Comparison of nasal, rectal, buccal, sublingual and intramuscular insulin efficacy and the effects of a bile salt absorption promoter

The purpose of this investigation was to develop a method to quantitate insulin absorption, and to compare insulin absorption from various noninjection sites of administration. Log dose/effect curves were established for i.m. insulin in adult male rats. The effects measured were the maximum change in plasma glucose concentration and the cumulative percentage of change in plasma glucose concentrations from 0 to 4 hr. Both log dose/effect curves gave similar results when calculating the efficacy of other routes, relative to i.m. Nasal, buccal, sublingual and rectal absorption sites were isolated by ligation procedures or with physical barriers. Rectal insulin was more efficacious than nasal, buccal and sublingual insulin, when administered without an absorption-promoting adjuvant. However, the efficacy relative to i.m. insulin was low for each route, probably due to a combination of slow membrane permeation and metabolism at the absorption site. Administration in a solution containing 5% sodium glycocholate, an absorption-promoting adjuvant, increased insulin efficacy by each route. The rank order was nasal greater than rectal greater than buccal greater than sublingual, with nasal and rectal insulin being roughly half as efficacious as i.m. insulin. Orally administered insulin, at doses 5 times higher than administered by other routes, and with Na glycocholate, produced no hypoglycemic response.     

Analysis of transient and reversible effects of poly-L-arginine on the in vivo nasal absorption of FITC-dextran in rats.

We have investigated whether poly-L-arginine, with a mean molecular weights of 8.9 and 45.5 kDa (poly-L-Arg (10) and poly-L-Arg (50)), can induce transient and reversible effects involving enhancement of the nasal absorption of fluorescein isothiocyanate-labeled dextran (MW 4.4 kDa, FD-4) and determined the main pathway for the increased transport of FD-4 in rats in vivo. Pre-administration and repeated administration studies were conducted involving the selection of different time intervals between intranasal administration of poly-L-Arg and administration of FD-4, with and without poly-L-Arg, to characterize these transient and reversible effects. The degradation of poly-L-Args in a diluted nasal drip was determined from the fluorescence of degraded poly-L-Arg-fluorescamine products. In the pre-administration study, poly-L-Arg exhibited a transient effect on the increased nasal FD-4 absorption depending on its molecular weight, associated with the degradation rate of poly-L-Arg in mucus. In the repeated administration study, additional poly-L-Arg produced similarly enhanced FD-4 absorption. Confocal laser scanning microscopy showed that fluorescence of FD-4 after co-administration of poly-L-Arg (50) was confined mainly to the paracellular spaces. In conclusion, poly-L-Arg exhibited molecular weight-dependent transient and reversible effects on the enhancement of nasal FD-4 absorption paracellularly in rats in vivo. The enzymatic degradation of poly-L-Arg is one of the key determinants of the transient effect on in vivo enhanced absorption of FD-4.     

Recent advances in buccal drug delivery and absorption--in vitro and in vivo studies.

In the first part of this study, the aim was to characterize transport of fluorescein isothiocyanate (FITC)-labelled dextrans of different molecular weights as model compounds for peptides and proteins through buccal mucosa. The penetration of these dextrans through porcine buccal mucosa (a nonkeratinized epithelium, comparable to human buccal mucosa) was investigated by measuring transbuccal fluxes and by analyzing the distribution of the fluorescent probe in the epithelium, using confocal laser scanning microscopy for visualizing permeation pathways. The results revealed that passage of hydrophilic compounds such as the FITC-dextrans through porcine buccal epithelium is restricted to permeants with a molecular weight lower than 20 kDa. The permeabilities of buccal mucosa for the 4 and 10 kDa FITC-dextran (of the order of 10(-8) cm/s) were not significantly different from each other or from the much smaller compound FITC. The confocal images of the distribution pattern of FITC-dextrans showed that the paracellular route is the major pathway through buccal epithelium. In the in vivo part of this study, buccal delivery of FITC-labelled dextran 4400 (FD4) and the peptide drug buserelin was investigated in vivo, in pigs. The delivery device consisted of an application chamber with a solution of FD4 or buserelin, and was attached to the buccal mucosa for 4 h using an adhesive patch. A randomized cross-over study including intravenous administration and buccal delivery without and with 10 mM sodium glycodeoxycholate (GDC) as an absorption enhancer was performed in pigs. After buccal administration, steady-state plasma levels were rapidly achieved. Co-administration of 10 mM GDC increased the absolute bioavailability from 1.8+/-0.5 to 12.7+/-2.0% for FD4. From the present studies, it is concluded that buccal administration is a suitable route for the delivery for macromolecules and hydrophilic compounds such as peptide drugs.     

Absorption and metabolism of nafarelin, a potent agonist of gonadotropin-releasing hormone

Nafarelin, a potent gonadotropin-releasing hormone (GnRH) agonist, was absorbed rapidly into systemic circulation (time to reach peak concentration, 20 to 40 minutes) after intranasal but not after sublingual or vaginal administration. Serum elimination half-life was about 2 hours. Nasal absorption of nafarelin was increased by increasing the concentration of the drug in the dose solution and incorporating sodium glycocholate into the nasal formulation. An optimal formulation providing maximum nasal absorption of nafarelin was one containing 1.75 mg nafarelin per ml and 2% sodium glycocholate. Bioavailability of this nasal formulation relative to a single subcutaneous dose averaged 21%. The metabolism and excretion of nafarelin were determined in three subjects after subcutaneous administration of [14C]-nafarelin. Radioactivity was excreted in approximately equal amounts in urine and stool. Six metabolites accounted for most of the radioactivity in urine. Four metabolites were short peptide fragments of nafarelin and the other metabolites were naphthylalanine and 2-naphthylacetic acid.     

Effects of bile salts on transport rates and routes of FITC-labelled compounds across porcine buccal epithelium in vitro

In this study the penetration enhancing effect of bile salts on the transport of hydrophilic macromolecular compounds across porcine buccal mucosa was investigated in-vitro. Coadministration of 100 mM of the trihydroxy bile salts sodium glycocholate (GC) and sodium taurocholate (TC) and the dihydroxy bile salts sodium glycodeoxycholate (GDC) and sodium taurodeoxycholate (TDC) increased the in-vitro transport of fluorescein isothiocyanate (FITC) by a factor of a hundred or more, without a significant difference between the four bile salts. The concentration dependence of the enhancing effect of GDC was studied using FITC-labelled dextrans of increasing molecular weight as permeants (FD4, MW 4400; FD10, MW 9400; FD20, MW 19 600). The maximal enhancement was observed when GDC was coadministered in a concentration of 10 mM, resulting in an enhancement ratio of about 2000 for FD4. Using confocal laser scanning microscopy the effects of bile salts on the penetration pathways of hydrophilic compounds were investigated. The uniform distribution of FITC throughout the epithelium was changed by coadministration of 100 mM of bile salt to an increased amount of the fluorescent probe present in the intercellular domains. The intercellular distribution of both FD4 and FD10 was not changed by a low, but effective, concentration of GDC (2 mM, enhancement ratio of 72 for FD4). Increasing the concentration of GDC to 10 and 100 mM resulted in uptake of the fluorescent probe in the epithelial cells. From these results we conclude that the di- and trihydroxy bile salts studied increase the transport of hydrophilic compounds across buccal epithelium in vitro, below 10 mM by increasing the intercellular transport and at 10 mM and higher concentrations by opening up a transcellular route.     

Effect of administration site in the gastrointestinal tract on bioavailability of poorly absorbed drugs taken after a meal.

Food-drug interactions may reduce the bioavailability of drugs taken after meals (negative food effect). In order to develop pharmaceutical technologies that overcome this problem, the effect of administration site within the gastrointestinal tract on the bioavailability of several model drugs was examined in rats. Bioavailability after oral administration to fed animals was one-fifth to one-tenth of that in the fasted animals because of interactions between drugs and large amounts of food components remaining in the stomach. This strong negative food effect was reduced when drugs were administered directly into any site of the small intestine. Bioavailability was maximized when the drug administration site was the middle small intestine. On the other hand, intracolonic administration did not result in the reduction of the negative food effect. Site-specific drug delivery to the middle small intestine could be a useful approach for reducing the negative food effect on drug absorption with maximized bioavailability.     

Buccal bioadhesive drug delivery--a promising option for orally less efficient drugs.

Rapid developments in the field of molecular biology and gene technology resulted in generation of many macromolecular drugs including peptides, proteins, polysaccharides and nucleic acids in great number possessing superior pharmacological efficacy with site specificity and devoid of untoward and toxic effects. However, the main impediment for the oral delivery of these drugs as potential therapeutic agents is their extensive presystemic metabolism, instability in acidic environment resulting into inadequate and erratic oral absorption. Parenteral route of administration is the only established route that overcomes all these drawbacks associated with these orally less/inefficient drugs. But, these formulations are costly, have least patient compliance, require repeated administration, in addition to the other hazardous effects associated with this route. Over the last few decades' pharmaceutical scientists throughout the world are trying to explore transdermal and transmucosal routes as an alternative to injections. Among the various transmucosal sites available, mucosa of the buccal cavity was found to be the most convenient and easily accessible site for the delivery of therapeutic agents for both local and systemic delivery as retentive dosage forms, because it has expanse of smooth muscle which is relatively immobile, abundant vascularization, rapid recovery time after exposure to stress and the near absence of langerhans cells. Direct access to the systemic circulation through the internal jugular vein bypasses drugs from the hepatic first pass metabolism leading to high bioavailability. Further, these dosage forms are self-administrable, cheap and have superior patient compliance. Developing a dosage form with the optimum pharmacokinetics is a promising area for continued research as it is enormously important and intellectually challenging. With the right dosage form design, local environment of the mucosa can be controlled and manipulated in order to optimize the rate of drug dissolution and permeation. A rational approach to dosage form design requires a complete understanding of the physicochemical and biopharmaceutical properties of the drug and excipients. Advances in experimental and computational methodologies will be helpful in shortening the processing time from formulation design to clinical use. This paper aims to review the developments in the buccal adhesive drug delivery systems to provide basic principles to the young scientists, which will be useful to circumvent the difficulties associated with the formulation design.     

Inducible nitric oxide synthase knockout mice exhibit resistance to the multiple organ failure induced by zymosan.

In the present study, by comparing the responses in wild-type mice (+/+) and mice lacking (-/-) the inducible (or type 2) nitric oxide synthase (iNOS), we investigated the role played by iNOS in the development of non-septic shock. A severe inflammatory response characterized by peritoneal exudation, high peritoneal levels of nitrate/nitrite, and leukocyte infiltration into peritoneal exudate was induced by zymosan administration in iNOS +/+ mice. This inflammatory process coincided with the damage of lung, liver, and small intestine, as assessed by histological examination. Lung, small intestine, and liver myeloperoxidase (MPO) activity, indicative of neutrophil infiltration and lipid peroxidation, were significantly increased in zymosan-treated iNOS +/+ mice. Peritoneal administration of zymosan in the iNOS +/+ mice induced also a significant increase in the plasma levels of nitrite/nitrate and in the levels of peroxynitrite at 18 h after zymosan challenge. Immunohistochemical examination demonstrated a marked increase in the immunoreactivity to nitrotyrosine and to poly ADP-ribose synthetase (PARS) in the lung, liver, and intestine of zymosan-treated iNOS +/+ mice. The intensity and degree of nitrotyrosine and PARS were markedly reduced in tissue section from zymosan-iNOS -/- mice. Zymosan-treated iNOS -/- mice showed a significantly decreased mortality and inhibition of the development of peritonitis. In addition, iNOS -/- mice showed a significant protection on the development of organ failure since tissue injury and MPO were reduced in lung, small intestine, and liver. Furthermore, a significant reduction of suppression of mitochondrial respiration, DNA strand breakage, and reduction of cellular levels of NAD+ was observed in ex vivo macrophages harvested from the peritoneal cavity of iNOS -/- mice subjected to zymosan-induced non-septic shock. In vivo treatment with aminoguanidine (300 mg/kg 1 and 6 h after zymosan administration) significantly prevents the inflammatory process. Taken together, our results clearly demonstrate that iNOS plays an important role in zymosan-induced non-septic shock.     

Intranasal delivery of systemic drugs: a new route for opioid drugs

The intranasal delivery of drugs is widely used for the local treatment of rhinitis or nasal polyposis. This route of delivery could represent an interesting alternative for systemic drugs with low digestive absorption. The nasal mucosa acts as an anatomical obstacle hard to get over, except for compounds with low molecular weight or highly lipophilic. Among morphinic drugs, fentanyl, very lipophilic, is rapidly absorbed via intranasal administration with a bioavailability close to 90%. This route of delivery for fentanyl is a new alternative for the treatment of breakthrough pain and gives the opportunity to discuss on the interest and the limits of nasal route administration of drugs, particularly of opioids.     

Absorption across the nasal airway mucosa in house dust mite perennial allergic rhinitis

House dust mite allergens express protease activity and it has been suggested that this property has pathogenic effects by increasing airway absorption. In accordance, house dust mite allergens may increase mucosal permeability in vitro. The objective of the present study was to examine nasal absorption of desmopressin (1-deamino-8-D-arginine vasopressin) in patients with perennial house dust mite allergic rhinitis and in healthy subjects in vivo. Patients with perennial allergic rhinitis were examined after a 4-week treatment withdrawal period, when symptoms of allergic rhinitis occurred, and healthy subjects were examined together with the patients. Desmopressin (20 microg ml(-1)) was moved into the nasal cavity using a nasal pool-device that contained 15 ml fluid. The fluid was kept in the nasal cavity for 15 min and then recovered. Urine was collected for 24 h after the nasal administration and the urinary excretion of desmopressin was determined as an index of nasal absorption. The urinary excretion of desmopressin was 1148+/-535 pmol 24 h(-1) in patients with perennial house dust mite allergic rhinitis and 1012+/-291 pmol 24 h(-1) in healthy subjects. We conclude that nasal airway absorption of the 1067 Da peptide desmopressin is unaffected in perennial house dust mite allergic rhinitis compared with healthy subjects.     

Gastro-intestinal patch system for the delivery of erythropoietin.

The absorption of erythropoietin (EPO) from rat small intestine was studied using gastro-intestinal patches (GI-PS) in the presence of absorption enhancers. Surfactants such as a saturated polyglycolysed C8-C18 glyceride (Gelucire 44/14), PEG-8 capryl/caprylic acid glycerides (Labrasol), and polyoxyethylene hydrogenated castor oil derivative (HCO-60) were used as absorption enhancers at 143, 94 and 20 mg/kg, respectively. The absorption of EPO was studied by measuring serum EPO levels by an ELISA method after small intestinal administration of EPO-GI-PS preparation in rats at the EPO dose level of 100 IU/kg. Labrasol showed the highest absorption enhancing effect after intrajejunum administration with maximum serum EPO level of 84.1+/-11.4 mIU/ml while Gelucire 44/14 and HCO-60 showed 43.5+/-9.8 and 26.5+/-2.3 mIU/ml, respectively. The appropriate site for EPO absorption was also investigated. Jejunum was found to be the most efficient absorption site for the absorption of EPO from GI-PS. Using Labrasol as the absorption enhancer and jejunum as the absorption site, the effect of EPO dose on EPO absorption was studied by increasing the EPO dose from 50, to 100, 300 and 600 IU/kg. It was found that 100 IU/kg was the optimum dose with a serum EPO level of 84.1+/-11.4 mIU/ml while escalating doses showed decreases in serum EPO levels 48.3+/-5.6 for 300 IU/kg and 50.6+/-10.3 mIU/ml for 600 IU/kg. The percent bioavailability (BA) of EPO-GI-PS with Labrasol as absorption enhancer was 7.9 at 50 IU/kg, 12.1 at 100 IU/kg, 3.2 at 300 IU/kg and 1.2 at 600 IU/kg. Histological studies showed no adverse effect at the site of administration.     

Development of omeprazole buccal adhesive tablets with stability enhancement in human saliva.

To develop an omeprazole buccal adhesive tablet, the absorption of omeprazole solutions from human oral cavity was evaluated and the physicochemical properties such as the bioadhesive forces of various omeprazole tablet formulations composed of bioadhesive polymers and alkali materials, and the stability of omeprazole tablets in human saliva were investigated. About 23% of the administered dose was absorbed from the oral cavity at 15 min after the administration of omeprazole solutions (1 mg/15 ml). A mixture of sodium alginate and HPMC was selected as the bioadhesive additive for the omeprazole tablet. Omeprazole tablets prepared with bioadhesive polymers alone had the bioadhesive forces suitable for buccal adhesive tablets, but the stability of omeprazole in human saliva was not satisfied. Among alkali materials, only magnesium oxide could be an alkali stabilizer for omeprazole buccal adhesive tablets due to its strong waterproofing effect. Two tablets composed of [omeprazole/sodium alginate/HPMC/magnesium oxide (20/24/6/50, mg/tab)] and [(20/30/0/50, mg/tab)] were suitable for omeprazole buccal adhesive tablets which could be attached to human cheeks without collapse and could be stabilized in human saliva for at least 4 h. It was concluded that these two formulae were potential candidates for the subject of further study for the development of omeprazole buccal adhesive tablets.     

Inhibition of active hexose and amino acid transport by conjugated bile salts in rat ileum

Abstract. The effect of conjugated trihydroxy bile salts, tauro- and glycocholate, and of deoxycholate on tissue uptake and mucosal to serosal transfer of actively transported hex-oses and amino acids has been examined in rat small intestine in vitro. Conjugated trihydroxy bile salts and deoxycholate markedly inhibited active transport of hexoses and amino acids in the ileum of rat small intestine, whereas in the jejunum, deoxycholate alone was inhibitory. The inhibitory effect of tauro- and glycocholate increased with incubation time. It persisted after washing of the tissue and reincubation with hexoses in a bile salt free medium, and could be observed with only 2 × 10^-4 M taurocholate. Taurocholate was able to evoke an increase of transmural potential difference (PD) in the ileum, but did not affect PD in the jejunum. Prein cubation of ileal small intestine with taurocholate depressed subsequent glucose-induced PD-increments. In the jejunum, however, taurocholate did not affect PD-increments induced by D-glucose. It is concluded that conjugated trihydroxy bile salts have to enter intestinal mucosal epithelial cells to an appreciable extent in order to affect other active, energy-requiring transport systems in rat small intestine. Previous results showing a failure of conjugated bile salts to inhibit active transport of hexoses and amino acids are explained by the fact that only jejunal transport had been examined.     

Prenatal diagnosis of cleft palate: contribution of color Doppler ultrasound.

The antenatal diagnosis of cleft palate by ultrasound can sometimes be difficult by conventional B-mode imaging, especially when the tongue is in its normal position.We describe two cases which illustrate the value of color Doppler in the antenatal diagnosis of cleft palate. In the first case, at 32 weeks' gestation, there was a large defect with a massive passage of flow extending from the buccal cavity into one of the nasal fossae. In the second case, at 22 weeks' gestation, a parasagittal view demonstrated the fetal tongue to be in the normal position, but there was an abnormal trajectory off low from the buccal cavity into one of the nasal fossae followed by an exit at the level of the cleft. Although a cleft lip was demonstrated on B-mode imaging, we would not have been able to make the diagnosis of cleft palate without color Doppler.This is the first report describing the contribution of color Doppler to the antenatal diagnosis of cleft palate.     

Intranasal drug delivery: an efficient and non-invasive route for systemic administration: focus on opioids

Intranasal administration is a non-invasive route for drug delivery, which is widely used for the local treatment of rhinitis or nasal polyposis. Since drugs can be absorbed into the systemic circulation through the nasal mucosa, this route may also be used in a range of acute or chronic conditions requiring considerable systemic exposure. Indeed, it offers advantages such as ease of administration, rapid onset of action, and avoidance of first-pass metabolism, which consequently offers for example an interesting alternative to intravenous, subcutaneous, oral transmucosal, oral or rectal administration in the management of pain with opioids. Given these indisputable interests, fentanyl-containing formulations have been recently approved and marketed for the treatment of breakthrough cancer pain. This review will outline the relevant aspects of the therapeutic interest and limits of intranasal delivery of drugs, with a special focus on opioids, together with an in-depth discussion of the physiological characteristics of the nasal cavity as well as physicochemical properties (lipophilicity, molecular weight, ionisation) and pharmaceutical factors (absorption enhancers, devices for application) that should be considered for the development of nasal drugs.     

Oral uptake and translocation of a polylysine dendrimer with a lipid surface.

A series of lipidic peptide dendrimers based on lysine with 16 surface alkyl (C(12)) chains has been synthesised in our laboratories. One of the series, a fourth generation dendrimer with a diameter of 2.5 nm was chosen to study its absorption after oral administration to female Sprague-Dawley rats (180 g, 9 weeks old). It was synthesised as the tritiated derivative (all acetyl portions) and had a molecular weight of 6300 and log P (octanol/water) of 1.24. First a single oral dose 14 mg/kg was administered by gavage. Maximum levels of dendrimer observed were 15% in the small intestine, 5% in the large intestine and 3% in the blood at 6 h after administration, while 1.5% reached the liver, 0.1% the spleen and 0. 5% the kidneys. In a parallel study with a higher dose of 28 mg/kg, approximately 1% was absorbed via Peyer's patches of the small intestine at 3 h. The maximum uptake by small intestine enterocytes was 4% of the dose after 3 h. After 12 h, 0.3 and 4% dendrimer was measured respectively in Peyer's patches and enterocytes of the large intestine. When calculated on the basis of target tissue weight, the total percentage of the dose absorbed through Peyer's patches was greater than through normal enterocytes in the small intestine after 3 and 24 h, but the opposite was true in the large intestine. These levels of uptake and translocation are lower than those exhibited by polystyrene particles in the range from 50 to 3000 nm. This might suggest that there is an optimum size for nanoparticulate uptake by the gut.     

腹部闭合性外伤性小肠破裂32例临床分析

目的探讨腹部闭合性外伤性小肠破裂的早期诊断和治疗方法。方法回顾性分析手术治疗的腹部闭合性外伤性小肠破裂32例临床资料。结果32例腹部闭合性外伤性小肠破裂全部手术治愈,术后发生肺部感染1例,腹腔内感染1例,肠粘连梗阻1例,切口感染2例,均经保守治疗治愈。结论掌握腹部闭合性外伤性小肠破裂的临床特点,及时诊断与合理治疗是提高临床治愈率和降低术后并发症发生率的关键。     

Involvement of human organic anion transporting polypeptide OATP-B (SLC21A9) in pH-dependent transport across intestinal apical membrane

Some organic anions are absorbed from the gastrointestinal tract through carrier-mediated transport mechanism(s), which may include proton-coupled transport, anion exchange transport, and others. However, the molecular identity of the organic anion transporters localized at the apical membrane of human intestinal epithelial cells has not been clearly demonstrated. In the present study, we focused on human organic anion transporting polypeptide OATP-B and examined its subcellular localization and functionality in the small intestine. Localization of OATP-B was determined by immunohistochemical analysis. Transport properties of estrone-3-sulfate and the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitor pravastatin by OATP-B-transfected human embryonic kidney 293 cells were measured. OATP-B was immunohistochemically localized at the apical membrane of intestinal epithelial cells in humans. Uptake of [3H]estrone-3-sulfate and [14C]pravastatin by OATP-B at pH 5.5 was higher than that at pH 7.4. [3H]Estrone-3-sulfate transport was decreased by pravastatin, aromatic anion compounds, and the anion exchange inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid, but not by small anionic compounds, such as lactic acid and acetic acid. The inhibitory effect of pravastatin on the uptake of [3H]estrone-3-sulfate was concentration-dependent, and the IC50 value was 5.5 mM. The results suggested that OATP-B mediates absorption of anionic compounds and its activity may be optimum at the acidic surface microclimate pH of the small intestine. Accordingly, OATP-B plays a role in the absorption of anionic compounds across the apical membrane of human intestinal epithelial cells, although it cannot be decisively concluded that pH-dependent absorption of pravastatin is determined by OATP-B alone.     

Scintigraphic evaluation in rabbits of nasal drug delivery systems based on carbopol 971p((R)) and carboxymethylcellulose.

The residence time of apomorphine mucoadhesive preparations incorporating 99mTc labeled colloidal albumin in rabbit nasal cavity was evaluated by gamma scintigraphy. This technique was used to compare the nasal clearance of preparations based either on Carbopol 971P((R)) or lactose (control), each with and without apomorphine, or carboxymethylcellulose with apomorphine. The planar 1-min images showed an excipient-dependent progressive migration of radioactivity with time from the nasal cavity to the stomach and intestine. Thirty minutes post insufflation, the percentages of the formulations cleared from the nasal cavity were 47% for lactose, 26% for lactose/apomorphine, 10% for Carbopol 971P((R)), and 3% for both Carbopol 971P((R))/apomorphine and carboxymethylcellulose/apomorphine. Three hours post insufflation, the percentages of the formulations cleared from the nasal cavity were 70% for lactose, 58% for lactose/apomorphine, 24% for Carbopol 971P((R)), 12% for Carbopol 971P((R))/apomorphine, and 27% for carboxymethylcellulose/apomorphine. Apomorphine inhibited nasal mucociliary clearance since migration of the radioactivity administered with apomorphine containing preparations was in all cases slower than that of the corresponding powder without apomorphine. The peak plasma concentration of apomorphine was attained while all the formulations were still within the nasal cavity. The use of mucoadhesive polymers such as Carbopol 971P((R)) or carboxymethylcellulose in nasal dosage forms increases their residence time within the nasal cavity and provides the opportunity for sustained nasal drug delivery.     

Physicochemical determinants of nasal drug absorption

Intranasal absorption has been demonstrated for various drugs, including peptidic compounds, under a wide range of delivery conditions. However, little is known of the physicochemical nature of the nasal mucosal membrane and how specific changes in the nasal microenvironment affect molecular transport. Using a modification of a previously reported ex vivo rat flow circuit model, we studied the nasal uptake of a series of alkanoic acids, alcohols, and steroids to determine the effects of pH, buffers, molecular size, and lipophilic/hydrophilic characteristics on nasal mucosal membrane transport. Nasal absorption was evaluated by measuring the rate of disappearance of radiolabeled test compounds from a recirculating bath. The uptake of each compound by flow circuit components was assessed prior to the animal studies to minimize system artifacts.Our preliminary results indicate that nasal membrane integrity is preserved for at least one hour in the ex vivo recirculation system. The absorption rates for decanoic, octanoic and hexanoic acids were pH dependent, reaching a maximum at pH 4.5, and steadily decreasing at more acidic or basic pH values. Further, the temporal pattern of the absorption profiles for the alkanoic acids was also pH dependent. Nasal absorption of mannitol was negligible, whereas, rate of uptake of steroid drugs was related to lipophilic/hydrophilic character and was pH independent.These findings suggest that for nonionized molecules, the nasal mucosal membrane is essentially a modified lipophilic transport barrier without obvious evidence of aqueous pores. Further, due to the complex architecture offered by the nasal passages, and the presence of a multicomponent overlying mucus layer, boundary layer mixing effects and microenvironmental pH may influence transport of charged species.