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MSc (Med),Dept of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand / Pain is the net effect of multidimensional mechanisms that engage most parts of the central nervous system (CNS) and the treatment of pain is one of the key challenges in clinical medicine (Le Bars et al., 2001; Miranda et al., 2008). Polypharmacy is seen as a barrier to analgesic treatment compliance, signifying the necessity for the development of fixed dose combinations (FDCs), which allow the number of tablets administered to be reduced, with no associated loss in efficacy or increase in the prevalence of side effects (Torres Morera, 2004). FDCs of analgesic drugs with differing mechanisms of nociceptive modulation offer benefits including synergistic analgesic effects, where the individual agents act in a greater than additive manner, and a reduced occurrence of side-effects (Raffa, 2001; Camu, 2002). This study aimed at producing a novel, rate-modulated, fixed-dose analgesic formulation for the treatment of mild to moderate pain. The fixed-dose combination (FDC) rationale of paracetamol (PC), tramadol hydrochloride (TM) and diclofenac potassium (DC) takes advantage of previously reported analgesic synergy of PC and TM as well as extending the analgesic paradigm with the addition of the anti-inflammatory component, DC. The study involved the development of a triple-layered tablet delivery system with the desired release characteristics of approximately 60% of the PC and TM being made available within 2 hours to provide an initial pain relief effect and then sustained zero-order release of DC over a period of 24 hours to combat the on-going effects of any underlying inflammatory conditions. The triple-layered tablet delivery system would thus provide both rapid onset of pain relief as well as potentially address an underlying inflammatory cause. The design of a novel triple-layered tablet allowed for the desired release characteristics to be attained. During initial development work on the polymeric matrix it was discovered that only when combined with the optimized ratio of the release retarding polymer polyethylene oxide (PEO) in combination with electrolytic-crosslinking activity, provided by the biopolymer sodium alginate and zinc gluconate, could the 24 hour zero-order release of DC be attained. It was also necessary for this polymeric matrix to be bordered on both sides by the cellulosic polymers containing PC and TM. Thus the application of multi-layered tableting technology in the form of a triple-layered tablet were capable of attaining the rate-modulated release objectives set out in the study. The induced barriers provided by the three layers also served to physically separate TM and DC, reducing the likelihood of the bioavailability-diminishing interaction noted in United States Patent 6,558,701 and detected in the DSC analysis performed as part of this study. The designed system provided significant flexibility in modulation of release kinetics for drugs of varying solubility. The suitability of the designed triple-layered tablet delivery system was confirmed by a Design of Experiments (DoE) statistical evaluation, which revealed that Formulation F4 related closest to the desired more immediate release for PC and TM and the zero-order kinetics for DC. The results were confirmed by comparing Formulation F4 to typical release kinetic mechanisms described by Noyes-Whitney, Higuchi, Power Law, Pappas-Sahlin and Hopfenberg. Using f1 and f2 fit factors Formulation F4 compared favourably to each of the criteria defined for these kinetic models. The Ultra Performance Liquid Chromatographic (UPLC) assay method developed displayed superior resolution of the active pharmaceutical ingredient (API) combinations and the linearity plots produced indicated that the method was sufficiently sensitive to detect the concentrations of each API over the concentration ranges studied. The method was successfully validated and hence appropriate to simultaneously detect the three APIs as well as 4-aminophenol, the degradation product related to PC. Textural profile analysis in the form of swelling as well as matrix hardness analysis revealed that an increase in the penetration distance was associated with an increase in hydration time of the tablet and also an increase in gel layer thickness. The swelling complexities observed in the delivery system in terms of both the PEO, crosslinking sodium alginate and both cellulose polymers as well as the actuality of the three layers of the tablet swelling simultaneously suggests further intricacies involved in the release kinetics of the three drugs from this tablet configuration. Modified release dosage forms, such as the one developed in this study, have gained widespread importance in recent years and offer many advantages including flexible release kinetics and improved therapy and patient compliance.

This paper presents the computer simulation results on the delivery of Etanidazole (radiosensitiser) to the brain tumor and examines several factors affecting the delivery. The simulation consists of a 3D model of tumor with poly (lactide-co-glycolide) (PLGA) wafers of 1% Etanidzole loading implanted in the resected cavity. A zero-order release device will produce a concentration profile in the tumor which increases with time until the drug in the carrier is depleted. This causes toxicity complications during the later stages of drug treatment. However, for wafers of similar loading, such release results in a higher drug penetration depth and therapeutic index as compared to the double drug burst profile. The numerical accuracy of the model was verified by the similar results obtained in the two-dimensional and three-dimensional models. / Singapore-MIT Alliance (SMA)

Les thérapeutiques individualisées et ciblées se développent actuellement, les formes galéniques évoluent donc en parallèle pour contrôler la libération des principes actifs (PA) et les conduire au plus proche des sites d’intérêts. Les formes orales solides représentent les formulations galéniques les plus utilisées, faciles d’emploi, indolores et réduisant le risque d’infection. Lors de leur conception, il est aussi possible de moduler la libération du PA.Deux approches sont étudiées dans ce manuscrit, l’une correspond au ciblage de la libération d’un PA vers son site d’action thérapeutique qui est le colon, la seconde consiste à contrôler la libération du PA pour maintenir une concentration constante, minimiser les effets indésirables et les périodes de présence de concentrations sub-thérapeutiques au niveau du site d’action.Première approche :Les traitements des Maladies Inflammatoires Chroniques de l’Intestin (MICI) peuvent être significativement améliorées par une libération localisée du PA. Une des approches est l’utilisation d’enrobages composés de polysaccharides dégradés par les enzymes sécrétées par la microflore colique. Mais l’absence d’une méthode in vitro reproductible simulant les conditions physiologiques du colon et l’impact potentiel des traitements antibiotiques associées qui pourraient affecter la quantité et la qualité des bactéries présentes et des enzymes sécrétées est un obstacle à sa mise au point. L’objectif de l’étude était d’effectuer un screening de polysaccharides ayant un intérêt dans le développement de nouvelles formulations à libération colique. Après cette sélection, la libération des formulations retenues ont été évaluées par une méthode utilisant des selles de patients atteints de MICI traités ou non par antibiothérapie. Enfin, l’utilisation de mélanges bactériens pour un éventuel remplacement de l’utilisation de selles fraiches a été évaluée.Seconde approche : Les formes orales enrobées présentent un grand potentiel pour la libération contrôlée de PA. Néanmoins, il est difficile d’obtenir une libération à vitesse constante avec ce type de formulation. Ceci est généralement dû au rôle prédominant du transport de masse par diffusion, ce qui entraine, avec le temps, une diminution de la concentration en PA au cœur du système, donc une réduction du gradient de concentration qui est la force motrice de la libération du PA. Ce type de cinétique de libération peut être inapproprié pour un traitement médicamenteux sûr et efficace. Malgré l’importance pratique de ce défi crucial de formulation, étonnamment, peu de stratégies efficaces sont connues. Dans cette étude, une nouvelle approche, basée sur une succession de couches de PA et de polymères (initialement dépourvu de PA) présentant une distribution initiale de PA non homogène, associé à un effet de temps de latence et à une diffusion partielle initiale à travers le noyau de la minigranule. Des variations de type, de quantité, d’épaisseur et de séquence des couches de PA et de polymères ont été testées. Un système assez simple composé de quatre couches (deux couches de PA et deux couches de polymère) permettait d’aboutir à une libération relativement constante durant 8h. / Individualized and targeted therapies are currently developed, therefore the dosage forms move in parallel to control the drug release and drive it nearest to interest sites. Solid oral dosage forms are the pharmaceutical formulations the most common, easy to use, painless and reducing the infectious risk. In these formulation designs, it is also possible to adjust the drug release.Two approaches are discussed in this manuscript, the first one targets the drug release to the therapeutic site of action which is the colon, and the second one consists on controlling the drug release to maintain a constant concentration, minimize side effects and periods of presence of sub-therapeutic concentrations at the site of action.The first approach:The treatment of colonic disease like Inflammatory Bowel Diseases (IBD), can be significantly improved via local drug delivery. One approach is to use polysaccharide coatings, which are degraded by enzymes secreted by the colonic microflora. However, the lack of a reliable in vitro test simulating conditions in a living colon and the potential impact of associated antibiotic treatments that could affect the quality and quantity of bacteria and enzymes secreted is an obstacle to its development. The aim of the study was to perform a screening of polysaccharides suitable for the development of new colonic release formulations. After this selection, the drug release of selected formulations were evaluated by a method using the stools of IBD patients treated or not with antibiotics. Finally, the use of bacterial mixtures substituting fresh fecal samples has been evaluated.The second approach: Coated pellets offer a great potential for controlling drug delivery systems. However, constant drug release rates are difficult to achieve with this type of dosage forms if the drug is freely water-soluble. This is because diffusional mass transport generally plays a major role and with time the drug concentration within the system decreases, resulting in decreased concentration gradients, which are the driving forces for drug release. This type of release kinetics might be inappropriate for an efficient and safe drug treatment. Despite the great practical importance of this potentially crucial formulation challenge, surprisingly little is yet known about efficient formulations. In this study, a novel approach is presented based on sequential layers of drug and polymer (initially free of drug) to provide a non-homogeneous initial drug distribution, combined with lag-time effects and partial initial drug diffusion towards the pellet’s core. By changing the type, number, thickness and sequence of the drug and polymer layers, a rather simple 4 layers system (2 drug and 2 polymer layers) allowed an about constant drug release during 8 h.

The objectives of this project encompass the design and development of a drug delivery system to continuously deliver therapeutic agents from the stomach to the proximal region of the intestine. The delivery system designed would have sufficient gastric residence time together with near zero-order release kinetics. The physicochemical properties pertaining to the formulation development of the model drug (alfuzosin HCl) were evaluated. Excipients were selected based on the studies of their physicochemical properties and compatibility with the active ingredient. Gastro-retentive dosage forms have been the topic of interest in recent years as a practical approach in drug deliveries to the upper GI tract or for release prolongation and absorption. These dosage forms are particularly suitable for drugs that have local effects on the gastric mucosa in the stomach. Other candidates include drugs that are likely to be absorbed in the upper small intestine, or drugs that are unstable in basic environment of distal intestine and colon or those with low solubility at elevated pH conditions (i.e. weak bases). To develop a gastro-retentive delivery system the following steps were taken. First, to investigate the possible incompatibility issues between the model drug and excipients to be used for the delivery system. Stability and physicochemical properties of the active agent and its mixture with excipients were studied using analytical techniques such as Raman spectroscopy and Differential scanning calorimetry (DSC). No incompatibility issues were detected. Second, Kollidon SR as a relatively new release-rate controlling polymer was incorporated in the final formulation. For solid dosage form the ability of the final powder mix to flow well during manufacturing and the intrinsic characteristics that make it compressible are critical. The in-depth compaction study of Kollidon SR was assessed with the help of a compaction simulator. The flowability, swelling and erosion behavior together with release-rate retarding properties of Kollidon SR were also assessed. The final oral delivery system was based on Kollidon SR and Polyethylene Oxide (PEO) 303 as a monolithic matrix system. The noneffervescent monolithic matrix was made by direct compression. In vitro evaluation of the designed system released the active content in a near zero manner. The dosage form was bouyant in pH 2.0 acidic buffer with no floatation lag time which minimizes the possibility of early gastric emptying. / Pharmaceutics

Diabetes is a leading cause of death and disability in the United States. Diabetes requires a lifetime medical treatment. Some diabetes drugs could be taken orally, while others require daily injection or inhalation to maximize bioavailability and minimize toxicity. Parenteral delivery is a group of delivery routes which bypass human gastrointestinal track. Among all the parenteral methods, we chose subcutaneous implant based on its fast act and high patient compliance. When using subcutaneous implant, drug release needs to be strictly controlled. There are three major groups of controlled release methods. Solvent controlled system is already used as osmotic implant. Matrix controlled system is used in Zoladex® implant to treat cancer. Membrane controlled systems is widely used in coating tablets, but not that popular as an implant. Based on the research reported by previous scientists, we decided to build a hybrid system using both matrix and membrane control to delivery human insulin and other small molecule drugs. Subcutaneous environment is different from human GI track. It has less tolerance for external materials so many polymers cannot be used. From the FDA safe excipient database, we selected albumin as our primary polymer and gelatin as secondary choice. In our preliminary insulin diffusion study, we successfully found that insulin mixed with albumin provided a slower diffusion rate compared with control. In addition, we added zinc chloride, a metal salt that can precipitate albumin. The insulin diffusion rate is further reduced. The preliminary study proved that matrix control using albumin is definitely feasible and we might add zinc chloride as another factor. In order to fabricate an implant with appropriate size, we use lyophilisation technology to produce uniformly mixed matrix. Apart from albumin and human insulin, we added sucrose as protectant and plasticizer. The fine powder after freeze-dry was pressed as a form of tablet. The tablets were sealed in Falcon® cell culture insert. Cell culture insert provide a cylinder shape and 0.3 cm2 surface area for drug release. Insulin release study provided a zero order kinetics from prototypes with zinc chloride or 0.4 micron pore size membrane. Caffeine was used as a model drug to investigate the releasing mechanism. Three pore size membranes (0.4, 3 and 8 micron) were tested with same formulation. While 0.4 micron prototypes provided the slowest release, 3 micron ones surprisingly released caffeine faster than 8 micron implants. We calculated the porosity with pore size and concluded that the percentage of open area on a membrane is the key point to control caffeine release. 0.4 micron membranes were used for future research. We increased the percentage of albumin in our excipient, and achieved a slower caffeine release. However, the zero order release could only last for 3 days. After we replaced sucrose with gelatin, a 5 day zero order release of caffeine was achieved. With all the results, we proposed our “Three Phase” drug release mechanism controlled by both membrane and matrix. Seven other small molecule drugs were tested using our prototype. Cloudy suspension was observed with slightly soluble drugs. We updated our “Three Phase” drug release mechanism with the influence of drug solubility. Data shows that releasing rate with same formulation and membrane follows the solubility in pH 7.4. This result proves that our prototype might be used for different drugs based on their solubility. Finally, with all the information of our prototype, we decided to build a “smart insulin implant” with dose adjustment. We proposed an electrical controlled implant with different porosity membranes. Solenoid was used as the mechanical arm to control membrane porosity. 3-D printing technology was used to produce the first real prototype of our implant. Finally, insulin implant with clinically effective insulin release rate was achieved. / Pharmaceutical Sciences

The aim of this thesis is to determine the feasibility of an injectable delivery system based on 5-ethylene ketal ε-caprolactone for localized delivery of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) for treating critical limb ischemia. HGF and VEGF were chosen because of their ability to simultaneously stimulate the proliferation and migration of endothelial cells, to initiate the formation of blood vessels and the recruitment of pericytes to stabilize the blood vessels. Homopolymer of 5-ethylene ketal ε-caprolactone and its copolymer with D,L-Lactide were synthesized by ring opening polymerization using hydrophobic initiator (octan-1-ol) or an hydrophilic initiator (MPEG), and stannous octanoate as a co-initiator/catalyst. The resulting polymers were amorphous and viscous liquids at room temperature. The viscosity, biodegradation rate, and release rate were varied by copolymerizing with D,L-lactide and/or initiating with MPEG or octan-1-ol. In vitro, the polymers degraded with surface erosion characterized by a nearly linear mass loss with time with no significant change in number average molecular weight and glass transition temperature. The ratio of EKC to DLLA in the copolymer remained the same throughout the degradation studies. A similar degradation mechanism was observed in vivo when the copolymer initiated with octan-1-ol was implanted subcutaneously in rats. In vivo, the polymer exhibited a moderate chronic inflammatory response, characterized by the presence of neutrophils, macrophages, fibroblasts and fibrous capsule formation. The inflammatory response decreased with time but was still on going after 18 weeks of subcutaneous implantation. Protein release from the polymer was transported by convection through the hydrated polymer region, at a rate determined by the osmotic pressure generated and the hydraulic conductivity of the polymer. Highly bioactive VEGF and HGF were released in a sustained manner, without burst effect for over 41 days when delivered simultaneously, using the osmotic release mechanism. VEGF was released at the rate of 36 ± 7 ng/day for 41 days, while HGF was released at the rate of 16 ± 2 ng/day for 70 days. Factors that influenced release of proteins were their solubility in the concentrated trehalose solution and hydraulic permeability of the polymer. This delivery system can serve as a potential vehicle for controlled release of VEGF and HGF for treating critical limb ischemia or the controlled release of other proteins for other clinical applications. / Thesis (Ph.D, Chemical Engineering) -- Queen's University, 2012-05-23 10:18:48.307