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Approaches to topical treatment (1) (2) (3) (1) Manipulate the barrier (2) Direct drugs to viable skin tissues (3) Skin treatment for systemic conditions Target regions of topical treatment Interfacial boundries (1) Surface (2) Stratum corneum Penetration routes Drug dissolves diffuses, releases from vehicle Partition/diffusion stratum corneum (3) Appendages Pilosebaseous unit Some treatments 1. Camouflage 2. Protective layer 3. Insect repellant 4. Antimicrobial 1. Emoliency 2. Keratosis Ecrine 1. Antiperspirant gland 2. Exfolient 3. Antibiotic 4. Depilatory Interfacial boundries Penetration routes Some treatments (con’t) (4) Viable epidermis Partition/diffusion viable epidermis 1. Antiinflammatory 2. Anaesthetic Dermis corneum (5) Circulation Partition/diffusion dermis Removal via circulation 3. Antipruritic 4. Antihistamine 1. Transdermal delivery Sample Question • Ms. Smiley consulted pharmacist Dr. Thoughtful for an insect repellant to be used on her 2 year old Bliss who has a dry skin problem. To maintain Bliss’s skin smooth and moist, Ms. Smiley has been applying Aquophilic (a water in oil cream). She wanted to know if it is OK to apply insect repellent on the skin that is moisturized with the cream. Transdermal drug delivery systems (TDDS) • Pharmaceutical formulations that are designed to deliver an active drug across the skin into systemic circulation. • Substances that possess both aqueous and lipid solubility characteristics are good candidates for diffusion through skin. • Types of transdermal control released systems. 1. Membrane controlled systems. 2. Adhesive diffusion - controlled systems. 3. Matrix controlled systems. TDD Patch Construction Matrix Nitro-Dur (Key Pharma) Reservoir E.g.Transderm-NitroTM (Ciba/Pharmaco) Drug-in-Adhesive Multi-Layer DeponitTM (Pharma-Schwartz) Backing Drug Drug-in-Adhesive Single-Layer Nitrodisc (Searle Pharma) Membrane Adhesive Liner/Skin Sample Question • Which of the patches outlined in the cartoon can be cut to customize dose according to patient need. Why transdermal drug delivery? • Continous IV administration at a constant rate of infusion is a superior mode of drug delivery • IV administration avoids hepatic first-pass metabolism and maintain constant therapeutic drug levels in the body • TDD can closely duplicate continuous IV fusion. Hence it is helpful in delivering drugs that undergo significant first pass metabolism and/or have narrow therapeutic index Sample Question • Ibuprofen (Motrin) is usually administered 300 mg every 6 hours for acute muscle pain/inflamation. Orally administered ibuprofen may cause gastric discomfort. Although ibuprofen is lipophilic and might have good skin permeability, transdermal delivery is not an alternative for ibuprofen why? Principles of diffusion through membranes Homogenous membrane Aqueous pores Cellulose fibres (1) Diffusion - random molecular motion. Must have concentration gradient. K D C0 Donor solution h Cd C1 C2 Donor Cr Receptor Fick’s law of diffusion dM SDC1 C2 J dt h Since K = C1 = C2 Cd Cr Where, dM = change in mass transferred dt in change of time t D = diffusion constant C1 = concentration in donor compartment C2 = concentration in receptor compartment S = surface area of membrane dM SDK Cd Cr dt h Under sink conditions and rearranging all constants, M r PSC d t Where, P = permeability constant Sample Questions • What is the flux of drug entering systemic circulation from a patch having a surface area of 10 cm2, containing 50 mg of drug. The average skin thickness of the patient is 7mm. Diffusion coefficient of the skin is 1 x 10-5 cm/min. • Using the above information, calculate the permeability coefficient of the drug across skin. • What is the total amount of drug delivered from the patch into blood stream in 12 hours. Complex diffusional barriers Stratum corneum Epidermis Dermis Subcutaneous 1 1 1 1 R ... t P DK D K D K t 1 1 2 2 n n Where, Rt = Total diffusing resistance Pt = Thickness – weighted permeability coeff. Parrallel dM SDK Cd Cr dt h FOR EACH Sample questions • Flux of a drug Y across the stratum corneum is 0.1g/cm2 hr and the flux across the rest of epidermis, dermis and sub-dermis is 0.5, 2 and 1.5 g/cm2 hr, respectively. Calculate the total diffusional resistance across the skin for drug Y. • The flux of drug Y across hair follicles, sweat glands and sebaceous glands is 10-5, 10-6 and 10-5 g/cm2 hr. What is the total appendageal flux of drug Y. • What is the total flux of drug Y across the skin, both transdermal and trans-appendageal combined. Factors influencing the rate of percutaneous diffusion 1. Diffusant solubility (C0) 2. Partition coefficient (K) 3. pH variation (K) 4. Co-solvents (K and C0) 5. Surface activity and micellization (C0) 6. Complexation (K) 7. Diffusivity (D) Sample Questions • Diffusion coefficient of drug A is 10-6 and the diffusion coefficient of drug B is 10-4 if all the other parameters are constant, which drug is likely to have better flux across skin. • If the surface area of patch A is 2 cm2 and that of patch B is 4 cm2, which of these two patches is likely to have more drug delivered across skin and by what extent. • Log K of drug X is -1, log K of drug Y is 2 and that of drug Z is 4, which is more likely to have better transdermal permeability and which is more likely to have better transappendageal permeability. Factors that effect percutaneous absorption Biological factors 1. Skin age 2. Skin condition 3. Regional skin sites 4. Skin metabolism 5. Circulatory effects Hints • Know how each of these factors affect skin permeability Physicochemical factors 1. Skin hydration 2. Drug/skin binding 3. Temperature 4. Penetration enhancers 5. Drug/vehicle interaction Hints • Know how each of these factors affect skin permeability Attributes of a Passive TDD Drug Candidate • • • • • • Daily dose (< 20 mg/day) Half-life (10 hours or less) Molecular weight (< 500 Daltons) Melting point (< 200 oC) Skin permeability Lipid solubility [partition coefficient (Log P) between –1.0 and 4] • Toxicology profile (non-irritating and non-sensitizing to skin) Hints • Know how each of these factors affect skin permeability