非洛地平-美托洛尔复方贴剂经不同动物皮肤的药物渗透性

目的制备非洛地平-美托洛尔复方透皮贴剂并研究经不同动物皮肤的体外药物渗透特性。方法采用改良的Franz透皮扩散装置,分别以离体小鼠、大鼠和兔皮肤为渗透屏障,生理盐水-乙醇(60:40)为接受液,用HPLC同时测定经皮渗透液中两药物的浓度,并计算渗透动力学参数。结果贴剂中,非洛地平和美托洛尔48 h内均以零级动力学经不同动物皮肤转运,并具一定同步性,动物皮肤对药物渗透性依次为:小鼠>大鼠>兔。结论非洛地平-美托洛尔复方透皮贴剂缓释长效特征明显,药物体外经皮渗透性稳定,各指标均可满足治疗血药浓度的要求。     

非洛地平-美托洛尔复方经皮给药系统的制备及其兔体内生物利用度

制备了非洛地平-美托洛尔复方经皮给药系统，并研究其药剂学性质及经兔皮肤给药的药代动力学和生物利用度。先建立了同时测定贴剂和经皮渗透液中非洛地平与美托洛尔含量的RP-HPLC方法，以考察贴剂的药物体外稳态透皮速率和经皮渗透机制，并进行质量控制和评价；再以高灵敏度的GC-ECD方法分别测定非洛地平和美托洛尔的血药浓度，研究贴剂经皮给药后在兔体内的药代动力学和生物利用度。结果显示，该给药系统的复方药物体外透皮转运具有零级动力学特征，其含量均匀度检查符合2005版中国药典规定，稳定性好；经皮给药的血药浓度明显较口服平稳，且波动性小，达峰时间推后，持效时间延长，非洛地平与美托洛尔的相对生物利用度分别为275.37%和189.76%。以上结果表明，非洛地平-美托洛尔复方经皮给药系统具有明显缓释特征，可较长时间维持稳定有效的血药浓度。     

非洛地平-美托洛尔复方透皮贴剂的处方与工艺研究

目的:考察并筛选非洛地平-美托洛尔(FEL-MET)复方透皮贴剂的基础处方与制备工艺。方法:以聚丙烯酸树脂Eu-dragit E PO和Eudragit RL PO为复合压敏胶,采用流涎法制备非洛地平-美托洛尔复方透皮贴剂。通过单因素试验考察处方与制备工艺对贴剂外观、物理黏性、药物体外释放和经皮渗透性等指标的影响,初步确定贴剂处方和工艺条件。结果:较佳的处方构成和工艺条件:FEL和MET载药量分别为2%~3%和20%~30%,Eudragit E PO∶Eudragit RL PO为4∶6~6∶4,贴剂厚度为(1·0±0·1)~(2·0±0·1)mm,固化条件为70℃干燥30min。上述各因素对贴剂质量考察指标影响显著。结论:筛选处方合理,工艺稳定可行,制备的贴剂质量符合相关要求。     

非洛地平-美托洛尔透皮贴剂与缓释片在兔体内药动学及生物利用度比较

目的：研究非洛地平-美托洛尔复方透皮贴剂与两药市售缓释片在兔体内药动学和生物利用度差异。方法：采用三周期随机交叉试验法，6只健康白兔随机分为3组，分别给予复方非洛地平-美托洛尔静脉注射液、透皮贴剂及两药市售缓释片各l片，以气相色谱-电子捕获法分别测定非洛地平和美托洛尔血药浓度，用DAS软件计算药动学参数和生物利用度，通过统计学检验评价不同剂型间差异。结果：透皮贴剂较口服缓释片药物吸收时间显著延长（P〈0.05），达峰时间显著推后（P〈0．05），血药浓度平稳，波动性小，体内作用时间长达2d-3d。贴剂中非洛地平和美托洛尔的生物利用度分别是其口服缓释片的114．30％和192．92％。结论：该贴荆缓释特征明显，达到了预期提高生物利用度、延长药物体内驻留时间、维持平稳血药浓度和方便用药的新剂型设计目的。     

非洛地平-美托洛尔复方经皮贴剂单次给药降压作用研究

目的评价非洛地平-关托洛尔复方经皮贴剂的降压作用。方法研制非洛地平-关托洛尔复方透皮给药系统，并将其应用于高血压大鼠，进行药效学评价。结果单次给药后，3个剂量组对收缩压、舒张压和心率的影响均呈剂量依赖性降低，分别与空白对照组和灌胃给药组比较，均有显著性差异（P〈0．05）。结论非洛地平-美托洛尔复方透皮贴剂的降压效果确切，降压作用平稳，持续时间长；其降压作用强度和持续时间具有剂量依赖性，降压效果优于非洛地平和美托洛尔的口服给药。     

长春西汀透皮贴剂的研制及体外释药机理的探讨

目的:制备长春西汀透皮贴剂,研究其体外释药机理.方法:在单层贴剂优化处方的基础上制备了单层、双层和三层贴剂,比较不同类型贴剂经不同皮肤的体外渗透速率,对三层贴剂进行了质量考察并研究了其释药机理.结果:三层贴剂和双层贴剂的经皮渗透量大于单层贴剂.去除角质层的皮肤对药物经皮渗透的屏障作用明显小于完整皮肤. 结论:长春西汀贴剂质量可控,刺激性小,药物经皮吸收的主要屏障为角质层,在经皮渗透中有较微弱的储库效应,其渗透行为主要是零级释药模式.     

双氯芬酸钠微乳的家兔皮肤刺激性及体外透皮吸收性能评价

目的:对双氯芬酸钠微乳(DS-ME)的性质、皮肤刺激性及体外透皮吸收进行考察,探讨其局部外用给药的可行性。方法:采用紫外分光光度法测定DS-ME中DS的含量;采用激光粒度仪测定DS-ME的粒径分布;家兔皮肤刺激性实验考察DS-ME和空白ME对单次给药正常皮肤、多次给药正常皮肤和单次给药破损皮肤的影响;Franz扩散池法比较DS-ME与市售DS凝胶经小鼠离体皮肤的透皮参数。结果:所制DS-ME为O/W型微乳,粒径为(30.140±9.020)nm;与空白ME比较,DS-ME对家兔皮肤的刺激评分无明显差异;DS-ME与市售DS凝胶的稳态渗透速率分别为34.16、18.62μg/(cm~2·h),渗透系数分别为1.029、0.561 cm/h,滞后时间分别为0.124 2、0.367 2 h。结论:DS-ME的粒径小,无皮肤刺激性,可提高DS的透皮吸收速率。     

烟酰胺在正常和气虚兔皮肤上促透作用的比较

目的:对比烟酰胺在正常和气虚家兔皮肤上的促透作用。方法:以烟酰胺为模型药在正常家兔与气虚家兔皮肤上进行透皮实验,测量不同时间接受液的药物浓度,计算其累积渗透量和渗透系数;制备病理切片,观察组织结构的变化。结果:与正常家兔离体皮肤的渗透系数比较,气虚家兔离体皮肤的渗透系数较低,二者比较有显著性差异(P<0.01)。病理组织切片显示,正常兔皮上皮细胞排列较为疏松,细胞间隙较大,上皮组织薄,脂肪等吸水性物质较多,脂肪层厚;气虚兔皮相对正常兔皮其上皮组织细胞排列紧密,脂肪较少。结论:正常家兔皮肤对烟酰胺的渗透性比气虚家兔皮肤更强。     

非洛地平-硬脂酸固体脂质纳米粒的制备及其体外透皮吸收研究

目的:以固体脂质纳米粒为栽体,通过透皮给药达到提高非洛地平透皮吸收及缓释长效的目的.方法:采用溶剂挥发-超声法制备非洛地平固体脂质纳米粒水分散体,以大鼠皮肤为渗透屏障对非洛地平固体脂质纳米粒的经皮渗透进行研究.结果:非洛地平-硬脂酸固体脂质纳米粒为类球形实体粒子,平均粒径范围在50～150 nm,包封率大于85%,栽药量大于7%,药物体外释放符合一级动力学过程.体外经皮渗透速率显著高于空白对照组.结论:非洛地平固体脂质纳米粒处方设计合理,制备工艺可靠,以纳米粒作为透皮给药载体具有广阔的发展前景.     

可乐定透皮贴剂体外透皮性能研究

目的:研究可乐定透皮贴剂体外透皮性能.方法:用离体豚鼠皮肤为透皮屏障,采用改进Franz扩散池,比较康倍得公司研制的可乐定透皮贴剂(C-TTS)、美国的可乐定透皮贴剂(Catapres-TTS)和国内的可乐定透皮贴剂(N-TTS)的体外透皮性能.检测方法为高效液相色谱法.结果:C-TTS与Catapres-TTS两种贴剂体外经皮渗透曲线符合零级方程(Q=kt),两者透皮速率无显著性差异(P>0.05);N-TTS体外经皮渗透曲线符合Ritger-peppas方程(Q=ktm),其透皮速率与C-TTS比较有显著性差异(P<0.01).3种样品试验结束揭去贴片后,皮肤中有一定的药物残留量,并且残留量与贴片面积呈线性关系.结论:C-TTS可以维持7d的恒定经皮渗透,与Catapres-TTS体外透皮行为相似.     

Oestrogen functions in skin and skin appendages

Oestrogens have significant effects on different cell types important in skin physiology, including the epidermal keratinocytes, dermal fibroblasts and melanocytes. In addition, they can also modulate skin appendages such as the hair follicle, the sebaceous gland and the apocrine glands. Oestrogens may also have important modulatory roles in events such as skin ageing, pigmentation, hair growth, sebum production and skin cancer. It is now recognised that oestrogens can modulate their actions via two distinct intracellular receptors (ERα and ERβ) or via cell surface receptors, which activate specific second messenger signalling pathways. This paper highlights the effects of oestrogens on different components of the skin and reviews some of the more recent developments in terms of receptor expression and cell signalling pathways.     

Oestrogen functions in skin and skin appendages

Oestrogens have significant effects on different cell types important in skin physiology, including the epidermal keratinocytes, dermal fibroblasts and melanocytes. In addition, they can also modulate skin appendages such as the hair follicle, the sebaceous gland and the apocrine glands. Oestrogens may also have important modulatory roles in events such as skin ageing, pigmentation, hair growth, sebum production and skin cancer. It is now recognised that oestrogens can modulate their actions via two distinct intracellular receptors (ERalpha and ERbeta) or via cell surface receptors, which activate specific second messenger signalling pathways. This paper highlights the effects of oestrogens on different components of the skin and reviews some of the more recent developments in terms of receptor expression and cell signalling pathways.     

Treatment of bacterial skin and skin structure infections

Bacterial skin and skin structure infections (SSSIs) are among the most frequently seen infectious entities in the community setting and occasionally in the institutional setting. A wide variety of SSSIs exist, with cellulitis, impetigo and folliculitis being the most common. Most SSSIs are caused by aerobic staphylococci and streptococci, with aerobic Gram-negative bacilli and anaerobes being involved in more complicated infections. Systemic therapy with a variety of beta-lactams, macrolides and lincosamides (clindamycin) have been the cornerstone of SSSI therapy for many years. With the exception of mupirocin, topical therapy occupies a small therapeutic niche. Despite the emergence of antimicrobial resistance among the pathogens most commonly associated with SSSIs (for example, Streptococcus pyogenes and macrolides; Staphylococcus aureus and methicillin, vancomycin, penicillin and mupirocin), few treatment failures have been reported. The newest antimicrobials reviewed herein (linezolid, quinupristin/dalfopristin, gatifloxacin, gemifloxacin and moxifloxacin) are not a significant improvement upon older agents in the treatment of SSSIs. Perhaps this assessment will change if the penetrance of the antimicrobial resistance patterns described above reach a critical threshold and clinical failures become more widespread.     

Moxifloxacin in uncomplicated skin and skin structure infections

Moxifloxacin is a fluoroquinolone antibacterial agent which attains good penetration into peripheral tissues and inflammatory fluids. The drug shows good in vitro activity against staphylococci and streptococci. Moxifloxacin is therefore a suitable option for the treatment of uncomplicated skin and skin structure infections of bacterial origin. In clinical trials, moxifloxacin was as effective as cephalexin in the treatment of uncomplicated skin and skin structure infections in patients aged >or=18 years. Moxifloxacin 400mg once daily or cephalexin 500mg three times daily for 7 days both resulted in clinical resolution in 84% of patients during a double-blind, randomised trial in 401 patients (intent-to-treat). The main infectious agent in this study was Staphylococcus aureus. Similar results were obtained in two other randomised, double-blind trials published as abstracts. The bioavailability of moxifloxacin is substantially reduced by coadministration with antacids or iron preparations. Moxifloxacin, however, does not show pharmacokinetic interaction with theophylline or warfarin. Dosage adjustments are not required in patients with renal impairment or in patients with mild to moderate hepatic insufficiency. The most common adverse events reported during moxifloxacin treatment are gastrointestinal disturbances. The potential for photosensitivity reactions during moxifloxacin treatment is low.     

腹部皮下血管网皮瓣修复手指皮肤脱套伤

目的客观判定腹部皮下血管网皮瓣修复术治疗手指皮肤脱套伤的疗效。方法应用传统的腹部袋状皮瓣和腹部带皮下血管网皮瓣治疗手部脱套伤,并将两种方法的治疗结果进行对比。结果 手指的屈伸功能效果方面,实验组82.2,对照组46.6;治疗后的外观效果方面,实验组优良率68.9,对照组优良率37.78。结论腹部皮下血管网皮瓣修复法是一种较理想的修复手指皮肤脱套伤的治疗方法。     

Oritavancin for acute bacterial skin and skin structure infections

Introduction: Inpatient treatment of acute bacterial skin and skin structure infections (ABSSSIs) exerts a significant economic burden on the healthcare system. Oritavancin is a concentration-dependent, rapid bactericidal agent approved for the treatment of ABSSSIs. Its prolonged half-life with one-time intravenous (i.v.) dosing offers a potential solution to this burden. In addition, oritavancin represents an alternative therapy for Streptococci and multidrug-resistant Gram-positive bacteria including methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. Animal models have also shown promising results with oritavancin for other disease states including those that require long courses of i.v. therapy.

Areas covered: This review covers oritavancin’s basic chemistry, spectrum of activity, pharmacodynamics/pharmacokinetics and efficacy in clinical trials, and provides expert opinion on future directions. To compose this review, a search of PubMed was performed, and articles written in the English language were selected based on full text availability.

Expert opinion: If oritavancin is proven to be a cost-effective strategy for outpatient treatment and prevents complications of prolonged i.v. therapy, it will be sought as an alternative antibiotic therapy for ABSSSIs. In addition, further clinical data demonstrating efficacy in Gram-positive infections requiring prolonged therapy such as endocarditis and osteomyelitis could support oritavancin’s success in the current market.     

Anticoagulant-related skin reactions

Cutaneous reactions have been reported during anticoagulant therapy with coumarin derivatives, unfractionated and low molecular weight heparins, heparinoids, danaparoid and hirudins. Anticoagulant-induced skin reactions vary from local allergic manifestations to skin necrosis. In patients with allergic reactions, diagnosis and crossreactions between anticoagulants can be confirmed by intracutaneous testing. Coumarin- and heparin-induced skin necrosis are rare, but are important side effects due to their high morbidity and occasional mortality. Cutaneous tests are contraindicated in these patients. In the future, anticoagulant strategies may include direct synthetic thrombin inhibitors (argatroban and melagatran/ximelagatran) and the Factor Xa inhibitor, pentasaccharide (fondaparinux).     

HSP27 as a biomarker for predicting skin irritation in human skin and reconstructed organotypic skin model

In vitro alternative tests aiming at replacing the traditional animal test for predicting the irritant potential of chemicals have been developed, but the assessing parameters or endpoints are still not sufficient. To discover novel endpoints for skin irritation responses, 2DE-based proteomics was used to analyze the protein expression in human skin exposed to sodium lauryl sulfate (SLS) following the test protocol of the European Centre for the Validation of Alternative Methods (ECVAM) in the present study. HSP27 was up-regulated most significantly among the eight identified proteins, consistent with our previous reports. Acid and basic chemicals were applied on human skin for further validation and results showed that the up-regulated expression of HSP27 was induced in 24 h after the exposure. Skin-equivalent constructed with fibroblasts, basement membrane and keratinocytes was used to investigate the potential of HSP27 as a biomarker or additional endpoint for the hazard assessment of skin irritation. Our skin-equivalent (Reconstructed Organotypic Skin Model, ROSM) had excellent epidermal differentiation and was suitable for the skin irritation test. HSP27 also displayed an up-regulated expression in the ROSM in 24 h after the irritants exposure for 15 min. All these results suggest that HSP27 may represent a potential marker or additional endpoint for the hazard assessment of skin irritation caused by chemical products.     

Impact of phenytoin therapy on the skin and skin disease

Phenytoin (diphenylhydantoin; Dilantin), ALZA Corp.) is a highly effective and widely prescribed anticonvulsant agent used in the treatment of focal and tonic clonic generalised seizures. The side effects of phenytoin can occassionally engender significant morbidity. Phenytoin can induce generalised eruptions that include: a maculopapular exanthem, Stevens-Johnson syndrome, generalised exfoliative dermatitis, toxic epidermal necrolysis, vasculitis and fixed drug eruptions. Phenytoin is linked to a hypersensitivity syndrome that manifests with fever, rash and lymphadenopathy. Patients receiving phenytoin may develop pseudolymphoma or, rarely, malignant lymphoma and mycosis fungoides-like lesions. Rarer cutaneous side effects include drug-induced lupus, purple hand syndrome, pigmentary alterations and IgA bullous dermatosis. Phenytoin can effect clotting function and alter vitamin and mineral levels. Prenatal exposure to phenytoin may result in a spectrum of structural, developmental and behavioural changes, known as the fetal hydantoin syndrome. Patients who use phenytoin in the long-term commonly manifest with gingival hyperplasia, coarsening of the facies, and hirsutism.