Continuous Drug Delivery is Significantly Affected by Relative Height Changes Between Patient and Syringe Driver

2021 ◽  
Vol 17 (1) ◽  
pp. e15-e19
Author(s):  
Aisha Zahid ◽  
Dusan Raffaj ◽  
Andrew Wignell ◽  
Patrick Davies
Keyword(s):  
Drug Delivery ◽  
Relative Height ◽  
Syringe Driver ◽  
Continuous Drug Delivery

scholarly journals P57 Continuous drug delivery is significantly affected by relative height changes between patient and syringe driver

2020 ◽  
Vol 105 (9) ◽  
pp. e36.1-e36
Author(s):  
Aisha Zahid ◽  
Andrew Wignell ◽  
Dusan Raffaj ◽  
Patrick Davies
Keyword(s):  
Drug Delivery ◽  
Vertical Movement ◽  
Relative Height ◽  
Becton Dickinson ◽  
Extreme Caution ◽  
Air Bubble ◽  
Equivalent Number ◽  
Syringe Driver ◽  
Before And After ◽  
Continuous Drug Delivery

AimsSyringe drivers are the principle method of giving continuous infusions of important drugs to patients. Many of these drugs are critical for the maintenance of normal physiology. Anecdotal evidence abounds of severe patient instability on movement of syringe drivers during infusion. Our objective was to define the variation in drug delivery seen in three different syringe drivers, with changes in relative height between the syringe driver and the end of the giving set.MethodsThree syringe drivers (Alaris CC (Becton Dickinson), Perfusor Space (B Braun), and Synamed μSP6000 (Arcomed)) were analysed for reliability of flow at 0.5, 1, 2, and 5 ml/hr. A small air bubble was introduced into the giving set, and the progression of this was documented before and after a vertical movement of the syringe driver by 25 or 50 cm upwards or downwards relative to the delivery port.ResultsFor all pumps, delivery was interrupted on movement of the pumps downwards, and a bolus was given with movement of the pump upwards. Delivery halted at lower pump speeds for longer than higher pump speeds. The maximum delivery interruption was 11.8 minutes. Boluses given on moving the pump up were calculated as the equivalent number of minutes needed to deliver the bolus volume at steady state. The maximum bolus given was equivalent to 15.8 minutes of delivery. We were unable to eliminate the effects seen by very slow, steady movement of the pumps up or down. Static height differences made no difference to delivery.ConclusionsSyringe drivers should not be moved vertically in relation to the patient. Critical drug delivery is interrupted for up to 12 minutes with relative downward movements, and significant boluses of drugs are given with relative upward movements. As far as possible, elimination of relative height movements is advised, and extreme caution is necessary if any movements are unavoidable.

Continuous drug delivery by an implantable pump

1984 ◽  
Vol 1 (2) ◽  
pp. 17-20 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Teddi M. Reeder
Keyword(s):  
Drug Delivery ◽  
Implantable Pump ◽  
Continuous Drug Delivery

scholarly journals A Novel Chitosan Nanosponge as a Vehicle for Transepidermal Drug Delivery

Pharmaceutics ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1329
Author(s):  
Jin Sil Lee ◽  
Hyeryeon Oh ◽  
Sunghyun Kim ◽  
Jeung-Hoon Lee ◽  
Yong Chul Shin ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Dermal Fibroblasts ◽  
Poloxamer 407 ◽  
The Novel ◽  
Drug Penetration ◽  
Drug Permeability ◽  
Drug Concentrations ◽  
Human Cadaver Skin ◽  
Cadaver Skin ◽  
Continuous Drug Delivery

Transepidermal drug delivery achieves high drug concentrations at the action site and ensures continuous drug delivery and better patient compliance with fewer adverse effects. However, drug delivery through topical application is still limited in terms of drug penetration. Chitosan is a promising enhancer to overcome this constraint, as it can enhance drug diffusion by opening the tight junctions of the stratum corneum. Therefore, here, we developed a novel chitosan nanosponge (CNS) with an optimal ratio and molecular weight of chitosan to improve drug penetration through skin. To prepare the CNS, two types of chitosan (3 and 10 kDa) were each conjugated with poloxamer 407 using para-nitrophenyl chloroformate, and the products were mixed with poloxamer 407 at ratios of 5:5, 8:2, and 10:0. The resulting mixtures were molded to produce flexible soft nanosponges by simple nanoprecipitation. The CNSs were highly stable in biological buffer for four weeks and showed no toxicity in human dermal fibroblasts. The CNSs increased drug permeability through human cadaver skin in a Franz-type diffusion cell, with substantially higher permeability with 3 kDa chitosan at a ratio of 8:2. This suggests the applicability of the novel CNS as a promising carrier for efficient transepidermal drug delivery.

Rotigotine for the Treatment of Advanced Parkinson's Disease

2009 ◽  
Vol 4 (2) ◽  
pp. 24
Author(s):  
Santiago Perez Lloret ◽  
Olivier Rascol ◽  
◽  
Keyword(s):  
Parkinson’S Disease ◽  
Drug Delivery ◽  
Parkinson's Disease ◽  
Clinical Efficacy ◽  
Transdermal Patch ◽  
Motor Complications ◽  
Once Daily ◽  
Rotigotine Patch ◽  
Continuous Drug Delivery ◽  
Rotigotine Transdermal Patch

Background: Rotigotine, a non-ergot dopamine agonist, has been developed as a novel transdermal formulation. The rotigotine transdermal patch is approved by the regulatory authorities for use in all stages of Parkinson’s disease (PD) in Europe and for early-stage PD in the US. For patients with advanced-stage PD and motor fluctuations, approved doses range from 4mg/24 hours to 16mg/24 hours. The rotigotine patch offers a certain number of potential advantages, including faster onset as intestinal absorption is not needed, continuous drug delivery and ease of use via application of a once-daily adhesive patch. An interesting element of this profile is continuous drug delivery, which may avoid the pulsatile dopaminergic stimulation that has been postulated to be related to the development of motor complications.Objective: The aim of this article is to review the pharmacokinetics, pharmacodynamics and clinical efficacy and tolerability of the rotigotine transdermal patch.Methods: Source material was identified using a PubMed search for the term ‘rotigotine’ in articles published up to October 2009 and a review of published congress abstracts. The review focused primarily on publications related to the rotigotine indication for advanced PD.Results and conclusions: The rotigotine transdermal patch demonstrates clinical efficacy and a tolerability profile that appears to be well within the range of that observed with other non-ergot dopamine agonists, except for local skin reactions, which are common with the rotigotine patch. The once-daily patch formulation may encourage compliance; however, as is the case for other theoretical advantages of continuous drug delivery, such as reduced emergence of motor complications and improved tolerance of peripheral adverse events, this requires further detailed study.

Continuous Drug Delivery in Parkinson’s Disease

CNS Drugs ◽  
2013 ◽  
Vol 28 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Marina Senek ◽  
Dag Nyholm
Keyword(s):  
Parkinson’S Disease ◽  
Drug Delivery ◽  
Parkinson's Disease ◽  
Continuous Drug Delivery
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