Intelligent Drug Delivery
      System (IDDS)



       By
       Dr. Shreeraj Shah
       Associate Professor,
       Dept. of Pharmaceutical Technology,
       L.J. Institute of Pharmacy, Ahmedabad
                                         1
Contents
Introduction of IDDS
Classification (Types of IDDS)
 Pulsatile system
 Responsive system
 System utilizing enzymes
 System utilizing chelation
 Systems utilizing antibody interactions
Recent Advances
References


                                            2
Introduction
   The conventional manner of introducing drug to patient is inefficient
    and often lead to toxic side effect.
   The dramatic advance in controlled and targeted drug delivery system
    over past few decades have lead to enormous expectation for treatment
    of no. of complicated aliments with minimum side effect.
   One class of such system is intelligent drug delivery system.
   Intelligent drug delivery systems are capable of adjusting drug release
    rates in response to a physiological need.
   This system help to maintain drug in therapeutic range with single
    dose, localize delivery of drug (at targeted site) to particular
    compartment,      preserve     the     medicament   that   are   rapidly
    destroyed ,improve the patient compliance.                             3
How it works…..




                  4
Schematic Diagram of working of IDDS
                                       5
Intelligent drug delivery system may be
1.Open- loop system or
2.Closed-loop systems.




                                          6
1. Open-loop control systems
In the controlled drug delivery field, open-
   loop systems are known as pulsed or
   externally regulated system.
The externally controlled devices apply
   external triggers for pulsed delivery of drug
   such as: magnetism, ultrasound, and electrical
   effect etc.
It involves following systems :
  ◦   Magnetically modulated drug delivery system
  ◦   Ultrasonically modulated drug delivery system
  ◦   Electrically modulated drug delivery system
  ◦   Thermo sensitive drug delivery system etc.

                                                      7
2. Closed-loop control systems
 The  closed-loop systems are known as self regulated system.
  In the self-regulated devices release rate of drug is controlled
  by feedback information, without any external intervention.
 In closed-loop control systems the controlled variable is
  detected and as a result the system output is adjusted
  accordingly.
 The self-regulated systems utilize several approaches as rate-
  control mechanisms like pH-sensitive polymers, enzyme-
  substrate reactions, pH-sensitive drug Solubility, competitive
  binding and metal concentration-dependent hydrolysis. It
  involve following system:
  ◦ pH responsive drug delivery
  ◦ Glucose-responsive insulin delivery
  ◦ Urea-responsive drug delivery system
  ◦ Inflammation-induced pulsatile release
  ◦ Morphine triggered Naltrexone delivery system etc.

                                                                     8
Classification of Intelligent Drug Delivery
System (IDDS)
   Classification (Types of IDDS)
     Pulsatile system
        Magnetically Modulated Systems
        Electrically Regulated System
        Ultrasonically Modulated Systems
        Photoresponsive Systems
     Responsive system
       pH responsive drug delivery
       Inflammation-induced drug release
       Thermoresponsive drug delivery system
       Glucose and Other Saccharide Sensitive Polymers
     System utilizing enzymes
       Glucose-responsive insulin release devices
       Urea-responsive delivery
       Morphine triggered Naltrexone delivery
     System utilizing chelation
     Systems utilizing antibody interactions
                                                          9
Schematic representation of classification
                                             10
1. Pulsatile system
PDDS     (pulsatile drug delivery systems) are
 gaining importance in the field of
 pharmaceutical technology as these systems
 deliver the right dose at specific time at a
 specific site. Some of the disease conditions
 wherein PDDS are promising include
 duodenal ulcer, cardiovascular diseases,
 arthritis, asthma, diabetes, neurological
 disorder, cancer, hypertension etc.
In pulsatile drug delivery system       drug
 release is programmed by external stimuli
 like magnetism, ultrasound, electrical effect
 and irradiation etc.                         11
a) Magnetically control drug delivery system :
Magnetic drug delivery by particulate carriers is a
 very efficient method of delivering a drug to a
 localized disease site.
Very high concentrations of chemotherapeutic and
 radiological agents can be achieved near the target
 site, such as a tumor without any toxic effects to
 normal surrounding tissue or to the whole body.
This approach involves incorporation of magnetic
 beads in elastic polymer(generally ethylene vinyl
 acetate copolymer) .
Application of oscillating magnetic field leading to
 swelling of polymer which modulate drug release
 from polymer matrix.
                                                    12
In magnetic targeting, a drug bound to a magnetic
 compound is administered to patient and then
 stopped with a powerful magnetic field in the
 target area. Depending on the type of drug, it is
 then slowly released from the magnetic carriers .
Magnetic carriers receive their magnetic response
 to a magnetic field from incorporated materials
 such as Magnetite (Fe3O4), Iron, Nickel, Cobalt etc.
For  biomedical applications, magnetic carriers
 must be water-based, biocompatible, non-toxic and
 non-immunogenic.


                                                    13
b) Electrically modulated drug delivery
system :
 This system exhibit drug release under the effect of
  an applied electrical field due to action of an
  applied electrical field on rate limiting membrane
  or directly on solute thereby controlling its
  transport across the membrane.
 Electrically modulated delivery systems are
  prepared from polyelectrolytes (polymers which
  contain relatively high concentration of ionisable
  groups along the backbone chain) and are thus, pH-
  responsive as well as electro-responsive.
 In this system drug is disperse in hydrogel which
  is implanted subcutaneously.
                                                     14
 When   drug release is desired, an electro conducting patch
  is applied on skin directly over gel and electrode are
  plugged into patch and electrical field is applied.
 Under influence of electrical field, electro responsive
  hydrogel swells or bends and release the drug.
 Also hydrogel in the form of beads can be injected
  subcutaneously or polymer solution which can be injected
  as liquid but which form gel at body temperature.
 Electrical current is also use in form of Iontophoresis or
  electroporation in field of transdermal drug delivery.
 Examples of naturally occurring polymers include
  hyaluronic acid, chondroitin sulphate, agarose, carbomer,
  xanthan gum and calcium alginate.
 The synthetic polymers are generally acrylate and
  methacrylate derivatives such as partially hydrolyzed
  polyacrylamide, polydimethylaminopropyl acrylamide
                                                           15
c) Ultrasonically modulated system:
In   this system release rate of drug is repeatedly
 modulated externally by ultrasound.
Both    non erodible as well as bioerodible polymer
 are used for preparation of polymer matrices.
Bioerodible      polymers    include   polylactide,
 polyglycolide, poly(bis(p-carboxyphenoxy)alkane
 anhydrides and their copolymers with sebacic
 acid.

                                                   16
The    bioactive used are p-aminohippurate,
 insulin and bovin serum albumin etc.
On exposure to ultrasound, polymer erosion
 occur and drug is released in controlled manner
 from polymer metrices.
While in the non erodible polymer system,
 drug release is diffusion controlled.
Studies revealed that release rate of bovine
 serum insulin from ethylene vinyl acetate
 copolymer matrices were 15 times higher when
 exposed to ultrasound.
It has been found that extent of enhancement
 can be regulated by the frequency, intensity, or
 cycle of applied ultrasound.
                                                17
d) Photoresponsive system:
This approach involves use of photo responsive
 polymer.
The photo responsive polymer consist of
 photoreceptor usually photochromic chromophore
 and functional part.
 Photoresponsive system is triggered by light
 stimulus leading to macroscopic changes in the
 system for controlled release of drug in terms of
 quantity, location and time.




                                                 18
The  Photoresponsive system is a molecular scale
 polymer matrix of photolabile conjugate with drug,
 which can be exposed to light stimuli with high
 level of control in terms of wavelength, duration,
 intensity and location; leading to photo-chemical
 reaction yielding deformation of conjugates and
 drug liberation from matrix.
 Photoresponsive system has found applications
 in the ophthalmology (Intra ocular lenses for
 cataract treatment) as well as in administration of
 NSAIDS.


                                                   19
2. Responsive system
This  system involves the use of polymer which
 are responsive to change in body enviroment.
In this system drug delivery is controlled by
 means of an interaction with the surrounding
 environment without the aid of any external
 stimuli.




                                              20
a) pH responsive drug delivery
This  approach utilizes the existence of pH
 change in different part of body.
There exists obvious change in pH along the
 GI tract from acidic in the stomach to basic
 in the intestine (pH=5–8).
Also ,there are      changes within different
 tissue like Certain cancers as well as inflamed
 or wound tissue exhibit a pH different from
 7.4 . For example, chronic wounds have been
 reported to have pH values between 7.4 and
 5.4 and cancer tissue is also reported to be
 acidic extracellularly .
                                               21
pH    in various tissues and cellular
 compartments:
Tissue/cellular compartment   pH
 ◦   Blood                   7.35–7.45
 ◦   Stomach                 1.5–3.5
 ◦   Small intestine         5.5-6.8
 ◦   Colon                   6.4–7.0
 ◦   Lysosome                4.5–5.0
 ◦   Golgi                   6.4
 ◦   Tumour, extracellular    6.5-7.2



                                         22
This   approach involve use of pH sensitive
 polymer.
By   selecting the pH dependent polymers drug
 release at specific location can be obtained.
 Examples of pH dependent polymers include
 Cellulose Acetate Phthalate, polyacrylates,
 HPMCP, etc.
Coating    of the drug core with pH sensitive
 polymers has been successfully used for
 colonic drug delivery.
                                             23
b) Inflammation-induced drug release :
   This approach is used to treat patients with inflammatory diseases like
    rheumatoid arthritis using anti-inflammatory drug.
   This approach involves dispersion of drug loaded lipid microspheres in
    to degradable metrices of cross linked hyaluronic acid.
   Hyaluronic Acid gel is injected at inflammatory sites which is
    specifically   degraded   by    hydroxyl     radicals   produced   from
    inflammation-responsive cells during inflammation.
   The degradation of hyaluronic acid by hydroxyl radicals may be
    dominant and rapid as compared to that by hyaluronidase
   Hyaluronic acid has been extensively used in vivo as a therapeutic
    agent for ophthalmic surgery and arthritis
                                                                         24
c) Thermoresponsive drug delivery system:
 The   use of temperature as a signal has been justified by the fact
  that the body temperature often deviates from the physiological
  temperature (37°C) in the presence of pathogens or pyrogens.
 This deviation is a useful stimulus that activates the release of
  therapeutic agents from various temperature-responsive drug
  delivery systems for diseases accompanying fever.
 The drug delivery systems that are responsive to temperature
  utilize various polymer properties, including the thermally
  reversible transition of polymer molecules, swelling change of
  networks, glass transition and crystalline melting.
 Examples of thermoresponsive polymers are Poly (N,N-
  diethylacrylamide),Poly (methyl vinyl ether),Poly (N-
  vinylcaprolactam) , Pluronics, tetronics


                                                                  25
d) Glucose and Other Saccharide Sensitive Polymers:

Brownlee   and Cerami (1979) firstly presented the
 basic principle of competitive binding and its
 application in controlled drug delivery.
They proposed the preparation of glycosylated
 insulin that is complementary to the major binding
 site of carbohydrate binding proteins like
 concanavalin A (Con A).
In this system, Con A is immobilized on sepharose
 beads and glycosylated insulin is attached to Con A.
When glucose is found in vicinity, glycosylated
 insulin is displaced from the Con A by glucose in
 proportion to the amount of glucose present.
                                                       26
Sato  et al., 1990, showed that the release rate of
 insulin is also dictated by the binding affinity of
 an insulin derivative to the Con A and can be
 influenced by the choice of saccharide group in
 glycosylated insulin.
With the encapsulation of glycosylated insulin
 bound Con A in a suitable polymer membrane,
 permeable to both glucose and insulin, the glucose
 influx and insulin efflux can be controlled.
(the responsive system also includes Ionic Cross-
 linking In Situ Gelling System and Enzymatic
 Cross-linking In Situ Gelling System)


                                                   27
Self regulating insulin delivery device   28
3. System utilizing enzyme:
a) Glucose-responsive insulin release devices :
In case of Diabetes mellitus there is rhythmic
 increase in the levels of glucose in the body,
 requiring injection of the insulin at proper time.
Several systems have been developed which are
 able to respond to changes in glucose
 concentration.
One such system includes pH sensitive hydrogel
 containing glucose oxidase, immobilized in the
 hydrogel encapsulating saturated insulin solution..


                                                   29
When      glucose concentration in the blood
 increases, glucose oxidase converts glucose
 into gluconic acid which changes the pH of the
 system.
This   pH change induces swelling of the
 polymer which results in insulin release.
Insulin   by virtue of its action reduces blood
 glucose level and consequently gluconic acid
 level also gets decreased .
                                               30
b) Urea-responsive delivery
Heller  and Trescony firstly reported the alteration
 in local pH by immobilization of enzymes that lead
 to change in polymer erosion rate.
The proposed system is based on the conversion of
 urea to NH4HCO3 and NH4OH by the action of
 urease.
As this reaction causes a pH increase, a polymer
 that is subjected to increased erosion at high pH is
 required.
 A partially esterifled copolymer of methyl vinyl
 ether and maleic anhydride was developed that
 displays pH dependent drug release.
                                                    31
 This   polymer dissolves by ionization of the carboxylic
  acid group.
 This   pH sensitive polymer containing dispersed drug is
  surrounded     by   a   hydrogel,     containing   urease,
  immobilized by crosslinking         of urease and bovine
  serum albumin with gluteraldehyde.
 Diffusion   of urea into hydrogel and its subsequent
  interaction with urease lead to increase in pH which
  causes erosion of polymer with concomitant drug
  release.                                                32
c) Morphine triggered Naltrexone
delivery
Naltrexone    is long acting opiate antagonist that
 blocks opiate induced euphoria and thus used for
 treatment of heroin addiction. It has been found
 that it is necessary to maintain opiate addicted
 subject on a dose of Naltrexone.
In this system, Naltrexone       is dispersed in
 biodegredable polymer metrices.This polymer
 metrics is in turn covered by lipid layer that
 prevents water entry into the matrix and there by
 retards its degradation


                                                   33
Then    system attached to enzyme-morphine
 conjugate which is complexed with the morphine
 antibody.
As antibodies are large molecules, access of
 subtracts to enzyme active site is sterically
 prevented, thus rendering the enzyme inactive.
When morphine is present in vicinity of device,
 morphine displaces enzyme-morphine conjugate
 from the antibody allowing now activated enzyme
 to degrade the protective lipid layer that permits the
 polymeric core degradation and release of
 naltrexone into body.


                                                      34
Naltrexone dispersed in
                     biodegradable polymer

                   Morphine-lipase conjugate complexed
                   With antibody




Showing Naltrexone delivery device



                                                         35
4. System Utilizing Chelation
 This system includes certain antibiotics and drugs for treatment of
  arthritis, as well as chelator used for treatment of metal poisoning.
 The concept is based on ability of metals to accelerate the hydrolysis
  of carboxylate or phosphate ester and amides.
 Attachment of chelator to a polymer chain by a covalent ester and
  amide link serves to prevent its premature loss by excretion and
  reduces its toxicity
 In presence of specific metal ion, bound chelating agent form
  complex followed by metal accelerated hydrolysis and subsequent
  elimination of metal chelate.
 Controlled drug release devices of poly (ethylene glycol-diacrylate)
  (PEG-DA)-        hydrogels      were prepared by free radical UV
  polymerization in the presence of chelating agent EDTA.
 Presence of chelating agent leads to a sustained drug release profile
  from hydrogel
                                                                      36
5. Systems utilizing antibody interactions
 This  approach has been proposed for antibody mediated
  release of contraceptive agent. The β- subunit of human
  chorionic gonadotropin (HCG) is grafted to the surface of
  the polymer, which is then exposed to antibodies to β-HCG
 After implantation, this delivery system remains quiescent
  until triggered by the first biochemical indication of
  pregnancy, i.e appearance of HCG in the circulatory system.
 The HCG competes for the polymer bound antibodies to
  HCG and initiates release of the contraceptive drug.
 This approach to contraception serves to minimize the
  frequency of drug administration and the side effects
  associated with contraceptive drugs.

                                                            37
Recent Advances
Insulin Pump
 Two or three injections of Insulin are required a day to maintain the
  normal blood glucose level. Because this method is burdensome and
  invasive to living organisms, the patient’s situation would not be good
  regarding the quality of life. Therefore, an electrical and mechanical
  controlled insulin pump that injects insulin automatically into the
  bloodstream has been developed.
 Wang developed an insulin reservoir consisting of silicone rubber,
  which releases insulin stored inside by generation of a pressure
  gradient by compression
 Siegel and Firestone designed an insulin release device using a
  polymer material as an actuator, which generates the pressure gradient
  for insulin release. The actuator is made from enzyme glucose oxidase
  and cationic hydrogel, whose swelling would change in response to
  glucose concentration through an enzymatic reaction. Insulin is
  released from these devices through the orifice.
                                                                        38
   Polymer materials used for insulin pumps should have superior
    biocompatibility. For this purpose, polymer membrane should have
    biocompatibility, insulin permeability, mechanical properties,   and
    processability
   Segmented polyurethane (SPU) can be used as an elastic material for
    preparation of the insulin reservoir.
   For enhancement of insulin permeability and biocompatibility, a
    novel     copolymer        composed     of    2-methacryloyloxyethyl
    phosphorylcholine (MPC) and 2-ethylhexyl methacrylate (EHMA) can
    be designed.
   Dis adv: The main problem of intraperitoneal insulin infusion from
    implantable pumps is the occurrence of under delivery of insulin. Two
    main mechanisms are generally involved in under delivery events:
    insulin aggregation in the pump insulin pathway and catheter
    occlusions.
                                                                       39
GlucoWatch™
 GlucoWatch™        biographer is non-invasive,

    watchlike device that measures glucose.
 Automatic      reading every 10 min up to 13 h is taken by it.
 This   system is based upon the principle of reverse Iontophoresis
A    low electric current pulls glucose through the skin. Glucose is
    accumulated in two gel collection discs in the auto sensor.
    Another electrode in the auto sensor measures the glucose.
    A signal in proportion to interstitial glucose level can thus be
    generated.


                                                                   40
MICROFABRICATED DRUG DELIVERY SYSTEMS
 Possible applications include micromachined silicon membranes to
  create implantable biocapsules for the immunoisolation of
  pancreatic islet cells as a possible treatment for diabetes and
  sustained release of injectable drugs needed over long time
  periods.
 The development of microneedles for transdermal drug delivery
  came about as an approach to enhance the poor permeability of the
  skin by creating microscale conduits for transport across the
  stratum corneum.
 Microfabrication technology has also created a new class of
  controlled release systems for drug delivery based on
  programmable devices called microchips.
 Microchips are particularly intriguing due to their small size,
  potential for integration with microelectronics and their ability to
  store and release chemicals on demand.
 The ultimate goal is to develop a microfabricated device devoid of
  moving parts, but with the ability to store and release multiple
  chemical substances.
                                                                    41
Microneedles for transdermal drug delivery
                                             42
References :
Vyas    S.P. And Khar Roop K., “Controlled
 Drug Delivery Concepts and Advances”;
 Vallabh Prakashan, Delhi. Page no. 36-44
Joseph    Kost and Robert Langer, Advanced
 Drug Delivery Reviews, 6 (1991),19-50
Patel   DM, et al., An Overview On Intelligent
 Drug Delivery Systems, International Journal
 of Advances in Pharmaceutical Research,
 (2011), 57-63
                                              43

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Intelligent drug delivery system

  • 1. Intelligent Drug Delivery System (IDDS) By Dr. Shreeraj Shah Associate Professor, Dept. of Pharmaceutical Technology, L.J. Institute of Pharmacy, Ahmedabad 1
  • 2. Contents Introduction of IDDS Classification (Types of IDDS) Pulsatile system Responsive system System utilizing enzymes System utilizing chelation Systems utilizing antibody interactions Recent Advances References 2
  • 3. Introduction  The conventional manner of introducing drug to patient is inefficient and often lead to toxic side effect.  The dramatic advance in controlled and targeted drug delivery system over past few decades have lead to enormous expectation for treatment of no. of complicated aliments with minimum side effect.  One class of such system is intelligent drug delivery system.  Intelligent drug delivery systems are capable of adjusting drug release rates in response to a physiological need.  This system help to maintain drug in therapeutic range with single dose, localize delivery of drug (at targeted site) to particular compartment, preserve the medicament that are rapidly destroyed ,improve the patient compliance. 3
  • 5. Schematic Diagram of working of IDDS 5
  • 6. Intelligent drug delivery system may be 1.Open- loop system or 2.Closed-loop systems. 6
  • 7. 1. Open-loop control systems In the controlled drug delivery field, open- loop systems are known as pulsed or externally regulated system. The externally controlled devices apply external triggers for pulsed delivery of drug such as: magnetism, ultrasound, and electrical effect etc. It involves following systems : ◦ Magnetically modulated drug delivery system ◦ Ultrasonically modulated drug delivery system ◦ Electrically modulated drug delivery system ◦ Thermo sensitive drug delivery system etc. 7
  • 8. 2. Closed-loop control systems  The closed-loop systems are known as self regulated system. In the self-regulated devices release rate of drug is controlled by feedback information, without any external intervention.  In closed-loop control systems the controlled variable is detected and as a result the system output is adjusted accordingly.  The self-regulated systems utilize several approaches as rate- control mechanisms like pH-sensitive polymers, enzyme- substrate reactions, pH-sensitive drug Solubility, competitive binding and metal concentration-dependent hydrolysis. It involve following system: ◦ pH responsive drug delivery ◦ Glucose-responsive insulin delivery ◦ Urea-responsive drug delivery system ◦ Inflammation-induced pulsatile release ◦ Morphine triggered Naltrexone delivery system etc. 8
  • 9. Classification of Intelligent Drug Delivery System (IDDS)  Classification (Types of IDDS)  Pulsatile system  Magnetically Modulated Systems  Electrically Regulated System  Ultrasonically Modulated Systems  Photoresponsive Systems  Responsive system  pH responsive drug delivery  Inflammation-induced drug release  Thermoresponsive drug delivery system  Glucose and Other Saccharide Sensitive Polymers  System utilizing enzymes  Glucose-responsive insulin release devices  Urea-responsive delivery  Morphine triggered Naltrexone delivery  System utilizing chelation  Systems utilizing antibody interactions 9
  • 10. Schematic representation of classification 10
  • 11. 1. Pulsatile system PDDS (pulsatile drug delivery systems) are gaining importance in the field of pharmaceutical technology as these systems deliver the right dose at specific time at a specific site. Some of the disease conditions wherein PDDS are promising include duodenal ulcer, cardiovascular diseases, arthritis, asthma, diabetes, neurological disorder, cancer, hypertension etc. In pulsatile drug delivery system drug release is programmed by external stimuli like magnetism, ultrasound, electrical effect and irradiation etc. 11
  • 12. a) Magnetically control drug delivery system : Magnetic drug delivery by particulate carriers is a very efficient method of delivering a drug to a localized disease site. Very high concentrations of chemotherapeutic and radiological agents can be achieved near the target site, such as a tumor without any toxic effects to normal surrounding tissue or to the whole body. This approach involves incorporation of magnetic beads in elastic polymer(generally ethylene vinyl acetate copolymer) . Application of oscillating magnetic field leading to swelling of polymer which modulate drug release from polymer matrix. 12
  • 13. In magnetic targeting, a drug bound to a magnetic compound is administered to patient and then stopped with a powerful magnetic field in the target area. Depending on the type of drug, it is then slowly released from the magnetic carriers . Magnetic carriers receive their magnetic response to a magnetic field from incorporated materials such as Magnetite (Fe3O4), Iron, Nickel, Cobalt etc. For biomedical applications, magnetic carriers must be water-based, biocompatible, non-toxic and non-immunogenic. 13
  • 14. b) Electrically modulated drug delivery system : This system exhibit drug release under the effect of an applied electrical field due to action of an applied electrical field on rate limiting membrane or directly on solute thereby controlling its transport across the membrane. Electrically modulated delivery systems are prepared from polyelectrolytes (polymers which contain relatively high concentration of ionisable groups along the backbone chain) and are thus, pH- responsive as well as electro-responsive. In this system drug is disperse in hydrogel which is implanted subcutaneously. 14
  • 15.  When drug release is desired, an electro conducting patch is applied on skin directly over gel and electrode are plugged into patch and electrical field is applied.  Under influence of electrical field, electro responsive hydrogel swells or bends and release the drug.  Also hydrogel in the form of beads can be injected subcutaneously or polymer solution which can be injected as liquid but which form gel at body temperature.  Electrical current is also use in form of Iontophoresis or electroporation in field of transdermal drug delivery.  Examples of naturally occurring polymers include hyaluronic acid, chondroitin sulphate, agarose, carbomer, xanthan gum and calcium alginate.  The synthetic polymers are generally acrylate and methacrylate derivatives such as partially hydrolyzed polyacrylamide, polydimethylaminopropyl acrylamide 15
  • 16. c) Ultrasonically modulated system: In this system release rate of drug is repeatedly modulated externally by ultrasound. Both non erodible as well as bioerodible polymer are used for preparation of polymer matrices. Bioerodible polymers include polylactide, polyglycolide, poly(bis(p-carboxyphenoxy)alkane anhydrides and their copolymers with sebacic acid. 16
  • 17. The bioactive used are p-aminohippurate, insulin and bovin serum albumin etc. On exposure to ultrasound, polymer erosion occur and drug is released in controlled manner from polymer metrices. While in the non erodible polymer system, drug release is diffusion controlled. Studies revealed that release rate of bovine serum insulin from ethylene vinyl acetate copolymer matrices were 15 times higher when exposed to ultrasound. It has been found that extent of enhancement can be regulated by the frequency, intensity, or cycle of applied ultrasound. 17
  • 18. d) Photoresponsive system: This approach involves use of photo responsive polymer. The photo responsive polymer consist of photoreceptor usually photochromic chromophore and functional part.  Photoresponsive system is triggered by light stimulus leading to macroscopic changes in the system for controlled release of drug in terms of quantity, location and time. 18
  • 19. The Photoresponsive system is a molecular scale polymer matrix of photolabile conjugate with drug, which can be exposed to light stimuli with high level of control in terms of wavelength, duration, intensity and location; leading to photo-chemical reaction yielding deformation of conjugates and drug liberation from matrix.  Photoresponsive system has found applications in the ophthalmology (Intra ocular lenses for cataract treatment) as well as in administration of NSAIDS. 19
  • 20. 2. Responsive system This system involves the use of polymer which are responsive to change in body enviroment. In this system drug delivery is controlled by means of an interaction with the surrounding environment without the aid of any external stimuli. 20
  • 21. a) pH responsive drug delivery This approach utilizes the existence of pH change in different part of body. There exists obvious change in pH along the GI tract from acidic in the stomach to basic in the intestine (pH=5–8). Also ,there are changes within different tissue like Certain cancers as well as inflamed or wound tissue exhibit a pH different from 7.4 . For example, chronic wounds have been reported to have pH values between 7.4 and 5.4 and cancer tissue is also reported to be acidic extracellularly . 21
  • 22. pH in various tissues and cellular compartments: Tissue/cellular compartment pH ◦ Blood 7.35–7.45 ◦ Stomach 1.5–3.5 ◦ Small intestine 5.5-6.8 ◦ Colon 6.4–7.0 ◦ Lysosome 4.5–5.0 ◦ Golgi 6.4 ◦ Tumour, extracellular 6.5-7.2 22
  • 23. This approach involve use of pH sensitive polymer. By selecting the pH dependent polymers drug release at specific location can be obtained. Examples of pH dependent polymers include Cellulose Acetate Phthalate, polyacrylates, HPMCP, etc. Coating of the drug core with pH sensitive polymers has been successfully used for colonic drug delivery. 23
  • 24. b) Inflammation-induced drug release :  This approach is used to treat patients with inflammatory diseases like rheumatoid arthritis using anti-inflammatory drug.  This approach involves dispersion of drug loaded lipid microspheres in to degradable metrices of cross linked hyaluronic acid.  Hyaluronic Acid gel is injected at inflammatory sites which is specifically degraded by hydroxyl radicals produced from inflammation-responsive cells during inflammation.  The degradation of hyaluronic acid by hydroxyl radicals may be dominant and rapid as compared to that by hyaluronidase  Hyaluronic acid has been extensively used in vivo as a therapeutic agent for ophthalmic surgery and arthritis 24
  • 25. c) Thermoresponsive drug delivery system:  The use of temperature as a signal has been justified by the fact that the body temperature often deviates from the physiological temperature (37°C) in the presence of pathogens or pyrogens.  This deviation is a useful stimulus that activates the release of therapeutic agents from various temperature-responsive drug delivery systems for diseases accompanying fever.  The drug delivery systems that are responsive to temperature utilize various polymer properties, including the thermally reversible transition of polymer molecules, swelling change of networks, glass transition and crystalline melting.  Examples of thermoresponsive polymers are Poly (N,N- diethylacrylamide),Poly (methyl vinyl ether),Poly (N- vinylcaprolactam) , Pluronics, tetronics 25
  • 26. d) Glucose and Other Saccharide Sensitive Polymers: Brownlee and Cerami (1979) firstly presented the basic principle of competitive binding and its application in controlled drug delivery. They proposed the preparation of glycosylated insulin that is complementary to the major binding site of carbohydrate binding proteins like concanavalin A (Con A). In this system, Con A is immobilized on sepharose beads and glycosylated insulin is attached to Con A. When glucose is found in vicinity, glycosylated insulin is displaced from the Con A by glucose in proportion to the amount of glucose present. 26
  • 27. Sato et al., 1990, showed that the release rate of insulin is also dictated by the binding affinity of an insulin derivative to the Con A and can be influenced by the choice of saccharide group in glycosylated insulin. With the encapsulation of glycosylated insulin bound Con A in a suitable polymer membrane, permeable to both glucose and insulin, the glucose influx and insulin efflux can be controlled. (the responsive system also includes Ionic Cross- linking In Situ Gelling System and Enzymatic Cross-linking In Situ Gelling System) 27
  • 28. Self regulating insulin delivery device 28
  • 29. 3. System utilizing enzyme: a) Glucose-responsive insulin release devices : In case of Diabetes mellitus there is rhythmic increase in the levels of glucose in the body, requiring injection of the insulin at proper time. Several systems have been developed which are able to respond to changes in glucose concentration. One such system includes pH sensitive hydrogel containing glucose oxidase, immobilized in the hydrogel encapsulating saturated insulin solution.. 29
  • 30. When glucose concentration in the blood increases, glucose oxidase converts glucose into gluconic acid which changes the pH of the system. This pH change induces swelling of the polymer which results in insulin release. Insulin by virtue of its action reduces blood glucose level and consequently gluconic acid level also gets decreased . 30
  • 31. b) Urea-responsive delivery Heller and Trescony firstly reported the alteration in local pH by immobilization of enzymes that lead to change in polymer erosion rate. The proposed system is based on the conversion of urea to NH4HCO3 and NH4OH by the action of urease. As this reaction causes a pH increase, a polymer that is subjected to increased erosion at high pH is required.  A partially esterifled copolymer of methyl vinyl ether and maleic anhydride was developed that displays pH dependent drug release. 31
  • 32.  This polymer dissolves by ionization of the carboxylic acid group.  This pH sensitive polymer containing dispersed drug is surrounded by a hydrogel, containing urease, immobilized by crosslinking of urease and bovine serum albumin with gluteraldehyde.  Diffusion of urea into hydrogel and its subsequent interaction with urease lead to increase in pH which causes erosion of polymer with concomitant drug release. 32
  • 33. c) Morphine triggered Naltrexone delivery Naltrexone is long acting opiate antagonist that blocks opiate induced euphoria and thus used for treatment of heroin addiction. It has been found that it is necessary to maintain opiate addicted subject on a dose of Naltrexone. In this system, Naltrexone is dispersed in biodegredable polymer metrices.This polymer metrics is in turn covered by lipid layer that prevents water entry into the matrix and there by retards its degradation 33
  • 34. Then system attached to enzyme-morphine conjugate which is complexed with the morphine antibody. As antibodies are large molecules, access of subtracts to enzyme active site is sterically prevented, thus rendering the enzyme inactive. When morphine is present in vicinity of device, morphine displaces enzyme-morphine conjugate from the antibody allowing now activated enzyme to degrade the protective lipid layer that permits the polymeric core degradation and release of naltrexone into body. 34
  • 35. Naltrexone dispersed in biodegradable polymer Morphine-lipase conjugate complexed With antibody Showing Naltrexone delivery device 35
  • 36. 4. System Utilizing Chelation  This system includes certain antibiotics and drugs for treatment of arthritis, as well as chelator used for treatment of metal poisoning.  The concept is based on ability of metals to accelerate the hydrolysis of carboxylate or phosphate ester and amides.  Attachment of chelator to a polymer chain by a covalent ester and amide link serves to prevent its premature loss by excretion and reduces its toxicity  In presence of specific metal ion, bound chelating agent form complex followed by metal accelerated hydrolysis and subsequent elimination of metal chelate.  Controlled drug release devices of poly (ethylene glycol-diacrylate) (PEG-DA)- hydrogels were prepared by free radical UV polymerization in the presence of chelating agent EDTA.  Presence of chelating agent leads to a sustained drug release profile from hydrogel 36
  • 37. 5. Systems utilizing antibody interactions  This approach has been proposed for antibody mediated release of contraceptive agent. The β- subunit of human chorionic gonadotropin (HCG) is grafted to the surface of the polymer, which is then exposed to antibodies to β-HCG  After implantation, this delivery system remains quiescent until triggered by the first biochemical indication of pregnancy, i.e appearance of HCG in the circulatory system.  The HCG competes for the polymer bound antibodies to HCG and initiates release of the contraceptive drug.  This approach to contraception serves to minimize the frequency of drug administration and the side effects associated with contraceptive drugs. 37
  • 38. Recent Advances Insulin Pump  Two or three injections of Insulin are required a day to maintain the normal blood glucose level. Because this method is burdensome and invasive to living organisms, the patient’s situation would not be good regarding the quality of life. Therefore, an electrical and mechanical controlled insulin pump that injects insulin automatically into the bloodstream has been developed.  Wang developed an insulin reservoir consisting of silicone rubber, which releases insulin stored inside by generation of a pressure gradient by compression  Siegel and Firestone designed an insulin release device using a polymer material as an actuator, which generates the pressure gradient for insulin release. The actuator is made from enzyme glucose oxidase and cationic hydrogel, whose swelling would change in response to glucose concentration through an enzymatic reaction. Insulin is released from these devices through the orifice. 38
  • 39. Polymer materials used for insulin pumps should have superior biocompatibility. For this purpose, polymer membrane should have biocompatibility, insulin permeability, mechanical properties, and processability  Segmented polyurethane (SPU) can be used as an elastic material for preparation of the insulin reservoir.  For enhancement of insulin permeability and biocompatibility, a novel copolymer composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) and 2-ethylhexyl methacrylate (EHMA) can be designed.  Dis adv: The main problem of intraperitoneal insulin infusion from implantable pumps is the occurrence of under delivery of insulin. Two main mechanisms are generally involved in under delivery events: insulin aggregation in the pump insulin pathway and catheter occlusions. 39
  • 40. GlucoWatch™  GlucoWatch™ biographer is non-invasive, watchlike device that measures glucose.  Automatic reading every 10 min up to 13 h is taken by it.  This system is based upon the principle of reverse Iontophoresis A low electric current pulls glucose through the skin. Glucose is accumulated in two gel collection discs in the auto sensor. Another electrode in the auto sensor measures the glucose.  A signal in proportion to interstitial glucose level can thus be generated. 40
  • 41. MICROFABRICATED DRUG DELIVERY SYSTEMS  Possible applications include micromachined silicon membranes to create implantable biocapsules for the immunoisolation of pancreatic islet cells as a possible treatment for diabetes and sustained release of injectable drugs needed over long time periods.  The development of microneedles for transdermal drug delivery came about as an approach to enhance the poor permeability of the skin by creating microscale conduits for transport across the stratum corneum.  Microfabrication technology has also created a new class of controlled release systems for drug delivery based on programmable devices called microchips.  Microchips are particularly intriguing due to their small size, potential for integration with microelectronics and their ability to store and release chemicals on demand.  The ultimate goal is to develop a microfabricated device devoid of moving parts, but with the ability to store and release multiple chemical substances. 41
  • 42. Microneedles for transdermal drug delivery 42
  • 43. References : Vyas S.P. And Khar Roop K., “Controlled Drug Delivery Concepts and Advances”; Vallabh Prakashan, Delhi. Page no. 36-44 Joseph Kost and Robert Langer, Advanced Drug Delivery Reviews, 6 (1991),19-50 Patel DM, et al., An Overview On Intelligent Drug Delivery Systems, International Journal of Advances in Pharmaceutical Research, (2011), 57-63 43