V terapii bolesti se stále častěji využívá moderních lékových forem, které výrazně vylepšují farmakokinetický profil analgetik. Jejich unikátní vlastnosti a rozdíly mezi jednotlivými přípravky přinášejí vyšší nároky na pacienty z hlediska správné aplikace. Článek uvádí příklady moderních lékových forem pro terapii akutní a chronické bolesti se zaměřením na principy výrobci používaných technologií. U jednotlivých lékových forem (orodispergovatelné tablety, tablety s řízeným uvolňováním, transdermální terapeutické systémy, transmukózní přípravky apod.) shrnuje informace poskytované farmaceutem pro jejich správné použití.
Modern dosage forms, which significantly improve the pharmacokinetic profile of analgesics, are increasingly being used in the treatment of pain. The unique features and differences of individual products bring higher demands on patients in terms of correct application. The article presents examples of modern dosage forms for the treatment of acute and chronic pain with focus on the principal technologies used by the producers. For each dosage form (orodispersible tablets, controlled release tablets, transdermal therapeutic systems, etc.), it summarizes the information provided by the pharmacist for proper use.
- Keywords
- transdermální terapeutické systémy,
- MeSH
- Acute Pain drug therapy MeSH
- Analgesics administration & dosage pharmacokinetics classification blood adverse effects MeSH
- Anti-Inflammatory Agents, Non-Steroidal classification blood therapeutic use MeSH
- Administration, Intranasal MeSH
- Administration, Oral MeSH
- Pain * drug therapy classification MeSH
- Buprenorphine administration & dosage MeSH
- Chronic Pain drug therapy MeSH
- Pharmaceutic Aids MeSH
- Fentanyl administration & dosage pharmacokinetics pharmacology classification MeSH
- Dosage Forms MeSH
- Humans MeSH
- Pain Management * methods MeSH
- Analgesics, Opioid administration & dosage pharmacokinetics classification MeSH
- Acetaminophen administration & dosage pharmacokinetics classification blood adverse effects MeSH
- Half-Life MeSH
- Breakthrough Pain drug therapy MeSH
- Tablets administration & dosage classification therapeutic use MeSH
- Drug Administration Routes MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- Grazax, Oralair,
- MeSH
- Hypersensitivity therapy MeSH
- Asthma therapy MeSH
- Desensitization, Immunologic * economics contraindications adverse effects MeSH
- Clinical Studies as Topic MeSH
- Skin Tests MeSH
- Humans MeSH
- Poaceae immunology adverse effects MeSH
- Pollen immunology adverse effects MeSH
- Mites immunology MeSH
- Rhinitis, Allergic, Seasonal therapy MeSH
- Sublingual Immunotherapy * MeSH
- Tablets administration & dosage MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
PURPOSE: Drug administration through nasogastric tube (NGT) is a standard practice but the real amount of the delivered drug is unknown. Therefore, we designed a study to determine the losses of various dosage forms administered by different methods through NGT. METHODS: In vitro model was used. Five different administration methods (A-E) and six dosage forms (simple compressed tablets - T/S; film coated tablets - T/FC; enteric coated tablets - T/EC; capsules with powder filling - C/P; capsules containing extended release pellets - C/ER; capsules containing gastro-resistant pellets - C/GR) were investigated. Measurement was repeated six times for each drug-method combination. The overall losses were determined by gravimetry. In method A partial losses associated with each step of drug administration were also determined. RESULTS: Significant drug losses were measured (4-38%). Only methods A (crushing-beaker-syringe-water-NGT) and B (crushing-water-syringe-NGT) were suitable for administration of all tested dosage forms. Method B proved the most effective for all kinds of tablets and C/GR (p<0.05) and tended to be more effective also for C/ER (p=0.052) compared to method A. C/P showed minimal losses for both tested methods (B and E). Flushing of the drug through NGT causes major losses during drug administration compared to crushing and transfer (p<0.05). All methods for intact pellets (C-E) were found inappropriate for clinical practice due to NGT clogging. CONCLUSIONS: Choosing a suitable administration method can significantly affect the amount of drugs delivered through NGT.
- MeSH
- Intubation, Gastrointestinal * MeSH
- Pharmaceutical Preparations administration & dosage chemistry MeSH
- Delayed-Action Preparations administration & dosage chemistry MeSH
- Tablets administration & dosage chemistry MeSH
- Capsules administration & dosage chemistry MeSH
- Publication type
- Journal Article MeSH
Předmět sdělení: Druhý oddíl literárního přehledu o důkazech podporujících současnou strategii prevence zubního kazu shrnuje poznatky o různých aplikačních formách fluoridů a jejich účinku, zejména u dětí a mládeže. Oddíl je rozčleněn na formy systémové fluoridace, zahrnující fluoridaci pitné vody a mléka, fluoridové suplementy a lokální aplikační formy, zubní pasty, ústní vody, fluoridové gely a laky, prostředky pomalu uvolňující fluorid a komplexní fluoridové soli stříbra. Citované údaje o jejich účinku jsou převzaty zejména z metaanalytických studií a zpráv z cochranovské databáze systematických review. Zmiňovány jsou dále základní dokumenty Světové zdravotnické organizace a národních i nadnárodních odborných organizací, které upozorňují na nutnost kvalifikovaného řízení fluoridové prevence na individuální i komunitní úrovni k dosažení maximálního účinku a minimalizace rizik. Účinnost (ale i bezpečnost) lokálně aplikovaných prostředků v individuální domácí péči o chrup je závislá na míře compliance jedinců, respektive rodičů dětí a na míře kompetence poskytovatelů preventivního poradenství. Široké spektrum těchto prostředků umožňuje individualizaci fluoridové prevence na základě analýzy rizika kazivé ataky a s přihlédnutím k dalším preventivním opatřením.
Background: The second part of the literature review presents evidences supporting the current strategy of caries prevention summarizes knowledge about different forms of fluoride and their effects, especially in children and youth. The review describes individual forms of systemic fluoridation comprising fluoridation of drinking water, milk and fluoride supplements, and topical forms comprising toothpastes, mouthwashes, fluoride gels and varnishes, slow release fluoride devices and complex fluoride salts of silver. The cited data on their effect are taken mainly from meta-analytic studies and reports from Cochrane database systematic reviews. Mentioned below are the basic documents of the World Health Organization and national and international professional organizations, which point to the need for the qualified management of fluoride prevention at the individual and community level to achieve maximum effect and risk minimization. Efficiency (but safety) of topically applied fluorides in individual home dental care is dependent on the degree of compliance of individuals, respectively parents of children and on the level of competence of providers of preventive counselling. The broad spectrum of these resources allows individualization of fluoride prevention based on risk analysis of caries attack and taking into account other preventive measures.
- Keywords
- systémová fluoridová prevence, lokální fluoridová prevence,
- MeSH
- Self Administration MeSH
- Fluorosis, Dental etiology MeSH
- Fluoridation * MeSH
- Fluorides * administration & dosage adverse effects therapeutic use MeSH
- Gels MeSH
- Cariostatic Agents administration & dosage adverse effects therapeutic use MeSH
- Sodium Chloride, Dietary MeSH
- Delayed-Action Preparations MeSH
- Humans MeSH
- Fluorides, Topical administration & dosage adverse effects therapeutic use MeSH
- Evidence-Based Medicine MeSH
- Milk MeSH
- Oral Hygiene MeSH
- Drinking Water MeSH
- Dietary Supplements MeSH
- Primary Prevention MeSH
- Tablets administration & dosage MeSH
- Mouthwashes MeSH
- Dose-Response Relationship, Drug MeSH
- Dental Caries * prevention & control MeSH
- Dental Materials chemistry MeSH
- Toothpastes administration & dosage chemistry MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- MeSH
- Allergens immunology classification adverse effects MeSH
- Hypersensitivity prevention & control MeSH
- Administration, Sublingual MeSH
- Asthma * diagnosis immunology pathology therapy MeSH
- Desensitization, Immunologic * methods utilization MeSH
- Child MeSH
- Adult MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- Rhinitis, Allergic, Seasonal prevention & control therapy MeSH
- Tablets administration & dosage therapeutic use MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- MeSH
- Conjunctivitis, Allergic drug therapy immunology MeSH
- Administration, Sublingual MeSH
- Desensitization, Immunologic methods adverse effects MeSH
- Child MeSH
- Adult MeSH
- Drug Evaluation MeSH
- Humans MeSH
- Poaceae immunology MeSH
- Adolescent MeSH
- Pollen immunology MeSH
- Randomized Controlled Trials as Topic MeSH
- Rhinitis, Allergic, Seasonal drug therapy immunology MeSH
- Tablets administration & dosage therapeutic use MeSH
- Treatment Outcome MeSH
- Dose-Response Relationship, Drug MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
Specifická alergenová imunoterapie je dosud jediná kauzální terapie zasahující do vývoje specifické imunologické přecitlivělosti. Svým postupným účinkem je schopna tlumit proces alergizace pacienta s navozením tolerance vůči příčinnému „přírodnímu“ alergenu. Rok 2011 byl v oboru alergologie a klinické imunologie významný, neboť uplynulo 100 let od doby, kdy v časopise Lancet byl publikován klíčový článek s názvem Prophylactic Inoculation against Hay Fever autora Leonarda Noona. Dnes je specifická alergenová imunoterapie součástí standardizovaných doporučených postupů. S vazbou na aeroalergeny je specifická alergenová imunoterapie v současné době indikována především při projevech alergické rinokonjunktivitidy, intermitentního a lehkého perzistujícího průduškového astmatu. V posledních letech se dostává do popředí z hlediska dostupnosti i bezpečnosti neinjekční forma alergenové imunoterapie – sublingvální aplikace. Světová alergologická organizace publikovala v roce 2009 významný dokument o sublingvální alergenové imunoterapii, ve kterém byly doloženy její účinnost, bezpečnost i efekt srovnatelný s léčbou injekční. Po sublingválních alergenech ve formě kapek jsou terapeutickou novinkou sublingvální alergenové imunoterapie tablety se standardizovaným obsahem pylových alergenů. Terapie je indikována u dětí starších 5 let, dospívajících a dospělých s klinicky významnými příznaky alergické rinokonjunktivitidy způsobené pyly trav. Alergická vazba by měla být potvrzena pozitivními kožními prick testy a popřípadě pozitivitou specifických IgE protilátek proti pylům trav. Otvírají se nám tak možnosti nové účinné formy sublingvální imunoterapie.
Specific allergen immunotherapy (SIT) is at present the only causal therapy interfering with development of specific hypersensitivity. With its gradual effects, it is capable of suppressing the patient's allergisation by inducing tolerance towards the „natural“ allergen in question. The year 2011 was an important one for the field of allergology and clinical immunology, because it had been 100 years since The Lancet published a key article called Prophylactic Inoculation against Hay Fever by Leonard Noon. Today, SIT forms a part of standardised recommended courses of treatment. In relation to aero-allergens, SIT is presently prescribed primarily for symptoms of allergic rhinoconjunctivitis, intermittent and mild persistent asthma. In the last couple of years, a new form of allergen immunotherapy has been coming to the forefront thanks to its safety and availability-sublingual application. In 2009, the World Allergologic Organisation (WAO) published an important document on sublingual allergen immunotherapy (SLIT), providing evidence for its effects, safety and efficacy comparable to injections. The most recent variant of SLIT (that came after sublingual allergen solutions in form of drops) are tablets containing a standardised dose of pollen allergens. The therapy is prescribed for children above 5 years of age, adolescents and adults with clinically significant symptoms of allergic rhinoconjunctivitis caused by the pollens of various grasses. The allergic nature of the symptoms should be verified by skin prick tests, or alternatively by a test for specific IgE antibodies for grass pollens. Thus, with a new, efficient form of sublingual immunotherapy, new possibilities are becoming open to us.
- Keywords
- Grazax, Oralair, specifická alergenová imunoterapie,
- MeSH
- Administration, Sublingual MeSH
- Desensitization, Immunologic methods utilization MeSH
- Child MeSH
- Adult MeSH
- Drug Evaluation MeSH
- Immunoglobulin E diagnostic use immunology MeSH
- Skin Tests methods utilization MeSH
- Humans MeSH
- Evidence-Based Medicine MeSH
- Meta-Analysis as Topic MeSH
- Adolescent MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Plant Extracts immunology therapeutic use MeSH
- Rhinitis, Allergic, Seasonal complications prevention & control MeSH
- Statistics as Topic MeSH
- Tablets administration & dosage adverse effects therapeutic use MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
The present study was undertaken to evaluate the possibility of chiral discrimination in the release of enantiomers of ketoprofen (KT) in tablet form and, in turn, the bioavailability of the individual enantiomers, using the rabbit as a model. The enantiomeric concentration of KT in plasma was determined using a customized chiral HPLC analysis. First the plasma concentration-time profile was established for pure (±) KT in order to assess the extent of chiral discrimination. Subsequently the tablet formulation (Rhofenid-100mg) was administered, at a dose equivalent to 10 mg/kg, to assess the enantiospecific bioavailability of KT enantiomers in the rabbit following the same protocol as followed for the pure KT. In vivo studies revealed that the bioavailability of S-KT is higher than that of the Renantiomer, after oral dosing with both KT-tablet and KT-pure. But the degree of chiral discrimination is more pronounced and more statistically significant in the case KT formulation as reflected by the enantioselective pharmacokinetic data. The observations presented in this article further emphasize the significance of differentiating between enantiomers of chiral drugs when assessing bioavailability and correlating efficiency with drug concentration. The study opens up a new avenue to the design of stereoselective dosage forms.
- MeSH
- Biological Availability MeSH
- Pharmacokinetics MeSH
- Financing, Government MeSH
- Data Interpretation, Statistical MeSH
- Ketoprofen administration & dosage metabolism therapeutic use MeSH
- Tablets administration & dosage pharmacokinetics therapeutic use MeSH
- Chromatography, High Pressure Liquid methods utilization MeSH
Polosyntetické a syntetické polymery našly své uplatnění v technologii hydrofilních matricových systémů s řízeným uvolňováním léčiva zejména v oblasti perorální aplikace. V poslední době vzrůstá zájem také o přírodní polymerní látky, jejichž přednosti spočívají v bezpečnosti, snadné dostupnosti a relativně nízké ceně. Představují tak zajímavou možnost v rozšíření výběru nových konstitutivních pomocných látek. Přehledný článek uvádí nejdůležitější přírodní polymery: alginany, karageny, arabskou gumu, pektiny, galaktomanany, ispaghulu a xantanovou gumu jako potenciální nosiče pro perorální hydrofilní systémy s řízenou liberací léčiv, popisuje jejich původ, vlastnosti a možnosti jejich využití ve farmacii.
Semisynthetic and synthetic polymers have found their use in the technology of hydrophilic matrix systems with controlled release of the active ingredient, in particular in oral administration. In the recent period, there is increased interest also in natural polymeric substances, whose advantage consists in safety, easy availability, and a relatively low price. They thus represent an interesting possibility to extend the selection of novel constitutive auxiliary substances. The present review paper surveys the most important natural polymers: alginans, carageens, Arabic gum, pectins, galactomanans, ispaghul, and xantan gum as potential carriers for oral hydrophilic systems with controlled release of active ingredients and describes its origin, properties, and possible uses in pharmacy.
- MeSH
- Alginates chemistry isolation & purification therapeutic use MeSH
- Gum Arabic chemistry isolation & purification therapeutic use MeSH
- Galactans chemistry therapeutic use MeSH
- Carrageenan chemistry isolation & purification therapeutic use MeSH
- Drug Delivery Systems MeSH
- Drug Carriers administration & dosage pharmacokinetics chemistry MeSH
- Pectins chemistry therapeutic use MeSH
- Polymers chemistry isolation & purification therapeutic use MeSH
- Review Literature as Topic MeSH
- Tablets administration & dosage MeSH
