Assignment on

Impact of Pharmacotherapy
in the Design of Drug Delivery Systems

Prepared By:
Sajan Maharjan
M.Pharm, 1st Semester
Kathmandu University
Dhulikhel, Kavre, Nepal.

Submitted To:
Professor Panna Thapa
MPharm PhD
Dean, KU School of Science
Kathmandu University
Dhulikhel, Kavre, Nepal.

Impact of Pharmacotherapy in the design of Drug delivery systems

Introduction
Pharmacotherapy can be defined as the treatment and prevention of illness and disease by
means of drugs of chemical or biological origin. It ranks among the most important methods of
medical treatment, together with surgery, physical treatment, radiation and psychotherapy.
Although it is almost impossible to estimate the exact extent of the impact of pharmacotherapy
on human health, there can be no doubt that pharmacotherapy, together with improved
sanitation, better diet and better housing, has improved peoples health, life expectancy and
quality of life.
Unprecedented developments in genomics and molecular biology today offer a plethora
of new drug targets. The use of modern chemical synthetic methods (such as combinatorial
chemistry) enables the synthesis of a large number of new drug candidates in shorter times
than ever before. At the same time, a better understanding of the immune system and rapid
progress in molecular biology, cell biology and microbiology allow the development of modern
vaccines against old and new challenges.
However, for all these exciting new drug and vaccine candidates, it is necessary to
develop suitable dosage forms or drug delivery systems to allow the effective, safe and reliable
application of these bioactive compounds to the patient. It is important to realize that the active
ingredient is just one part of the medicine administered to the patient and it is the formulation of
the drug into a dosage form or drug delivery system that translates drug discovery and
pharmacological research into clinical practice.
Indeed the drug delivery system employed plays a vital role in
controlling the pharmacological effect of the drug as it can influence the pharmacokinetic profile
of the drug, the rate of drug release, the site and duration of drug action and subsequently the
side-effect profile. An optimal drug delivery system ensures that the active drug is available at
the site of action for the correct time and duration.
Drug delivery systems
Drug delivery refers to approaches, formulations, technologies, and systems for transporting
a pharmaceutical compound in the body as needed to safely achieve its desired therapeutic
effect.
Drug delivery systems according to the physical state
Based on physical state, drug delivery systems may be:
Gaseous (e.g. anaesthetics),
Liquid (e.g. solutions, emulsions, suspensions),
Semisolid (e.g. creams, ointments, gels and pastes) and
Solid dosage forms (e.g. powders, granules, tablets and capsules).
Drug delivery systems according to route of administration
Another way of differentiating dosage forms is according to their site or route of administration.

 Parenteral drug delivery: Drugs can be administered directly into the body, through
injection or infusion. Depending on the site of administration into the body it can be
differentiated into:
a) Subcutaneous injection
b) Intramuscular injection
c) Intravenous injection
d) Intradermal injection
e) Intraperitoneal injection
Oral drug delivery: The oral route is the most popular route to administer drugs.
Suspensions, tablets, capsules,etc are administered through this route.
Topical drug delivery: Drugs can also be administered on to the skin to enter into the
body. Mostly semisolid dosage forms are used for this, including creams, ointments,
gels and pastes. However, liquid dosage forms, such as emulsions, or solid dosage
forms, such as transdermal controlled drug delivery systems (patches), can also be
used.
Transmucosal: In this drugs are administered hrough nasal, buccal/sublingual, vaginal,
ocular and rectal routes.
Drug delivery systems according to mechanism of drug release
Another system that can be used to differentiate drug delivery systems is according to the way
the drug is released. It can be differentiated as:
Immediate release drug is released immediately after administration.
Modified release drug release only occurs sometime after the administration or for a
prolonged period of time or to a specific target in the body. Modified-release systems
can be further classified as:
a) Delayed release: drug is released only at some point after the initial administration.
b) Extended release: prolongs the release to reduce dosing frequency
Sustained release: These systems maintain the rate of drug release over a sustained
period of time.
Controlled release: Controlled-release systems also offer a sustained-release profile
but, in contrast to sustained-release forms, controlled-release systems are designed to
lead to predictably constant plasma concentrations, independently of the biological
environment of the application site. This means that they are actually controlling the
drug concentration in the body, not just the release of the drug from the dosage form,
as is the case in a sustained-release system.
Targeted drug delivery (smart drug delivery): It is a method of delivering medication to
a patient in a manner that increases the concentration of the medication in some parts
of the body relative to others. The goal of a targeted drug delivery system is to prolong,
localize, target and have a protected drug interaction with the diseased tissue.

Disease and Design of drug delivery system

A disease is an abnormal condition that affects the body of an organism. It is often construed as
a medical condition associated with specific symptoms and signs. It may be caused by factors
originally from an external source, such as infectious disease, or it may be caused by internal
dysfunctions,
such
as autoimmune
diseases, it
sometimes
includes injuries, disabilities, disorders, syndromes, infections,
isolated symptoms,
deviant behaviors, and a typical variations of structure and function.
Medical therapies are efforts to cure or improve a disease
or other health problem. A number of drug molecules have already been developed but
development of further more new drug molecule is expensive and time consuming. So,
improving efficacy ratio of old drugs is considered a good idea. This has been attempted by
developing new drug delivery systems that helps in individualizing drug therapy, dose titration,
and therapeutic drug monitoring easily. Delivering drug at controlled rate, slow delivery, targeted
delivery are very attractive methods and have been pursued vigorously. Drug delivery systems
modify drug release profile, absorption, distribution and elimination for the benefit of improving
product efficacy and safety. It also ensures patient convenience and compliance.
There are some drug molecules which show site specific drug release
eg, peptides and proteins. Such drugs cannot show their action without appropriate drug
delivery system. So,the increasing number of peptide and protein drugs being investigated
demands the development of dosage forms which exhibit site-specific release. Delivery of drugs
into systemic circulation through colonic absorption represents a novel mode of introducing
peptide and protein drug molecules and drugs that are poorly absorbed from the upper
gastrointestinal (GI) tract. Oral colon-specific drug delivery systems offer obvious advantages
over parenteral administration. Colon targeting is naturally of value for the topical treatment of
diseases of the colon such as Crohn's disease, ulcerative colitis and colorectal cancer.
Sustained colonic release of drugs can be useful in the treatment of nocturnal asthma, angina
and arthritis. Peptides, proteins, oligonucleotides and vaccines are the potential candidates of
interest for colon-specific drug delivery. Sulfasalazine, ipsalazide and olsalazine have been
developed as colon-specific delivery systems for the treatment of inflammatory bowel disease
(IBD).
Worldwide, over 40 million people are infected with the Human Immunodeficiency Virus (HIV).
The High Activity Antiretroviral Therapy (HAART) combines at least three antiretroviral (ARV)
drugs and, for over a decade, has been used to extend the lifespan of the HIV-infected patients.
Chronic intake of HAART is mandatory to control HIV infection. The frequent administration of
several drugs in relatively high doses is a main cause of patient incompliance and a hurdle
toward the fulfillment of the pharmacotherapy. High adherence to HAART does not lead to
complete HIV virus elimination from the host. Intracellular and anatomical viral reservoirs are
responsible for the perpetuation of the infection. Active transport mechanisms involving proteins
of the ATP-binding cassette superfamily prevent the penetration of ARV drugs into the brain and
may account for the limited bioavailability after oral administration. A new research that
addresses from simple organoleptic or technological problems to more complex issues involving
the targeting of specific tissues and organs has emerged. With the aim to reduce dosing
frequency, to improve the compliance of the existing pharmacotherapy and to target viral
reservoirs, the design of drug delivery systems is becoming complementary to new drug
discovery.

Conclusion
Whenever a person suffers from a disease, he/she requires a medical treatment and every one
of us prefer the safe, effective, economic and a convenient one. This can only be achieved by
development of appropriate drug delivery system. No matter how dosage forms are classified,
the role of the drug delivery systems is to allow the effective, safe, and reliable application of the
drug to the patient.
For the proper Pharmacotherapy, delivery systems should allow and facilitate the drug to
reach its target site in the body. For example, a tablet formulation containing an antihypertensive
drug must disintegrate in the gastrointestinal tract, the drug needs to dissolve and the dissolved
drug needs to permeate across the mucosal membrane of the gastrointestinal tract into the
body. So, for the development of dosage forms the formulation scientist needs to optimize the
bioavailability of the drug.
Similarly, the delivery system is to allow the safe application of the drug. This includes that
the drug in the formulation must be chemically, physically and microbiologically stable. Sideeffects of the drug and drug interactions should be avoided or minimized by the use of suitable
drug delivery systems. The delivery systems also need to improve the patients compliance with
the pharmacotherapy by the development of convenient applications. For example, one can
improve patient compliance by developing an oral dosage form where previously only parenteral
application was possible.
Finally, the delivery system needs to be reliable and its formulation needs to be technically
feasible. However, for any application of a drug delivery system on the market, the dosage form
needs to be produced in large quantities and at low costs to make affordable medicines
available. Therefore, it is also necessary to investigate the feasibility of the developed systems
to be scaled up from the laboratory to the production scale.
References

Research article on Drug delivery systems in HIV pharmacotherapy by Alejandro

Sosnik, Diego A Chiappetta, Angel M Carcaboso

Pharmaceutics Drug Delivery and Targeting by Perrie, Yvonne; Rades, Thomas

Wikipedia.org
Journal on Novel oral colon-specific drug delivery systems for pharmacotherapy of
peptides
and
nonpeptide
drugs
by
Reddy, S.M., et al.