 2012; 69:116-24. [PMID: 22215357 DOI: 10.2146/ajhp110158] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The properties of various transdermal drug delivery system (TDDS) products are reviewed, with safety recommendations and guidance on addressing questions frequently posed by patients and caregivers. SUMMARY Drug delivery via a TDDS can offer many advantages over other methods of administration, but those benefits can be compromised by improper use or alteration of medication patches or a lack of awareness of the properties of different patch types (reservoir, matrix, drug-in-adhesive). To assess current TDDS technologies and recommended practices for safe and effective use of medication patches, a literature search for articles on commonly used TDDS products available in the United States was conducted; supplemental information was obtained from package inserts and through direct communication with manufacturers. In addition to recommendations on the site and duration of TDDS application and proper patch disposal, clinicians must consider (1) potential problems with cutting patches as a method of dosage adjustment, (2) safety concerns related to the electric conductivity of metal-containing patches, (3) appropriate strategies for managing patch adhesion failures, and (4) the advisability of writing on patches for medication safety or compliance reasons. Clinicians should also be prepared to counsel patients about TDDS-specific recommendations on the avoidance of sunlight and other external heat sources during the use of a medication patch. CONCLUSION Practical considerations related to transdermal drug delivery include the appropriateness of cutting patches, the implications of their containing metallic components, and whether they may be covered with tape or written on. Manufacturers of patches provide some useful information on these topics.
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Affiliation(s)
- Cheryl Durand
- Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences (MCPHS)-Manchester, Manchester, NH, USA [corrected].
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Vashi NA, Souza A, Cohen N, Franklin B, Cohen DE. Allergic contact dermatitis caused by methylphenidate. Contact Dermatitis 2011; 65:183-5. [PMID: 21827513 DOI: 10.1111/j.1600-0536.2011.01949.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Neelam A Vashi
- Department of Dermatology, New York University School of Medicine, New York, NY 10016, USA.
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Abstract
INTRODUCTION Transdermal patch systems are an effective method of administering active ingredients through the skin, with considerable advantages over other drug delivery routes, for example, maintenance of constant plasma drug levels and avoidance of first-pass metabolism. However, repeated epicutaneous application may be associated with local skin reactions. AREAS COVERED This review addresses current issues regarding the effective/safe use of transdermal patch systems, and provides a critical analysis of the addition of 'skin-caring' ingredients to patch systems. Effective use of transdermal systems includes choosing an appropriate body area for application, maintaining regular skin care regimens before application and not replacing a patch in the same area (rotation) within 7 days. Another strategy, developed in an attempt to improve the tolerability of transdermal systems, is the addition of assumed 'skin-caring' ingredients (e.g., Aloe Vera) to patch systems. However, at present there is neither proof nor clinical evidence of any benefit. On the contrary, plant-derived ingredients might be associated with allergenic potential. EXPERT OPINION Transdermal systems are generally well tolerated; physicians must adequately inform patients of the most effective ways to use these formulations for maximum therapeutic benefit, while minimising local adverse events. Skin-caring agents, including Aloe Vera, cannot be recommended until well-controlled clinical trials with standardised extracts are available.
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Affiliation(s)
- Johannes Wohlrab
- Martin Luther University Halle-Wittenberg, Department of Dermatology and Venereology, Ernst-Kromayer-Str. 5, D 06097 Halle (Saale), Germany.
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Mas-Vidal A, Gómez-Díez S, Salgueiro-Vázquez M, Jimeno Demuth F. Intoxicación por opioides transdérmicos en un paciente con psoriasis generalizada. FARMACIA HOSPITALARIA 2010; 34:209-10. [DOI: 10.1016/j.farma.2009.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 09/19/2009] [Accepted: 10/07/2009] [Indexed: 10/19/2022] Open
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Abstract
Delivery of biologically active agents to animals is often perceived to be the poor relation of human drug delivery. Yet this field has a long and successful history of species-specific device and formulation development, ranging from simple approaches and devices used in production animals to more sophisticated formulations and approaches for a wide range of species. While several technologies using biodegradable polymers have been successfully marketed in a range of veterinary and human products, the transfer of delivery technologies has not been similarly applied across species. This may be due to a combination of specific technical requirements for use of devices in different species, inter-species pharmacokinetic, pharmacodynamic and physiological differences, and distinct market drivers for drug classes used in companion and food-producing animals. This chapter reviews selected commercialised and research-based parenteral and non-parenteral veterinary drug delivery technologies in selected domestic species. Emphasis is also placed on the impact of endogenous drug transporters on drug distribution characteristics in different species. In vitro models used to investigate carrier-dependent transport are reviewed. Species-specific expression of transporters in several tissues can account for inter-animal or inter-species pharmacokinetic variability, lack of predictability of drug efficacy, and potential drug-drug interactions.
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Affiliation(s)
- David J Brayden
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin (UCD) and UCD Conway Institute, Belfield, Dublin 4, Ireland.
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Cohen MR, Smetzer JL. Risk of Cutting Certain Medication Patches; Warfarin by Generic Name; Why Doctors Must Include Medication Purpose on Prescriptions; Carac-Kuric Mix-Ups. Hosp Pharm 2009. [DOI: 10.1310/hpj4401-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800–233–7767 (800–23-ERROR). Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
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Affiliation(s)
- Michael R. Cohen
- Institute for Safe Medication Practices, 200 Lakeside Drive, Suite 200, Horsham, PA 19044
| | - Judy L. Smetzer
- Institute for Safe Medication Practices, Horsham, Pennsylvania
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