Pulsatile drug-delivery systems.

Delivery systems with a pulsatile-release pattern are receiving increasing interest for the development of drugs for which conventional controlled drug-release systems with a continuous release are not ideal. These drugs often have a high first-pass effect or special chronopharmacological needs. A pulsatile-release profile is characterized by a time period of no release (lag time) followed by a rapid and complete drug release. Pulsatile drug-delivery systems can be classified into site-specific systems in which the drug is released at the desired site within the intestinal tract (e.g., the colon), or time-controlled devices in which the drug is released after a well-defined time period. Site-controlled release is usually controlled by environmental factors, like the pH or enzymes present in the intestinal tract, whereas the drug release from time-controlled systems is controlled primarily by the delivery system and, ideally, not by the environment. This review covers various single- and multiple-unit oral pulsatile drug-delivery systems with an emphasis on time-controlled drug-release systems.     

Advances in gastro retentive drug-delivery systems

INTRODUCTION: In recent years, various technological improvements have been achieved and new concepts have been developed, in the area of controlled release solid oral dosage forms, especially for products where an extended time of release is associated with an extended gastric retention time. These Gastro Retentive Systems have been quite investigated because they can improve the in-vivo performance of many drugs. AREAS COVERED: This paper summarizes current approaches in the research and development of gastro retentive dosage forms from recent literature. Apart from the numerous mechanisms of action involved, a short review of different key parameters is proposed, taking into account the stomach physiology. Most of the current technologies published, patented or marketed are presented. Promising drugs to develop in the near future are mentioned, and the importance of such systems in fixed Dose Combinations is also discussed. The importance of food effect is mentioned, and the impact of the multiple unit systems versus monolithic approach is discussed, especially regarding the dose intake. EXPERT OPINION: In conclusion, numerous mechanisms like floating, sinking, effervescence, swelling, bioadhesion, magnetic, etc. have been proposed over the years. While most of the proposed systems show promising dissolution profiles and in-vitro retention, only few of them have also shown success in-vivo. Currently, the polymeric swelling monolithic systems are the most prominent marketed forms. The possibility to combine different mechanisms in order to ensure true gastric retention even in the fasted state should be further investigated.     

Therapeutic opportunities in colon-specific drug-delivery systems

Oral colon-specific drug-delivery systems have recently gained importance for delivering a variety of therapeutic agents. The major obstacles to delivering drugs to the colon are the absorption and degradation pathways in the upper gastrointestinal tract. However, a successfully designed colon-targeted system can overcome these obstacles. Targeting drugs to the colon has proven quite valuable in a variety of disorders, and the colon has proven to be a potential site for local as well as systemic administration of drugs. Colon targeting has proven beneficial for local action in a variety of disease conditions, such as inflammatory bowel disease, irritable bowel syndrome, and colonic cancer. Aminosalicylates, corticosteroids, immunosuppressive agents, cationized antioxidant enzymes, genetically engineered bacteria to produce cytokines, nicotine, and other drugs have exhibited significantly enhanced efficacy when delivered to the colon. Targeting drugs to cancer cells through receptors and ligands have opened up new avenues in the treatment of colonic cancer. Colon targeting has also proven useful for systemic action of protein-peptide drugs such as insulin, calcitonin, and met-enkaphalin and even for other nonpeptide drugs such as cardiovascular and antiasthmatic agents. This review also presents various approaches for targeting orally administered dosage forms to the colon. The use of a prodrug approach, bioadhesive polymers, and coating with pH-sensitive and biodegradable polymers has been, to an extent, highly successful in delivering the targeted formulations to the site of action. Biodegrable hydrogels such as amylose, chondroitin sulphate, chitosan, inulin, guar gum, and pectin have also been successfully used to achieve oral colon-targeted delivery.     

Advances in gastro retentive drug-delivery systems

Introduction: In recent years, various technological improvements have been achieved and new concepts have been developed, in the area of controlled release solid oral dosage forms, especially for products where an extended time of release is associated with an extended gastric retention time. These Gastro Retentive Systems have been quite investigated because they can improve the in-vivo performance of many drugs.

Areas covered: This paper summarizes current approaches in the research and development of gastro retentive dosage forms from recent literature. Apart from the numerous mechanisms of action involved, a short review of different key parameters is proposed, taking into account the stomach physiology. Most of the current technologies published, patented or marketed are presented. Promising drugs to develop in the near future are mentioned, and the importance of such systems in fixed Dose Combinations is also discussed. The importance of food effect is mentioned, and the impact of the multiple unit systems versus monolithic approach is discussed, especially regarding the dose intake.

Expert opinion: In conclusion, numerous mechanisms like floating, sinking, effervescence, swelling, bioadhesion, magnetic, etc. have been proposed over the years. While most of the proposed systems show promising dissolution profiles and in-vitro retention, only few of them have also shown success in-vivo. Currently, the polymeric swelling monolithic systems are the most prominent marketed forms. The possibility to combine different mechanisms in order to ensure true gastric retention even in the fasted state should be further investigated.     

Nanofibers as drug-delivery systems for antimicrobial peptides

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Gastroretentive floating drug-delivery systems: a critical review

The oral delivery of drugs with a narrow absorption window in the gastrointestinal tract (GIT) is often limited by poor bioavailability with conventional dosage forms due to incomplete drug release and short residence time at the site of absorption. To overcome this drawback and to maximize the oral absorption of these drugs, gastroretentive systems such as mucoadhesive, high-density, expandable, and floating systems have been developed. These systems provide controlled delivery of drugs with prolonged gastric residence time. However, in humans, differences in various physiological and biological factors can affect the gastric residence time and drug-delivery behavior from gastroretentive systems. Some floating drug-delivery systems (FDDS) have shown the capability to accommodate these variations without affecting drug release. This review mainly focuses on various physiological considerations for development of FDDS, and highlights recent technological developments including new dosage forms and their production techniques (e.g., holt-melt extrusion, melt pelletization, and pulsed plasma-irradiation processes). Alternatives to the existing in vitro compendial methods for evaluating floating dosage forms will be discussed, and a critical analysis of the existing literature on FDDS, identifying the potential areas for future research, is provided.     

Retinoids: new use by innovative drug-delivery systems

Background: Retinoids represent an old class of bioactives used in the treatment of different skin pathologies (such as acne and psoriasis) and in the treatment of many tumors. Unfortunately, they present several side effects, i.e., burning of skin and general malaise after systemic administration and they are very unstable after exposition to light. Methods: One of the most promising new approaches for reducing the side effects of retinoids while improving their pharmacological effect is the use of drug-delivery devices. This review explains the current status of retinoid drug transport, which has been developing over the last few years, explaining the modification of their biopharmaceutical properties in detail after encapsulation/inclusion in vesicular and polymeric systems. Results/conclusion: Different colloidal and micellar systems containing retinoid drugs have been realized furnishing important potential advancements in traditional therapy.     

Challenges and solutions in topical ocular drug-delivery systems

Vision significantly affects quality of life and the treatment of ocular disease poses a number of unique challenges. This review presents the major challenges faced during topical ocular drug administration and highlights strategies used to overcome the natural transport barriers of the eye. The circulation of tear fluid and aqueous humor decrease the residence time of topically delivered drugs, while ocular barriers in the corneal and conjuctival epithelia and the retinal pigment epithelium limit transport. Successful treatment strategies increase the residence time of drugs in the eye and/or enhance the ability of the drug to penetrate the ocular barriers and reach the target tissue. In this review, we discuss several drug-delivery strategies that have achieved clinical success or demonstrate high potential. We also draw attention to a number of excellent reviews that explore various ocular drug-delivery techniques in depth. Finally, we highlight cutting-edge drug-delivery technologies that improve the efficacy of current drug-delivery methods or use proven techniques to deliver novel therapeutics.     

New drugs and drug-delivery systems in the year 2000

Innovative new drugs and drug-delivery systems are discussed as they pertain to health-care delivery for the next 20 years. In general, experts predict that new drugs will differ in three respects from today's agents: (1) they will be more specific, (2) they will act closer to the site of the lesion, and (3) they will more often be natural products such as peptides and proteins. Immunomodulators are expected to be greatly different as substances such as interferon and the interleukins are used clinically. Major innovations are likely to occur for neurotransmitters, neurotrophic hormones, and mood-altering drugs. Genetic engineering will also have a marked effect on the availability of certain kinds of drugs in large quantities, on the treatment of some inherited diseases, and on the prevention of cancer. Monoclonal antibodies and prostaglandins are already being considered for therapeutic roles. Finally, genetic engineering will permit the development of vaccines with increased safety profiles. Regarding drug-delivery systems, controlled-release technology is an area of intense research. Magnetic systems are in the development stage for the treatment of localized internal conditions such as tumors or transplanted organs. Implanted pumps, liposomes, and improved delivery of neurotransmitters are also being developed further. The implications of new drugs and delivery systems are far-reaching for pharmacists. The role of pharmacists as information providers will likely increase, and pharmacists will find that they increasingly will handle high-technology drug-delivery systems rather than simple tablets and syrups.     

Microspheres as floating drug-delivery systems to increase gastric retention of drugs

Gastric emptying is a complex process, which is highly variable and makes in vivo performance of the drug-delivery systems uncertain. In order to avoid this variability, efforts have been made to increase the retention time of the drug-delivery systems for more than 12 h. The floating or hydrodynamically controlled drug-delivery systems are useful in such applications. The present review addresses briefly the physiology of the gastric emptying process with respect to floating drug-delivery systems. In recent years, the multiparticulate drug-delivery systems are used in the oral delivery of drugs. One of the approaches toward this goal is to develop the floating microspheres so as to increase the gastric retention time. Such systems have more advantages over the single-unit dosage forms. The development of floating microspheres involves different solvent evaporation techniques to create the hollow inner core. The present review addresses the preparation and characterization of the floating microspheres for the peroral route of administration of the drug.     

Shear-induced solvent release from gel particles: application to drug-delivery systems

The behaviour of a swollen-in-water hydrogel particle and of a chitosan-alginate micro-capsule immersed in a silicon oil under shear is studied by the rheo-optical method. Both gel and capsule quantitatively behave in a same way. Shear stress leads to a solvent release from a particle and a further increase of shear stress induces the solvent detachment from the released areas. Particle deformation and solvent release are reversible: when stopping the shear, the particle recovers its initial shape and volume. But when some solvent is detached, it flows separately as would do low-viscosity droplets immersed in a high-viscosity matrix.     

Cell-based drug-delivery platforms

Cell systems have recently emerged as biological drug carriers, as an interesting alternative to other systems such as micro- and nano-particles. Different cells, such as carrier erythrocytes, bacterial ghosts and genetically engineered stem and dendritic cells have been used. They provide sustained release and specific delivery of drugs, enzymatic systems and genetic material to certain organs and tissues. Cell systems have potential applications for the treatment of cancer, HIV, intracellular infections, cardiovascular diseases, Parkinson's disease or in gene therapy. Carrier erythrocytes containing enzymes such us L-asparaginase, or drugs such as corticosteroids have been successfully used in humans. Bacterial ghosts have been widely used in the field of vaccines and also with drugs such as doxorubicin. Genetically engineered stem cells have been tested for cancer treatment and dendritic cells for immunotherapeutic vaccines. Although further research and more clinical trials are necessary, cell-based platforms are a promising strategy for drug delivery.     

Understanding the lipid-digestion processes in the GI tract before designing lipid-based drug-delivery systems

Many of the compounds present in lipid-based drug-delivery systems are esters, such as acylglycerols, phospholipids, polyethyleneglycol mono- and di-esters and polysorbate, which can be hydrolyzed by the various lipolytic enzymes present in the GI tract. Lipolysis of these compounds, along with dietary fats, affects the solubility, dispersion and bioavailibity of poorly water-soluble drugs. Pharmaceutical scientists have been taking a new interest in fat digestion in this context, and several studies presenting in vitro gastrointestinal lipolysis models have been published. In most models, it is generally assumed that pancreatic lipase is the main enzyme involved in the gastrointestinal lipolysis of lipid formulations. It was established, however, that gastric lipase, pancreatic carboxyl ester hydrolaze and pancreatic lipase-related protein 2 are the major players involved in the lipolysis of lipid excipients containing acylglycerols and polyethyleneglycol esters. These findings have shown that the lipolysis of lipid excipients may actually start in the stomach and involve several lipolytic enzymes. These findings should therefore be taken into account when testing in vitro the dispersion and bioavailability of poorly water-soluble drugs formulated with lipids. In this review, we present the latest data available about the lipolytic enzymes involved in gastrointestinal lipolysis and suggest tracks for designing physiologically relevant in vitro digestion models.     

Advancing transdermal drug-delivery systems past development barriers to the clinic: an industry perspective

"In order to increase the quality of transdermal drug-delivery systems, it [quality] must be built into the systemic product development".     

Selection and use of crystallization inhibitors for matrix-type transdermal drug-delivery systems containing sex steroids

The purpose of this study was to stabilize transdermal drug-delivery systems (TDDS) highly loaded with sex steroids against recrystallization of drugs during storage. To facilitate the selection of potential crystallization inhibitors a drug-excipient interaction test was also established. Analysis of the thermal behaviour of 1:1 steroid-excipient mixtures by differential scanning calorimetry (DSC) revealed that oestradiol and gestodene interact strongly with silicone dioxide and povidones, e.g. povidone K12. The addition of povidone K12 to polyacrylate-based matrix TDDS containing either 3% oestradiol or 2% gestodene resulted in stable systems which did not recrystallize during storage at 25 degrees C for more than 5 years. Significant recrystallization was, on the other hand, observed in non-stabilized reference patches even after 1 to 2 months storage. The DSC screening model proved very effective for selection of inhibitors of the crystallization of sex steroids in matrix TDDS. The crystallization inhibitor approach is a highly versatile stabilization tool for matrix patches containing high concentrations of sex steroids.     

On-off pulsed oral drug-delivery systems: a possible tool for drug delivery in chronotherapy

Circadian rhythms regulate most body functions and are important factors to consider when administering drugs. The existence of circadian rhythms in nature and their influences on human biological systems have given rise to the concept of chronotherapy, which is the science of delivering drugs in a synchronized manner with the rhythm-dependent circadian variation inherent in the human body. The safety and efficacy of a drug can be improved by matching the peak plasma concentration during a 24 h period of the rhythms. An on-off pulsed (pulsatile or time-controlled) release drug-delivery system offers rapid and transient release; stepwise release; and the sustained release of a certain amount of drug within a short time period after a predetermined off-release period according to the circadian rhythm of disease states. These systems deliver the drug at the right time and at an appropriate dosage and are the best approach for chronotherapy. These systems show promise for the optimal therapy of chronic diseases such as asthma, hypertension, myocardial infarction and arthritis, which show a circadian dependency. Various technologies have been adopted to mimic circadian rhythms in physiological functions and diseases. This review focuses on the basic concept of circadian rhythm, chronotherapy and recent advances in the development of on-off pulsed oral drug-delivery systems for optimal therapy.     

In vitro evaluation of intestinal absorption of desmopressin using drug-delivery systems based on superporous hydrogels

The aim of this study was to investigate and modify the potential of drug-delivery systems based on superporous hydrogel (SPH) for improving the intestinal transport of the peptide drug desmopressin in vitro. The swelling properties and mechanical strength of SPHs were studied. The release profile of desmopressin was investigated by changing the composition of excipients in the formulations. Subsequently, the ability of the SPH-based drug-delivery systems to enhance the transport of desmopressin across porcine intestine was performed in vitro. The swelling properties and mechanical strength of SPHs were affected by the addition of the disintregrant AcDiSol. This disintregrant reduced the swelling ratio to 10% and the time to 80% swelling was retarded by 3-5 min in comparison to the negative control. AcDiSol increased the mechanical strength, according to the increasing of penetration pressure value, the pressure that the punch can penetrate the gel, of the SPHs. The transport of desmopressin across the intestinal mucosa in vitro was enhanced four- and six-fold by applying SPH, with AcDiSol, in the absence and presence of the additional absorption enhancer trimethyl chitosan chloride, respectively, in comparison to the negative control. It is concluded that drug-delivery systems based on SPHs are promising for enhancing the intestinal absorption of desmopressin.