Drug Delivery for Analgesia: Opioid Focus
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Questions and Answers

What is the primary characteristic of hydrophilic matrices in drug formulation?

  • Utilizes insoluble polymers only
  • Swells in the presence of water (correct)
  • Remains completely intact during GI transit
  • Sensitive to pH changes
  • How do osmotic pumps regulate drug release?

  • By hydrostatic pressure in a water-soluble core (correct)
  • By controlling the pH level of the drug core
  • Via reaction with gastric acid
  • Through evaporation of the drug solution
  • What role does tortuosity play in the release rate of drugs from an insoluble polymer matrix?

  • It modifies the pathway for drug diffusion. (correct)
  • It increases the viscosity of the drug solution.
  • It decreases the drug release rate.
  • It has no effect on drug release.
  • What commonly used material is an example of an insoluble polymer matrix?

    <p>Ethylcellulose (C)</p> Signup and view all the answers

    Which of the following describes the mechanism of a membrane-controlled system?

    <p>Water enters through a semi-permeable membrane and dissolves the drug. (B)</p> Signup and view all the answers

    What is the primary purpose of the viscous gel structure formed in hydrophilic matrices?

    <p>To act as a barrier to liquid ingress (C)</p> Signup and view all the answers

    What defines a multi-particulate system in drug formulation?

    <p>It is composed of drug-coated sugar spheres or pellets. (D)</p> Signup and view all the answers

    In polymer-coated formulations, what typically serves as the rate-controlling step?

    <p>Erosion of the polymer coating (A)</p> Signup and view all the answers

    Which of the following is a benefit of extended release formulations in pain management?

    <p>Maintaining plasma concentration within therapeutic levels (D)</p> Signup and view all the answers

    Which characteristic is crucial for the effectiveness of sublingual delivery of drugs?

    <p>Absorption through the oral mucosa (A)</p> Signup and view all the answers

    What can interfere with the control of release and absorption in oral extended release formulations?

    <p>Physiological factors including pH, enzyme activity, and transit rates (B)</p> Signup and view all the answers

    What is a primary advantage of intravenous drug administration for analgesia?

    <p>Elimination of variability in absorption (C)</p> Signup and view all the answers

    Which factor limits the maximum period of an extended release product in the gastrointestinal tract?

    <p>Gastric and intestinal motility (D)</p> Signup and view all the answers

    What risk is associated with an overdose of oral extended release medications?

    <p>Slow drug clearance from the body (D)</p> Signup and view all the answers

    What mechanism primarily governs drug absorption in transdermal delivery?

    <p>Diffusion through lipid channels (D)</p> Signup and view all the answers

    Which definition accurately describes extended release formulations?

    <p>Releases the drug at a constant rate over 12-24 hours (D)</p> Signup and view all the answers

    What can potentially happen if a patient chews an extended release tablet?

    <p>Accidental poisoning (C)</p> Signup and view all the answers

    Which of the following describes an issue with formulating high drug load extended release tablets?

    <p>Increased tablet size and difficulty in swallowing (C)</p> Signup and view all the answers

    What is a significant disadvantage of extended release formulations?

    <p>Possible overdose due to cumulative effects (B)</p> Signup and view all the answers

    Which route of administration is least likely to be affected by first pass metabolism?

    <p>Sublingual (D)</p> Signup and view all the answers

    What is a critical characteristic for an ideal extended release formulation?

    <p>High solubility without dissolution issues (B)</p> Signup and view all the answers

    What materials are commonly used in a hydrophilic matrix for sustained drug release?

    <p>Hydroxypropylmethyl cellulose (HPMC) and PEG (C)</p> Signup and view all the answers

    How does oral controlled release enhance patient comfort?

    <p>By maintaining therapeutic drug levels without peaks and troughs (C)</p> Signup and view all the answers

    What is a key factor in the formulation of transdermal drugs for optimal absorption?

    <p>Lipophilicity of the drug (D)</p> Signup and view all the answers

    Which dosage form uses water diffusion through a semi-permeable membrane for drug delivery?

    <p>Osmotic pumps (B)</p> Signup and view all the answers

    What key characteristic affects the absorption of low permeability drugs in extended release formulations?

    <p>Non-site specific absorption (C)</p> Signup and view all the answers

    What is the primary purpose of using buprenorphine in sublingual tablets?

    <p>For fast absorption and rapid onset of action (B)</p> Signup and view all the answers

    Why might some modified release products differ in effectiveness even if intended to be the same?

    <p>Variations in release mechanisms and profiles (C)</p> Signup and view all the answers

    What primary limitation does the oral route have regarding drug administration?

    <p>Unpredictable absorption and first pass metabolism (D)</p> Signup and view all the answers

    Which of the following leads to improved patient compliance with oral extended release formulations?

    <p>Reduced dosing frequency (A)</p> Signup and view all the answers

    Why is osmotic pumping used in drug delivery systems?

    <p>To control the rate of drug release through osmotic pressure (B)</p> Signup and view all the answers

    What role does lipid solubility play in the formulation of transdermal drugs?

    <p>Increases the drug's absorption through the epidermis (D)</p> Signup and view all the answers

    What is a common characteristic of drugs used in buccal delivery?

    <p>Rapid disintegration (C)</p> Signup and view all the answers

    Flashcards

    Oral controlled release

    A drug delivery system that releases the medication slowly over an extended period, maintaining therapeutic levels.

    Modified-release

    A general term for drug delivery systems that release drugs at a controlled rate.

    Extended-release

    A drug delivery system that releases a drug slowly over an extended period.

    Intravenous administration

    Drug delivery directly into the bloodstream.

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    Sublingual/buccal administration

    Drug delivery under the tongue (sublingual) or in the cheek (buccal).

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    Transdermal delivery

    Drug absorption through the skin.

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    Stratum Corneum

    The outermost layer of the epidermis (skin), acting as a barrier to drug absorption.

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    Log P

    Partition coefficient; measure of how well a drug dissolves in fat versus water.

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    Hydrophilic matrix

    Drug delivery system where the matrix is water-loving.

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    Insoluble polymer/lipid matrix

    Drug delivery system where the matrix is not water soluble.

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    Membrane controlled release

    Drug delivery system that uses a semi-permeable membrane to control drug release.

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    Osmotic pump

    Drug delivery system that uses osmosis to create a pressure gradient that drives drug release.

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    Breakthrough pain

    Pain that occurs despite ongoing treatment.

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    Reduced dosing frequency

    Giving a drug less often.

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    Increased compliance

    Patient's adherence to treatment.

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    First-pass metabolism

    Drug metabolism in the liver before reaching systemic circulation.

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    Oral Extended Release Limitations

    Physiological factors like stomach acid, enzymes, and gut transit times can affect how quickly the medicine is released and absorbed; also, the dosage form may have a limited time in the gastrointestinal tract (no more than 24 hours).

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    Extended-release overdose risk

    If the medicine's therapeutic index is narrow, slowing down its removal from the body can cause prolonged and potentially dangerous effects.

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    Extended-release accidental poisoning

    Chewing or breaking extended-release pills, especially those with a high drug content, can lead to accidental overdose and potential fatality.

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    Extended-release tablet size

    Extended-release tablets/capsules are often large, which can make swallowing more difficult.

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    Formulation challenges

    Making extended-release pills with lower inactive ingredients can be harder than making regular pills, especially if there's a high amount of active medicine.

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    Non-bioequivalence (MR products)

    Even when extended-release products are intended to have the same effect, different technologies for release mechanism and time can cause differences in actual medicine release.

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    Gastrointestinal Transit Times

    The time it takes drugs to pass through the stomach (≈30 mins - 4 hours), small intestine(≈ 3-5 hours), and large intestine(≈12-72 hours).

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    Drug Absorption - Stomach

    Particles in extended-release pills rapidly leave the stomach, but larger ( > 7 mm) may stay for up to 10 hours.

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    Drug Absorption - Solubility and permeability

    A highly soluble drug absorbs easily, promoting passive diffusion. Drugs with low permeability might not be suitable for extended-release formulation.

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    Hydrophilic matrix vs Insoluble polymer extended release

    Hydrophilic matrix tablets rely on gel erosion and diffusion while insoluble polymer ones rely on diffusion through a non dissolving polymer scaffold or lipid matrix and lipid digestion.

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    Insoluble Polymer Matrix

    A drug delivery system where the drug is embedded in a matrix made of an insoluble polymer like ethylcellulose or polymethacrylate. The drug diffuses through a network of tiny channels in the matrix, controlling release.

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    Matrix Swelling

    The process where a hydrophilic matrix absorbs water and expands, creating a barrier that controls drug release.

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    Matrix Erosion

    The gradual breakdown of the hydrophilic matrix as it dissolves in the gastrointestinal tract, releasing the drug.

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    Hydrostatic Pressure

    The pressure created inside an osmotic pump as water enters the core, forcing the drug out through the hole.

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    Multi-particulate System

    A drug delivery system that uses multiple tiny drug-containing particles coated with a membrane. This approach provides controlled release by increasing the overall surface area.

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    How does a membrane controlled release system work?

    Water enters through the membrane, dissolves the drug inside, and then the drug diffuses through the membrane at a controlled rate.

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    What is the main purpose of extended release in pain management?

    Extended release formulations help maintain therapeutic drug levels over a longer period, minimizing fluctuations in pain relief and improving patient comfort.

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    Study Notes

    Drug Delivery for Analgesia: Opioid Focused

    • The lecture focuses on drug delivery routes and formulations, especially for opioids used in analgesia.
    • Delivery routes include oral, intravenous, transdermal, epidural, intrathecal, sublingual/buccal, nasal, and rectal.

    Routes of Delivery/Dosage Forms for Analgesia

    • Intravenous: Rapid delivery directly to the circulation, eliminating lag time between administration and action, leading to more predictable responses.
    • Sublingual/Buccal: Absorption through oral mucosa (beneath the tongue) results in rapid onset and high blood levels. It bypasses first-pass metabolism.

    Oral Controlled Release

    • Modified-release formulations (extended-release) manage drug release, differing from immediate-release that delivers the entire dose upfront.
    • Extended-release mechanisms include hydrophilic matrix, insoluble polymer/lipid matrix, membrane-controlled, and osmotic pumps.

    Buccal Delivery

    • The oral mucosa shows significant variations in the epithelial tissue's keratinization across different mouth regions.
    • Regions with less keratinization, like sublingual, are more permeable.

    Sublingual Tablets

    • Used for transmucosal delivery.
    • Small, porous, fast-disintegrating tablets placed under the tongue, offering a rapid onset of action.

    Transdermal Delivery

    • Drug diffusion from a reservoir through epidermis and dermis to the bloodstream.
    • Absorption mainly occurs through lipid channels in the stratum corneum, ideal for small lipophilic molecules.

    Ideal Properties for Transdermal Drugs

    • Lipophilic drugs with low molecular weight tend to be better for transdermal delivery.
    • Log P (partition coefficient) values between 1-4
    • Molecular weights below 500
    • Daily dose of 10-20mg/20cm²

    Transdermal: Rate Limiting

    • Two types: rate limiting membrane or matrix systems.
    • Maintains sustained drug plasma profile for several days within the therapeutic window, eliminating dips in dose throughout the night, a common problem with oral tablets.
    • Convenient and high patient compliance.

    Oral Extended Release: Definitions

    • Immediate release: Whole dose releases promptly.
    • Modified release: Time course and/or location of release are adjusted for therapeutic benefit.
    • Two types: Delayed release (e.g., enteric-coated) and extended-release (modified release).

    Oral Extended Release: Meaning for Patients (1)

    • Extended-release formulations keep drug levels within a therapeutic range for an extended period.
    • One dose can maintain therapeutic levels overnight, improving sleep quality, and fewer doses are used. This contrasts with immediate-release requiring multiple doses.
    • Reduces peak drug concentrations and the frequency of drug administration, reducing the risk of side effects.

    Oral Extended Release: Meaning for Patients (2)

    • Extended release can help prevent breakthrough symptoms and side effects if plasma levels fall below the required level.
    • Reduces the overall drug dose administered throughout the treatment period, minimizing exposure to drugs.

    Oral Extended Release: Meaning for Patients (3)

    • Reduced dosing frequency benefits those with drugs that require frequent dosing.
    • Increased patient compliance.
    • Reduction in time spent on health services

    Oral Extended Release: Limitations

    • Physiological factors like gut pH, enzyme activity, and transit rate can impact drug release and absorption.
    • Drug passage along the GI tract restricts the duration of therapeutic release from 30 minutes to 72 hours.
    • Overdosing risk.
    • Potential for toxicity if therapeutic index is narrow.
    • Extended-release formulations may be larger, posing difficulties for swallowing.

    Oral Extended Release: Additional Limitations

    • Risk of poisoning from chewing/consuming the whole release tablet.
    • Non-bioequivalence – similar intent drugs may differ in their therapeutic reaction
    • Differences in drug release mechanism and time of release profile.

    Factors Influencing the Design of Extended Release Oral Formulations

    • Gastrointestinal (GI) physiology and absorption mechanisms.
    • Rate of drug molecule movement through the GI tract affects the maximum duration of therapeutic release.
    • Aqueous solubility and permeability of the drug—essential properties influencing dissolution and absorption.

    Oral Extended Release: Key Formulations

    • Hydrophilic matrix tablets, insoluble polymer matrices, membrane-controlled release, and osmotic pumps.
    • Different types of excipients (e.g., polymers, salts, fillers) form the base of the formulations.

    Oral Extended Release: Polymer Matrices / Drug Delivery Systems

    • Insoluble polymer matrices (e.g., ethylcellulose, polymethacrylates) embed the drug, which diffuses through channels as the matrix degrades.
    • Hydrophilic polymer matrices (e.g., hydroxypropyl methylcellulose, HPMC) swell in water, increasing the drug release rate.

    Membrane Controlled System: Release Mechanism

    • Water diffuses into the tablet, causing drug dissolution and diffusion through a polymer membrane.
    • Release is mostly controlled by membrane erosion.

    Osmotic Pumps

    • Water enters the core of an osmotic pump (tablet), creating pressure to release the drug through a small hole in a semipermeable membrane.
    • Drug release is dependent on membrane properties, solution/suspension properties, and the hole's diameter.

    Why should patients not chew extended release formulations?

    • Chewing can release the entire drug dose immediately, potentially causing adverse effects from rapid absorption and exceeding the safe therapeutic levels.

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    Description

    This quiz covers various drug delivery routes and formulations specifically for opioids used in analgesia. Topics include intravenous, sublingual, and controlled-release oral formulations, along with their mechanisms of action and advantages. Test your knowledge on effective pain management strategies through drug delivery methods.

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