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Questions and Answers
What is one major limitation of controlled drug delivery systems (CDDS)?
What is one major limitation of controlled drug delivery systems (CDDS)?
Which type of drug is typically difficult to formulate in CDDS?
Which type of drug is typically difficult to formulate in CDDS?
What can slow absorption in CDDS lead to?
What can slow absorption in CDDS lead to?
Which characteristic makes a drug unsuitable for controlled release delivery?
Which characteristic makes a drug unsuitable for controlled release delivery?
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What is a potential issue with dose adjustment in CDDS?
What is a potential issue with dose adjustment in CDDS?
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Which of the following factors is not a limitation of CDDS?
Which of the following factors is not a limitation of CDDS?
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Why are poorly absorbed drugs challenging for CDDS?
Why are poorly absorbed drugs challenging for CDDS?
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What is one advantage of controlled drug delivery systems?
What is one advantage of controlled drug delivery systems?
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How can controlled drug delivery systems improve patient compliance?
How can controlled drug delivery systems improve patient compliance?
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What is a possible consequence of 'dose dumping'?
What is a possible consequence of 'dose dumping'?
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What is one physiological constraint that may influence the performance of a controlled release system?
What is one physiological constraint that may influence the performance of a controlled release system?
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What factor does NOT affect patient compliance?
What factor does NOT affect patient compliance?
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What factor is essential in minimizing unwanted side effects when designing a controlled drug delivery system?
What factor is essential in minimizing unwanted side effects when designing a controlled drug delivery system?
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Which of the following is a feature of active self-programmed insulin pumps?
Which of the following is a feature of active self-programmed insulin pumps?
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Which type of therapy might require a different design approach due to treatment duration?
Which type of therapy might require a different design approach due to treatment duration?
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One of the economical advantages of new drug delivery systems is that:
One of the economical advantages of new drug delivery systems is that:
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How does controlled drug delivery improve the therapeutic action of drugs?
How does controlled drug delivery improve the therapeutic action of drugs?
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What aspect of the disease state can impact the design of a drug delivery system?
What aspect of the disease state can impact the design of a drug delivery system?
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What can minimize local and systemic side effects in drug therapy?
What can minimize local and systemic side effects in drug therapy?
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How does the patient's condition influence controlled release product design?
How does the patient's condition influence controlled release product design?
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Which of the following is NOT a reason for patient noncompliance in drug therapy?
Which of the following is NOT a reason for patient noncompliance in drug therapy?
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Which example illustrates a different design problem for sustained release products?
Which example illustrates a different design problem for sustained release products?
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What is the effect of high plasminogen activator levels in tumor cells on drug design?
What is the effect of high plasminogen activator levels in tumor cells on drug design?
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Which characteristic of the ocular environment is crucial when designing ocular controlled release products?
Which characteristic of the ocular environment is crucial when designing ocular controlled release products?
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What does the abbreviation 'CD' stand for?
What does the abbreviation 'CD' stand for?
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Which abbreviation indicates a formulation that releases the drug over an extended period?
Which abbreviation indicates a formulation that releases the drug over an extended period?
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What can potentially result from inefficient bioavailability of a drug to target tissues?
What can potentially result from inefficient bioavailability of a drug to target tissues?
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What does the term 'sustained action' refer to in the context of drug release?
What does the term 'sustained action' refer to in the context of drug release?
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Which of the following is true about conventional dosage forms?
Which of the following is true about conventional dosage forms?
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What does 'IR' stand for in medication terminology?
What does 'IR' stand for in medication terminology?
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Which of the following can lead to toxic effects in non-target tissues?
Which of the following can lead to toxic effects in non-target tissues?
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What is a common consequence of using high doses in drug administration?
What is a common consequence of using high doses in drug administration?
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What must happen for a drug to maintain constant blood or tissue levels in a controlled release system?
What must happen for a drug to maintain constant blood or tissue levels in a controlled release system?
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Why are drugs that are absorbed at specific sites of the gastrointestinal tract considered poor candidates for controlled release systems?
Why are drugs that are absorbed at specific sites of the gastrointestinal tract considered poor candidates for controlled release systems?
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Which biological factor can be rate limiting in drug elimination kinetics?
Which biological factor can be rate limiting in drug elimination kinetics?
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What is a key consideration when formulating a controlled release system for drugs extensively metabolized by the liver?
What is a key consideration when formulating a controlled release system for drugs extensively metabolized by the liver?
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Which property must drugs have for effective formulation in controlled release systems?
Which property must drugs have for effective formulation in controlled release systems?
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What commonly influences the design of controlled release drug delivery systems (CDDS)?
What commonly influences the design of controlled release drug delivery systems (CDDS)?
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What can happen to metabolism in slow release drug systems compared to conventional dosage forms?
What can happen to metabolism in slow release drug systems compared to conventional dosage forms?
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What is a disadvantage of drugs that induce or inhibit enzyme synthesis concerning controlled release systems?
What is a disadvantage of drugs that induce or inhibit enzyme synthesis concerning controlled release systems?
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What is a primary benefit of controlled drug delivery systems (CDDS)?
What is a primary benefit of controlled drug delivery systems (CDDS)?
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Which type of drug delivery system responds to external stimuli?
Which type of drug delivery system responds to external stimuli?
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What is the main disadvantage of conventional and prolonged-released dosage forms?
What is the main disadvantage of conventional and prolonged-released dosage forms?
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In order to achieve constant drug levels in plasma, what must the release rate from a controlled release dosage form do?
In order to achieve constant drug levels in plasma, what must the release rate from a controlled release dosage form do?
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Which drugs benefit most from localized drug action?
Which drugs benefit most from localized drug action?
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What is one preferred non-invasive route for drug delivery compared to IV infusion?
What is one preferred non-invasive route for drug delivery compared to IV infusion?
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What is an example of localized drug action in ophthalmic therapy?
What is an example of localized drug action in ophthalmic therapy?
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What is one key goal of an ideal drug delivery system?
What is one key goal of an ideal drug delivery system?
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Study Notes
Chapter 1: Drug Delivery System
- Drug delivery systems (DDS) are a focus of development due to several reasons
- Improved therapeutic efficacy and safety via precise spatial and temporal drug placement in the body, reducing the size and number of doses
- Potential for re-patenting existing drugs by using new techniques and concepts
- Increasing costs of new drug development encourage DDS creation
- New systems are necessary to deliver novel and genetically-engineered pharmaceuticals without significant immunogenic or biological inactivation
- Enzyme deficient disease and cancer therapy can be improved with better targeting
Introduction
- Attention focused on DDS development for therapeutic efficacy, safety, spatial, and temporal drug placement reducing dose size and number.
- Possibility of re-patenting
- Increasing costs encourage DDS development
- Delivering novel, genetically-engineered pharmaceuticals (biopharmaceuticals, peptides, and proteins) to target sites without adverse effects
- Enzyme deficient disease and cancer therapy can be enhanced by better targeting
Drug Delivery
- Drug delivery involves approaches, formulations, technologies, and systems needed (place and rate) to safely achieve a desired therapeutic outcome.
- Drug delivery encompasses quantity and duration of drug presence inside the body by various chemical formulations (prodrug)
- Medical devices and drug-device products can be a part of drug delivery mechanisms
- Drug delivery is a concept integrated with dosage form and route of administration
Drug Delivery Technologies
- Drug delivery technologies modify drug release profiles for improved efficacy, safety, and patient convenience and compliance
- Current efforts in drug delivery involve
- Controlled release drug action: drug is released from formulation (sustained, delayed, pulsed)
- Targeted delivery systems: drug action is confined to a specific target area of the body (important in cancer therapy)
- Localized drug action: drug action is confined to a particular tissue or organ (spatial control), examples include intrauterine devices and ophthalmic delivery
Controlled Release Formulation
- When a drug is injected or ingested, systemic drug level may exceed therapeutic level briefly, then declines to ineffective levels.
- Fluctuations can be undesirable, especially in drugs with a low therapeutic index.
- Fluctuation magnitude depends on absorption rate, distribution rate, and elimination rate and dosing intervals
- Plasma drug concentration may not be maintained above a minimum therapeutic level for a very long period
- Administering a dose before the first dose is fully eliminated can cause drug accumulation in the body, leading to toxic levels
Controlled Release Formulation
- Each drug has a therapeutic window where drug-plasma concentration below therapeutic level is insufficient, and above it results in undesirable/toxic effects.
- Ideal profile maintains relatively constant drug concentration throughout treatment duration.
- Controlled release systems can reduce undesired fluctuations in drug levels, reducing side effects and improving therapeutic outcomes. Drug is released continually at a rate dictated by the body's needs (Kabs).
Terminology of Drug Delivery and Targeting
- Drug delivery and targeting terminology is extensive and evolving.
- Systems are described with terms like "controlled release," "sustained release,” "zero-order," "reservoir," "monolithic," "membrane-controlled," “smart,” “stealth” (RES), etc.
- Terms are not always used consistently and may be inaccurate.
Terminology of Drug Delivery and Targeting
- Common terms in drug delivery and targeting include:
- Prolonged/Sustained Release: extended drug presence
- Zero-Order Release: constant effective drug level over time
- Variable Release: variable drug input rate
- Bio-responsive Release: drug release modulated by a biological stimulus
Terminology of Drug Delivery and Targeting
- Common terms include
- Pulsatile Release: drug release in pulses (circadian rhythms where constant release is not desired)
- Delayed Release: release at a time other than immediately after administration (e.g., enteric coated)
- Modulated/Self-Regulated Release: drug delivery controlled by the patient
- Temporal Drug Delivery: controlled delivery to achieve desired time-related effects in the body
- Spatial Drug Delivery (Targeted Delivery Systems): Drug delivery to a specific body region, both route and distribution.
- Drug Delivery System (DDS): general term for any sophisticated delivery system incorporating various advanced technologies (rate-control, pulsatile release, bio-responsive) to target spatial and/or temporal delivery.
Commonly Used Abbreviations
- List of common abbreviations (CD, CR, DR, ER, XL, XR, XT, IR, ES, XS, MR, SA, SR, LA, LAR) and their meanings related to drug delivery.
- Note that no industry standard exists and confusion or misinterpretations have led to prescribing errors.
Targeted Drug Delivery
- Conventional dosage forms reach all parts of the body (healthy and diseased)
- Drug effect results from action on a target (receptor) site, while undesirable effects stem from action on non-target sites.
- Some drugs are specific in their action (hormones, enzymes), interacting with receptors in specific cell types.
- Many drugs are not specific and interact with both target and non-target cells.
Targeted Drug Delivery
- Drug molecule availability to a cell is governed by pharmacokinetics (release, absorption, distribution, elimination).
- High drug doses can lead to high drug levels in non-target sites, creating local/systemic side effects.
- Conventional dosage forms often have excess drug compared to needs.
Targeted Drug Delivery
- New controlled drug delivery systems are available to restrict drug action to target sites.
- Therapeutic effects can be improved by increasing the amount of drug in target cells while reducing it in non-target tissues.
- Targeting is crucial in cancer chemo, intracellular parasitic disease treatments, and gene/enzyme therapies.
- Combining targeting and controlled release technologies in dosage forms is potential.
Targeted Drug Delivery
- Definition: use of carriers to deliver drugs only to target cells (albumin, antibodies, liposomes, micro/nanoparticle carriers, cyclodextrins, viruses, RBCs) linked through covalent or non-covalent binding
- Drug-carrier complexes' in vivo distribution is dictated by carrier properties and not by the drug properties
- Carriers can be specific or non-specific in their distribution
Targeted Drug Delivery
- Specific distribution relies on chemical recognition between the carrier and target site
- Non-specific distribution relies on carrier properties (size, distribution, lipophilicity/hydrophilicity, surface charge)
- Carriers offer advantages: protect drugs from degradation, avoid immunogenicity and antigenicity, and improve drug solubility
Drug Carriers
- Examples of drug carriers are shown (Antibodies, liposomes, and micelles). Different methods/ types exist and are categorized..
Localized Drug Action
- Site of application is the site of action.
- Localized drug action involves placing a DDS directly into the affected tissue or organ.
- Combine localized action with controlled release for rate-controlled drug delivery.
- Important in cases of anticancer and anti-fertility drugs, ophthalmic delivery, dermal therapy, local GIT problems, and lower respiratory tract.
The Rational of CDDS
- An ideal drug delivery system should deliver drug at a rate determined by the body's needs for the treatment period and direct the drug to the precise treatment site or localized to diseased tissue/organs.
- CDDS aim to alter drug pharmacokinetics, either through novel delivery systems or by modifying the drug's molecular structure or physiological parameters.
- Goals of CDDS are to enhance drug delivery control, safety, and efficacy, promoting patient compliance
Available Drug Delivery System
- Current DDS systems cannot fully meet goals of precise rate/site control for drug delivery.
- Conventional and prolonged release systems are unable to fully control rate/site and cannot maintain constant drug level in plasma/target tissue through these forms.
- IV infusion can maintain constant plasma levels but is inconvenient.
- Oral and transdermal routes are preferred for DDS because of their non-invasive nature
Types of Therapeutic Systems
- Three types of therapeutic systems are available:
- Passive pre-programmed: predetermined release rates, no response to external cues.
- Active pre-programmed: release rate altered by external cues (e.g., insulin pumps);
- Active self-programmed: release rates are modulated in response to biological cues (e.g., blood sugar levels).
Advantages of Controlled Drug Delivery System
- Reduced dosing frequency
- Reduced fluctuation in circulating drug levels
- Avoidance of night-time dosing
- Therapeutic action enhancement via consistent drug exposure
- Reduction in undesirable local/systemic side effects
- Improved patient adherence and treatment success (especially for long-term therapies)
- Crucial for patient compliance to drug regimens.
Patient Compliance
- Patient compliance significantly impacts treatment success.
- Factors affecting compliance include disease awareness, faith in treatment, understanding treatment schedules, complexities of regimen, cost, and adverse effects.
- The use of CDDS can address patient non-compliance by minimizing the frequency and complexity of drug intake, and minimizing local/systemic side effects.
Economic Advantages
- Lower cost of introducing new DDS of successful existing drugs compared to the costs of introducing new drugs overall.
- FDA requirements for new DDS are less restrictive than for new drugs.
- Repatenting existing successful drugs with new DDS is an economic option
Limitations of Controlled Drug Delivery System
- Possible dose dumping from faulty formulations
- Limited ability to precisely adjust medication dosage
- Potential for increased first-pass metabolism
- Unpredictable and poor in-vivo-in-vitro correlation
- Slow drug absorption
- Toxicity risk from polymer additives
- High cost to develop and maintain these systems relative to conventional forms
- Not suitable to all drugs and needs.
Drugs That May Be Difficult to Formulate in CDDS
- Drugs with short biological half-lives (t1/2 < 2 hr)
- Drugs with long biological half-lives (t1/2 > 8 hr)
- Potent drugs with narrow therapeutic indices
- Drugs given in large doses
- Poorly absorbed drugs
- Poorly or slightly soluble drugs
Drugs That May Be Difficult to Formulate in CDDS
- Drugs needing extensive first-pass metabolism
- Poorly/low bioavailability
- Absorption windows
Example of CDDS
- Many drugs are now formulated as controlled delivery systems.
- Examples of substances/drugs available in controlled release dosage forms (vitamins, minerals, hormones, diuretics/CV drugs, CNS drugs, respiratory drugs). Specific examples of drugs include potassium, pyridoxine, methyltestosterone, nitroglycerin, procainamide, acetazolamide, isosorbide dinitrate, diazepam, phenobarbital, amphetamine sulfate, aminophylline, and phenylpropanolamine HCI
Some Applications of CDDS
- Cancer therapy: control pharmacokinetic behavior of anti-tumor drugs, reduce adverse effects
- Fertility control: using synthetic polymers in contraception e.g., intra-uterine and intra-vaginal devices for sustained release of progestins or estrogens
- Treatment of glaucoma: overcome poor ocular penetration and loss from ocular cavity in conventional preparations. Employ synthetic polymers, and prodrugs
- Enzyme replacement therapy: improve stability and cellular uptake by using carrier complexes.
Factors Influencing the Design and Performance of CDDS
- Drug Properties: influence on drug release characteristics, availability, and target site accessibility.
- Route of Drug Delivery: limits to suitable controlled release mechanisms/devices at different administration sites.
- Physiological constraints: first-pass metabolism, gastrointestinal motility, and blood supply, negatively impact delivery/efficiency at some routes
- Target Site: maximizing the fraction of the drug reaching the target site to reduce unwanted side effects (localized delivery versus systemic
- Disease state: Pathological changes during disease course (e.g., time course of ocular changes, protein content).
- Patient characteristics: ambulatory vs. bedridden status will factor into the design considerations
Physicochemical Properties of Drugs
- Drug release characteristics reflect drug availability, controlled by drug release.
- Development of CDDS requires complete knowledge of the intrinsic properties of the drug and how they influence system design.
- Drug properties (aqueous solubility, partition coefficient, molecular size, stability, protein binding) influence drug release patterns from dosage forms and impact delivery properties, potentially necessitating changes to the desired outcome, administration route and/or efficacy
Physicochemical Properties of Drugs
- Aqueous solubility: to be absorbed, drugs must be in solution, limited GI transit time and solubility at absorption site.
- Partition coefficient and molecular size: impact drug permeability, membrane diffusion and delivery system constraints.
- Drug stability: in-vitro vs. in-vivo stability impacting chemical/physical and microbiological properties during and post release. Potential degradation or metabolism in target regions will alter the intended use/outcome
- Protein binding: impact on duration, absorption, and candidacy for CDDS.
Biological Properties of Drugs
- Comprehensive picture of drug disposition (absorption, distribution, metabolism, excretion).
- Proper pharmacological parameters (drug half-life, duration of action, drug absorption) are needed in the design for a CDDS.
- Key properties (absorption, distribution, metabolism, and excretion) and how they affect the CDDS design
- Absorption, Distribution, metabolism
- Duration and action: Biological half-life of a drug, duration of action, margin of safety. Drugs that have short and inconsistent half-lives are a poor candidate for CDDS systems
- Side effects: Minimize local and systemic side effects through the use of CDDS
- Disease state and circadian rhythm: Important factor in CDDS design; should be aligned (e.g., disease onset and drug release rate; circadian rhythm)
Selected Routes of Drug Administration
- Route of administration has a vital role in drug efficacy.
- Dosage forms are designed for different routes of administration and DDS should be appropriate for the chosen route.
- Oral delivery is the preferred route, but other non-injectable routes are gaining interest (buccal, sublingual, transdermal, nasal, pulmonary).
Route of Drug Administration
- Large surface area: enhances absorption, e.g., villi in the small intestine, lung surfaces enhance drug absorption
- Low metabolic activity: reduced enzyme activity minimizes drug metabolism, e.g., nasal cavity and buccal routes have lower metabolic activity
- Contact time: the time of contact between drug and the absorbing tissue influences drug absorption rate
- Blood supply: absorption site's blood flow delivers drug to action sites
- Accessibility: Certain absorption sites such as alveolar regions require complex devices to ensure drug delivery
- Lack/variability: essential for consistent and highly-potent drug delivery; conditions such as extremes of pH and food presence might affect drug outcomes negatively. Variations such as female menstrual cycle are further considerations
- Permeability: Some tissues/membrane surfaces (e.g., skin) impede drug absorption
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Description
This quiz explores the fundamentals of drug delivery systems (DDS) and their significance in improving therapeutic efficacy and safety. It discusses innovations in DDS, including techniques for delivering novel pharmaceuticals, the need for precise dosing, and the implications for drug development costs. Ideal for students studying pharmacology and drug design.