Implanted Drug Delivery Systems for Control of Chronic Pain

1997 ◽  
pp. 302-324 ◽  
Author(s):  
Robert M. Levy ◽  
Damon Salzman
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Delivery Systems

scholarly journals Use of Color Flow Doppler Ultrasonography to Increase the Safety of Intrathecal Drug Delivery System Refills

2019 ◽  
pp. 173-177
Author(s):  
Ankur D. Mehta
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Doppler Ultrasonography ◽  
Delivery Systems ◽  
Ultrasound Images ◽  
Common Procedure ◽  
Color Flow ◽  
Intrathecal Drug Delivery ◽  
Flow Leak

Intrathecal drug delivery systems are effective tools in the treatment of chronic pain or spasticity. Using intrathecal drug delivery systems, drugs are directly infused into the cerebrospinal fluid and gain access to critical receptors in the central nervous system. This delivery method allows for the use of markedly reduced doses of medications to produce the same effects as seen with higher orally administered doses. Reduced dosing produces fewer side effects, creating a more favorable treatment course for patients already suffering from chronic pain or spasticity. Complications with intrathecal drug delivery systems can occur during both the implantation process and the postoperative maintenance of the device. The most common procedure carried out during postoperative maintenance of these devices is the intrathecal pump refill. This procedure must be performed by experienced practitioners in a systematic way in order to prevent complications. The most dreaded of these complications is inadvertent injection of medication into the subcutaneous space as opposed to into the device, commonly referred to as a “pocket fill.” This paper describes and recommends the routine use of color flow doppler ultrasonography as an easy, safe, and effective tool to reduce the chance of a catastrophic “pocket fill.” Routine utilization of live color flow ultrasound guidance during pump refills allows the practitioner to carefully document flow of medication into the pump under the silicone septum. It also allows for demonstration of no leakage from, or fluid increase superficial to, the septum. Additionally, 2 ultrasound images are obtained to document color flow deep to the septum and no color flow/leak/fluid superficial to the septum. Although this complication is rare, it can lead to severe complications including oversedation, respiratory depression, and death. As such, we believe that the utilization of color phase doppler ultrasonography could further reduce this incidence. Key words: Analgesics, opioids, chronic pain, drug overdose, infusion pumps, implantable, injections, spinal, medication errors, spasticity, ultrasonics, methods, ultrasonography, interventional

A Two-Liquid Electroosmotic Pump for Portable Drug Delivery Systems

2007 ◽  
Author(s):  
Shawn Litster ◽  
Byunghang Ha ◽  
Daejoong Kim ◽  
Juan G. Santiago
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Drug Dosage ◽  
Delivery Systems ◽  
Chronic Pain Management ◽  
Patient Mobility ◽  
Infusion Pumps ◽  
Electroosmotic Pump ◽  
Improve Patient

Portable drug delivery systems present an opportunity to improve patient mobility and reduce drug dosage. Infusion pumps for drug delivery are heavily used in hospital and home care settings to administer a variety of therapies such as chemotherapy, antimicrobials, analgesia, anesthesia, and post-operative and chronic pain management. We are developing electroosmotic (EO) pumps for drug delivery applications. EO pumps offer active dosage control, are compact, use low power, and have no moving parts. We here explore a two-liquid EO pump that decouples the drug from the working electrolyte with a series of collapsible membranes and enables EO pumping of a wide variety of medications.

Physician Guidance on the Use of Off‐Labeled Drugs in Intrathecal Drug Delivery Systems for Chronic Pain

2019 ◽  
Vol 22 (7) ◽  
pp. 765-768
Author(s):  
Timothy Deer ◽  
Phillip Kim ◽  
Jason E. Pope ◽  
Salim Hayek ◽  
Gladstone McDowell ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Delivery Systems ◽  
Intrathecal Drug Delivery

Implanted Drug Delivery Systems for Control of Chronic Pain

2018 ◽  
pp. 693-702.e2 ◽  
Author(s):  
David E. Jamison ◽  
Steven P. Cohen ◽  
Joshua Rosenow
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Delivery Systems

Implanted drug delivery systems for the control of chronic pain

2011 ◽  
pp. 451-461
Author(s):  
Allan Nanney ◽  
Kenji Muro ◽  
Robert M. Levy
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Delivery Systems

Techniques For The Preparation of Tissue Samples Containing Injectable Polymer Microcapsules

1985 ◽  
Vol 43 ◽  
pp. 710-711
Author(s):  
G.E. Visscher ◽  
R. L. Robison ◽  
G. J. Argentieri
Keyword(s):  
Drug Delivery ◽  
Drug Delivery Systems ◽  
Gastrocnemius Muscle ◽  
Degradation Process ◽  
Delivery Systems ◽  
Tissue Reaction ◽  
Electron Microscopic ◽  
Tissue Samples ◽  
Injectable Polymer ◽  
Microscopic Techniques

The use of various bioerodable polymers as drug delivery systems has gained considerable interest in recent years. Among some of the shapes used as delivery systems are films, rods and microcapsules. The work presented here will deal with the techniques we have utilized for the analysis of the tissue reaction to and actual biodegradation of injectable microcapsules. This work has utilized light microscopic (LM), transmission (TEM) and scanning (SEM) electron microscopic techniques. The design of our studies has utilized methodology that would; 1. best characterize the actual degradation process without artifacts introduced by fixation procedures and 2. allow for reproducible results.In our studies, the gastrocnemius muscle of the rat was chosen as the injection site. Prior to the injection of microcapsules the skin above the sites was shaved and tattooed for later recognition and recovery. 1.0 cc syringes were loaded with the desired quantity of microcapsules and the vehicle (0.5% hydroxypropylmethycellulose) drawn up. The syringes were agitated to suspend the microcapsules in the injection vehicle.

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