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Current Opinion in Biotechnology Apr 1991Methods for the delivery of the products of biotechnology, namely peptides and proteins, are reviewed. More efficient methods of parenteral administration include the... (Review)
Review
Methods for the delivery of the products of biotechnology, namely peptides and proteins, are reviewed. More efficient methods of parenteral administration include the incorporation of drugs in liposomes, whereas the system favoured for respiratory delivery is the nasal route. The improved oral delivery of polypeptides remains an elusive goal.
Topics: Animals; Drug Administration Routes; Drug Delivery Systems; Humans; Recombinant Proteins
PubMed: 1367865
DOI: 10.1016/0958-1669(91)90018-z -
Pediatric Emergency Care Jul 2014Intranasal medication administration in the emergency care of children has been reported for at least 20 years and is gaining popularity because of ease of... (Review)
Review
Intranasal medication administration in the emergency care of children has been reported for at least 20 years and is gaining popularity because of ease of administration, rapid onset of action, and relatively little pain to the patient. The ability to avoid a needle stick is often attractive to practitioners, in addition to children and their parents. In time-critical situations for which emergent administration of medication is needed, the intranasal route may be associated with more rapid medication administration. This article reviews the use of intranasal medications in the emergency care of children. Particular attention will be paid to anatomy and its impact on drug delivery, pharmacodynamics, medications currently administered by this route, delivery devices available, tips for use, and future directions.
Topics: Administration, Intranasal; Analgesics; Anticonvulsants; Child; Drug Administration Routes; Drug Delivery Systems; Emergency Treatment; Humans; Hypnotics and Sedatives; Nose; Pediatrics; Pharmacokinetics
PubMed: 24987995
DOI: 10.1097/PEC.0000000000000171 -
Pharmaceutical Research May 2009Anatomy and physiology of the eye makes it a highly protected organ. Designing an effective therapy for ocular diseases, especially for the posterior segment, has been... (Review)
Review
Anatomy and physiology of the eye makes it a highly protected organ. Designing an effective therapy for ocular diseases, especially for the posterior segment, has been considered as a formidable task. Limitations of topical and intravitreal route of administration have challenged scientists to find alternative mode of administration like periocular routes. Transporter targeted drug delivery has generated a great deal of interest in the field because of its potential to overcome many barriers associated with current therapy. Application of nanotechnology has been very promising in the treatment of a gamut of diseases. In this review, we have briefly discussed several ocular drug delivery systems such as microemulsions, nanosuspensions, nanoparticles, liposomes, niosomes, dendrimers, implants, and hydrogels. Potential for ocular gene therapy has also been described in this article. In near future, a great deal of attention will be paid to develop non-invasive sustained drug release for both anterior and posterior segment eye disorders. A better understanding of nature of ocular diseases, barriers and factors affecting in vivo performance, would greatly drive the development of new delivery systems. Current momentum in the invention of new drug delivery systems hold a promise towards much improved therapies for the treatment of vision threatening disorders.
Topics: Animals; Drug Administration Routes; Drug Delivery Systems; Eye Diseases; Humans; Nanotechnology
PubMed: 18758924
DOI: 10.1007/s11095-008-9694-0 -
Nature Reviews. Drug Discovery Jan 2019Biologics now constitute a significant element of available medical treatments. Owing to their clinical and commercial success, biologics are a rapidly growing class and... (Review)
Review
Biologics now constitute a significant element of available medical treatments. Owing to their clinical and commercial success, biologics are a rapidly growing class and have become a dominant therapeutic modality. Although most of the successful biologics to date are drugs that bear a peptidic backbone, ranging from small peptides to monoclonal antibodies (~500 residues; 150 kDa), new biologic modalities, such as nucleotide-based therapeutics and viral gene therapies, are rapidly maturing towards widespread clinical use. Given the rise of peptides and proteins in the pharmaceutical landscape, tremendous research and development interest exists in developing less-invasive or non-invasive routes for the systemic delivery of biologics, including subcutaneous, transdermal, oral, inhalation, nasal and buccal routes. This Review summarizes the current status, latest updates and future prospects for such delivery of peptides, proteins and other biologics.
Topics: Administration, Inhalation; Administration, Intranasal; Administration, Oral; Biological Products; Drug Administration Routes; Drug Carriers; Drug Delivery Systems; Drug Stability; Humans
PubMed: 30498202
DOI: 10.1038/nrd.2018.183 -
Discovery Medicine Jan 2019NSAIDs may prevent Alzheimer's disease (AD) but have failed as a treatment, possibly because only 1-2% of an oral NSAID dose reaches the brain. This minuscule dose is... (Review)
Review
NSAIDs may prevent Alzheimer's disease (AD) but have failed as a treatment, possibly because only 1-2% of an oral NSAID dose reaches the brain. This minuscule dose is enough to have a preventative effect on Alzheimer's disease but not to treat it. We propose a new route of administration for drugs to treat AD: transspinal delivery by transdermal patch over the back-of-neck/cervical spine. The drug would diffuse from the patch through the intervertebral spaces, penetrate the dura, enter the CSF, and reach the brain. For example, diclofenac from a transdermal patch over the back of neck should readily penetrate the dura mater to reach the CSF and brain; since the analgesic ziconotide, and antisense molecules for treating spinal muscular atrophy in children and Huntington's disease, are delivered intrathecally and readily enter the brain. In addition to NSAIDs, an anticancer drug, paclitaxel, has considerable potential as an AD treatment. Paclitaxel is administered IV. But the blood-brain penetration of paclitaxel is poor and paclitaxel has systemic side effects such as anemia, leukopenia, peripheral neuropathy, etc. A high dose of paclitaxel might be administered to the brain by transdermal patch over the back of the neck/cervical spine while avoiding the systemic side effects. A transdermal patch over the cervical spine could revolutionize the drug therapy of AD, and probably other neurodegenerative/neuropsychiatric diseases as well.
Topics: Administration, Cutaneous; Alzheimer Disease; Anti-Inflammatory Agents, Non-Steroidal; Antineoplastic Combined Chemotherapy Protocols; Back; Diclofenac; Drug Administration Routes; Drug Delivery Systems; Humans; Neck; Neoplasms; Transdermal Patch
PubMed: 30721650
DOI: No ID Found -
Chemical Immunology and Allergy 2010Epinephrine (adrenaline) is universally recommended as the initial drug of choice for the treatment of anaphylaxis. No other medication has similar life-saving... (Review)
Review
Epinephrine (adrenaline) is universally recommended as the initial drug of choice for the treatment of anaphylaxis. No other medication has similar life-saving pharmacologic effects in multiple organ systems, including prevention and relief of both upper and lower airway obstruction, and of shock. Failure to inject epinephrine promptly contributes to anaphylaxis fatalities. It is most effective when given immediately after the onset of anaphylaxis symptoms. The initial recommended adult dose is 0.3-0.5 mg, injected intramuscularly in the anterolateral aspect of the mid-thigh. Injected by other routes, epinephrine appears to have a less satisfactory therapeutic window; for example, onset of action is potentially delayed when it is injected subcutaneously, and risk of adverse effects potentially increases when it is injected intravenously. The possibility of randomized, controlled trials of epinephrine in anaphylaxis should be considered. For ethical reasons, these trials will not be placebo-controlled. They might involve comparison of one epinephrine dose versus another, or one route of epinephrine administration versus another. For first-aid treatment of people with anaphylaxis in the community, novel epinephrine formulations are being developed. These include epinephrine autoinjectors that are safer and easier to use, and epinephrine formulations that can be administered through non-invasive routes.
Topics: Anaphylaxis; Community Medicine; Drug Administration Routes; Drug Dosage Calculations; Epinephrine; Humans; Practice Guidelines as Topic; Randomized Controlled Trials as Topic
PubMed: 20519893
DOI: 10.1159/000315954 -
British Journal of Addiction Mar 1992Route of administration of various drugs is an area of study to which specific attention must be paid in study of different HIV risks of drug use by various routes. If...
Route of administration of various drugs is an area of study to which specific attention must be paid in study of different HIV risks of drug use by various routes. If changes in route are seen in individuals or within populations, then study of these transitions in route may identify new approaches which could be developed in HIV prevention. The consideration in this paper is based around ten questions: (i) What is a transition? (ii) Do routes of administration vary by time and place? (iii) Is choice of route influenced by availability of drug paraphernalia? (iv) How does the context influence initial choice of administration, and possible subsequent transitions? (v) Are lapse and relapse meaningful concepts? (vi) Transitions: how much of it is going on? (vii) How much does change of route (with the same drug) signify a change of drug effect, its significance, or its relationship with other risk behaviour? (viii) Is change of route of use of one drug always accompanied by the same change of route of other drugs? (ix) Injectors/non-injectors and sharers/non-sharers: do these behavioural characteristics exist as categories or are they distributed along a continuum? (x) Are transitions reversible? This paper is accompanied by two research reports which describe explorations into the extent and nature of transitions amongst heroin users.
Topics: Cocaine; Drug Administration Routes; HIV Seroprevalence; Heroin Dependence; Humans; Illicit Drugs; Needle Sharing; Substance Abuse, Intravenous
PubMed: 1559046
DOI: 10.1111/j.1360-0443.1992.tb01948.x -
The Annals of Pharmacotherapy Jul 2015To review the administration of antidepressant and antipsychotic medications via inhaled, intranasal, buccal, sublingual, transdermal, and rectal routes. (Review)
Review
OBJECTIVE
To review the administration of antidepressant and antipsychotic medications via inhaled, intranasal, buccal, sublingual, transdermal, and rectal routes.
DATA SOURCES
A PubMed search was conducted for all data through March 31, 2015 to identify pertinent literature. Search terms included the generic name of each antidepressant and antipsychotic medication in combination with the following terms: alternate routes of administration, inhaled, intranasal, buccal, sublingual, transdermal, and rectal.
STUDY SELECTION AND DATA EXTRACTION
English-language case reports, studies, and reviews describing medication administration in human subjects were included.
DATA SYNTHESIS
Commercially available products that use an alternative route of administration include loxapine for inhalation, asenapine for sublingual administration, and selegiline for transdermal administration. Case reports and studies describe intranasal, sublingual, and transdermal routes of administration of antipsychotic medications as well as buccal, sublingual, transdermal, and rectal administration of antidepressant medications. The concordance between the physicochemical properties possessed by some antipsychotic and antidepressant agents and the physicochemical properties required for nontraditional routes of administration suggest that administration via alternative routes may be feasible for some of these drugs. Further exploration of drug absorption via alternative routes in addition to consideration of patient and formulation factors may yield improvements in medication therapy for patients with psychiatric illnesses.
CONCLUSIONS
For patients unable to tolerate oral or injectable therapy, administration of psychotropic medications via nontraditional routes may be feasible. The development of alternative routes of drug delivery could prevent discontinuation of needed medication therapy.
Topics: Administration, Buccal; Administration, Cutaneous; Administration, Inhalation; Administration, Intranasal; Administration, Rectal; Administration, Sublingual; Antidepressive Agents; Antipsychotic Agents; Humans; Mental Disorders
PubMed: 25907529
DOI: 10.1177/1060028015583893 -
Pharmaceutical Nanotechnology 2019Diabetes is a group of diseases characterized by hyperglycemia and originating from the deficiency or resistance to insulin, or both. Ultimately, the most effective... (Review)
Review
Diabetes is a group of diseases characterized by hyperglycemia and originating from the deficiency or resistance to insulin, or both. Ultimately, the most effective treatment for patients with diabetes involves subcutaneous injections of insulin. However, this route of administration is often painful and inconvenient, as most patients will have to selfadminister it at least twice a day for the rest of their lives. Also, infection, insulin precipitation, and either lipoatrophy or lipohypertrophy are frequently observed at the site of injection. To date, several alternative routes of insulin administration have been explored, including nasal, pulmonary and oral. Although the delivery of insulin is an ideal route for diabetic patients, several limitations have to be overcome such as the rapid degradation of insulin in gastric fluid and low oral bioavailability. Numerous strategies have been carried out to improve these limited parameters such as the use of enzyme inhibitors, absorption enhancers, mucoadhesive polymers and chemical modification for receptor-mediated absorption. Also, insulin-loaded nanocarriers bypass several physiological barriers. This current review focuses on the various barriers existing in the delivery of insulin through the oral route and the strategies undertaken so far to overcome those obstacles using nanocarriers as a potential vehicle of insulin.
Topics: Administration, Inhalation; Administration, Intranasal; Administration, Oral; Animals; Diabetes Mellitus; Drug Carriers; Drug Compounding; Humans; Insulin; Nanoparticles; Polymers
PubMed: 30907328
DOI: 10.2174/2211738507666190321110721 -
Veterinary Parasitology Mar 2017The goal of the current study was to evaluate the comparative efficacy of ivermectin (IVM) against small strongyles (cyathostomins) following its oral and intramuscular... (Randomized Controlled Trial)
Randomized Controlled Trial
The goal of the current study was to evaluate the comparative efficacy of ivermectin (IVM) against small strongyles (cyathostomins) following its oral and intramuscular (IM) administration, in naturally parasitized horses. The parasitological data were complemented with the assessment of the plasma disposition kinetics of IVM. The trial included two different experiments. In experiment I, 40 horses naturally infected with small strongyles were randomly allocated into four experimental groups (n=10) and treated with IVM (0.2mg/kg) as follows: IVM oral paste, animals were orally treated with Eqvalan (IVM 1.87% paste, as the reference formulation) by the oral route; IVM oral solution, animals were orally treated with Remonta (IVM 2% solution, as a test formulation); IVM IM solution, animals were IM treated with the test product (Remonta IVM 2% solution); and control, animals were kept without treatment as untreated controls. In experiment II, 24 horses naturally parasitized with small strongyles were randomly allocated into the same four experimental groups (n=6) described for experiment I. Faecal samples were individually collected directly from the rectum of each horse prior (day -1) and at 7 and 15 (Experiment I) or 7, 15 and 21 (Experiment II) days after-treatment, to assess the eggs per gram (epg) counts and estimate the efficacy of the treatments. Additionally, the comparative plasma disposition kinetics of IVM in treated animals was assessed in experiment II. In both experiments, an excellent (100%) IVM efficacy was observed after its oral administration (test and reference formulations). However, the IM administration of IVM resulted in a low efficacy (36-64%). Similar IVM plasma concentration was observed after its oral administration as a paste or as a solution. The higher IVM plasma profiles observed after the IM administration accounted for an enhanced systemic availability. The improved IVM efficacy observed against adult cyathostomins after its oral administration can be explained by an enhanced drug exposure of the worms located at the lumen of the large intestine. These findings may have a direct impact on the practical use of macrocyclic lactones in horses.
Topics: Administration, Oral; Animals; Anthelmintics; Drug Administration Routes; Feces; Horses; Injections, Intramuscular; Ivermectin; Parasite Egg Count; Strongyle Infections, Equine; Strongyloidea
PubMed: 28288767
DOI: 10.1016/j.vetpar.2017.01.025