A SEMINAR ON NASAL DRUG Nasal Drug Delivery System 1 Prepared By… Chinchole Pravin Sonu [IIst sem M. Pharm.] Department of Pharmaceutics R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur 4/12/2016 DELIVERY SYSTEM CONTENT 1. 2. 4. 5. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Nasal Drug Delivery System 6. 4/12/2016 3. INTRODUCTION ANATOMY & PHYSIOLOGY OF NOSE MERIT & LIMITATION MACHANISM OF ABSORPSION BARRIARS OF NASAL ABSORPSION FACTOR AFFECTIONING NASAL ABSORPSION MUCOCILLARY CLEARANCE DRUG DISTRUBUTION STRATERGIES TO IMPROVE NASAL ABSORPSION PENETRATION ENHANCERS FORMULATION DELIVERY SYSTEM EVALUATION APPLICATION CONCLUSION REFERENCE 2 In ancient times the Indian Ayurvedic system of medicines used nasal route for administration of drug and the process is called as “Nasya-karma” It has been used for local effects extensively in decongestant and local activity. In recent times intranasal drug delivery is being considered as a preferred route of drug delivery for systemic bioavailability Nasal Drug Delivery System 4/12/2016 3 4/12/2016 Nasal Drug Delivery System 4 The nasal cavity is run from the nasal vestibule to the nasopharynx which has 4/12/2016 depth of approximately 12-14cm. The nasal vestibule, the respiratory region and the olfactory region are the three Nasal Drug Delivery System main regions of the nasal cavity. The submucosal zone of the nasal mucosa directly connects to the systemic circulation, thus avoids first pass metabolism. The lateral walls of the nasal cavity includes a folded structure which enlarges the surface area in the nose to about 150cm2 . This folded structure includes three turbinates: the superior, the median and the inferior. These turbinates increases the area of absorption. Nasal cavity is about 60mm in length. 5 The nasal cavity is covered with a mucous membrane which can be divided into nonolfactory and olfactory epithelium areas. The nonolfactory area Nasal blood flow external & internal carotid arteries. Nasal secretions (1500-2000ml/day):- Goblet cell, nasal glands, lacrimal Nasal Drug Delivery System 4/12/2016 includes the nasal vestibule and respiratory region. glands Composition:- 95% water, 1-2% salt, 2-3% mucin. in trace amount Na, K, Ca, Albumin also present. Nasal enzymes:- Monooxygenase, lactate dehydrogenase, oxidoreductase, phosphates , hydrolases, esterases, etc. Nasal pH:- 5.5-6.5(adults) 5.0-6.7(infants & child) 6 MERITS Hepatic first – pass metabolism is absent. Rapid drug absorption. Quick onset of action. The bioavailability of larger drug molecules can be improved by means of Nasal Drug Delivery System Drug degradation is absent. 4/12/2016 absorption enhancer or other approach. Better nasal bioavailability for smaller drug molecules. Drugs which can not be absorbed orally may be delivered to the systemic circulation through nasal drug delivery system. Convenient route when Compared with parenteral route for long term therapy. 7 LIMITATIONS 4/12/2016 The absorption enhancers used to improve nasal drug delivery system may have Nasal Drug Delivery System histological toxicity which is not yet clearly established. Absorption surface area is less when compared to GIT. Once the drug administered can not be removed. Nasal irritation. 8 MECHANISM OF ABSORPTION Majority of Drugs are absorbed by passive diffusion. Some may be by active transport, such as amino acids. Literature shows that upto 1000dalton drug get easily absorbed without help of 4/12/2016 Nasal Drug Delivery System penetration enhancers. Two mechanisms are found: Transcellular process: Transport of lipophillic drugs through cell membrane by active transport or transport through opening of tight junction. Example: Levodopa,Carbidopa Paracellular process: It involves aqueous route of transport. it is slow and passive.Water soluble drugs which have moleculer weight greater than 1000 daltons shows poor bioavailability. Example: Insulin,MSH,ACTH 9 PATHWAY OF ABSORPTION 4/12/2016 Nasal Drug Delivery System 10 BARRIERS TO NASAL ABSORPTION It is due to Low membrane permeability (limiting factor for high mol.weight polar drugs like protein and peptides ) Low Membrane Transport: Rapid clearance of administered formulation due to MCC. Ex: Liquid and powder formulation shows rapid clearance Nasal Drug Delivery System 4/12/2016 Low Bioavailability: Enzymatic Degradation: Degradation of protein and peptides by Exopeptidase and Endopeptidase. 11 FACTORS AFFECTING ABSORPTION Chemical form: Example : Nasal absorption of carboxylic acid esters of L-Tyrosine significantly Polymorphism: Polymorphism is known to affect the dissolution rate, solubility of drug and thus their absorption through biological membranes. Nasal Drug Delivery System greater than that of L-Tyrosine. 4/12/2016 The form of a drug can be important in determining absorption. Molecular Weight: A linear molecular correlation has been reported between the absorption of drugs and Weight up to 300 Daltons. Absorptions decreases significantly if the molecular weight is greater than12 1000 Daltons (except with the use of absorption enhancers). Particle Size: It has been reported that particle sizes 10 -20 μm are deposited in the nasal of greater than 20 um size exhaled with air. Solubility and Dissolution Rate: Drug solubility and dissolution rates are important factors in determining nasal absorption from powders and suspensions. The particles deposited in the nasal cavity need to be dissolved prior to absorption. Nasal Drug Delivery System 4/12/2016 cavity. Particles Which are less than 2 μm can be retained in the lungs, and particles Nasal pH: 5.5-6.5(adult) 5.0-6.7(infants) 13 MUCOCILIARY CLEARANCE It is a preventive function. Prevents the entry of hazardous particles When the drugs adhere to the nasal mucosa, they eventually goes into nasopharynx This clearance of mucus & the adsorbed/dissolved substances into GIT called as Mucocilliary clearance. A-Ciliated cells B-Nonciliated cells C-Goblet cells D-Mucus layer E-Sol layer F-Basal cells G-Basement membrane Fig- Cell types of the nasal epithelium Nasal Drug Delivery System and lead towards GIT. 4/12/2016 14 Strategies To Improve Nasal Absorption 1.Nasal Enzymes Inhibitors: boroleucin inhibitors. 3. Modifying drug structure: eg- chemical modification of salmon calcitonin to ecatonin (C-N bond replaces the S-S bond) showed better bioavailability than salmon calcitonin. 4.Prodrug approach: Nasal Drug Delivery System 2.Formulation Design: 4/12/2016 eg- peptidases, proteases, tripsin, aprotinin, borovaline, amas-tatin, bestatin and eg- peptides like angiotensin II, bradykinin, caulein, carnosine, enkepha-lin, vasopressin and calcitonin. 5.Particulate drug delivery: 6.Absorption Enhancers: 15 Mechanism of Penetration Enhancers: Reduce mucus viscosity Reduce MCC Open tight junctions Solubilize the drug Ideal Properties: 1.It should increase in the absorption of the drug 2. It should not cause permanent damage or alteration to the tissue Nasal Drug Delivery System Inhibit enzymetic activity 4/12/2016 3. It should be non irritant and nontoxic. 4. It should be effective in small quantity. 5. The enhancing effect should occur when absorption is required . 6. The effect should be temporary and reversible . 7. It should be compatible with other excipients. 16 Classification of penetration enhancer Surfactants Sodium dodecyl sulphate, Polyoxyethylene-9-lauryl ether, Saponin Complexing and chelating agents EDTA, Salicylates Cyclodextrins and derivatives α-, β-, γ-cyclodextrin, DMβcyclodextrin, HPβ-cyclodextrin Bile salts Sodium taurocholate Sodium glycocholate Sodium deoxycholat Fusidic acid derivatives Fatty acid salts Oleic acid, Caprylate (C8), Caprate (C10), Laurate (C12) Dry microspheres Degradable starch microsphere Dextran microsphere Nasal Drug Delivery System Examples 4/12/2016 Type 17 FORMULATION CONSIDERATION To avoid irritation of nasal mucosa. To allow drug to be available in unionised form for absorption. To prevent growth of the bacteria in nasal passage. To sustain normal physiological ciliary moments. HUMECTANTS To prevent dehydration adequate intranasal moisture is required humectants are added. Prevent nasal irritation. The commonly used humectants are Nasal Drug Delivery System 4/12/2016 pH of the formulation It is important as.. and therefore - Glycerine - Sorbitol - Manitol 18 OSMOTIC AGENT The osmolarity of the dosage form affect the nasal absorption of the drug. The higher concentration of drug not only causes increased bioavailability but also leads to the toxicity to the nasal epithelium. The commonly used osmotic agents are Sodium Chloride Sodium sulfite Sodium acid phosphate SOLUBILISERS Aqueous solubility of drug is always a limitation for nasal drug delivery of dosage form. Commonly used solubilisers are Glycols Small quantities of alcohol Transcutol(diethylene glycol monoethyl ether) Medium chain glycerides Labrasol(saturated polyglycolysed C8-C10 glycerides) 19 Surfactant Cyclodextrin (B-cyclodextrin) 4/12/2016 Nasal Drug Delivery System GELLING/VISCOSIFYING AGENTS/GEL FORMING CARRIER Increasing solution viscosity may provide means of prolonging the therapeutic effect of nasal preparations. Highly viscous formulations interfere with the normal functions like ciliary beating or mucociliary clearance and thus alter the permeability of drug. Commonly used gelling agents are… Nasal Drug Delivery System Carbopol, Cellulose agents, Starch, Dextran, Chitosan, etc. 4/12/2016 ABSORPTION ENHANCERS Unlike the most small drug molecules, some drugs and peptides do no cross the nasal membrane efficiently. The nasal mucosa is almost impermeable to molecular size greater than 1000 Dalton. The low nasal membrane permeability is due to Molecular Size Lack Of Lipophilicity Enzymatic Degradation 20 PRESERVATTVE Commonly Used Preservatives Parabens Benzolkonium Choride Phenyl Ethyl Alcohol Benzoyl alcohol Mercury containing preservatives are not used. Nasal Drug Delivery System Usually antioxidants do not affect drug absorption or cause nasal irritation. Chemical / Physical interaction of antioxidant with drug and excipients should be considered during formulation development. Commonly used antioxidants are - Sodium Metabisulfite - Sodium Bisulfite - Butylated Hydroxytoluene - Tocopherol. 4/12/2016 ANTIOXIDANT 21 DELIVERY SYSTEM Nasal Drops Nasal drops are one of the most simple and convenient systems developed for nasal delivery. Nasal drops delivered the drug to a larger area back in the nasal cavity. Nasal Drug Delivery System 4/12/2016 The main disadvantage of this system is the lack of the dose precision. 22 4/12/2016 Nasal Drug Delivery System 23 Nasal spray Both solution and suspension sprays. Due to the availability of metered dose pumps and actuators, a nasal spray can deliver an exact dose from 25 to 200 μm. Nasal Drug Delivery System formulations can be formulated into nasal 4/12/2016 Choice of pumps and actuators:The particles size and morphology of the drug viscosity of the formulation . 24 Nasal gels are high-viscosity thickened solutions or suspension . • Advantages : The reduction of post-nasal drip due to high viscosity . • Reduction of taste impact due to reduced swallowing. • Reduction of leakage of the formulation. • Reduction of irritation by using emollient. Nasal Drug Delivery System 4/12/2016 Nasal Gels 25 This dosage form may be developed if can not be developed , such as lack of drug stability. Advantages: Nasal Drug Delivery System solution and suspension dosage forms 4/12/2016 Nasal Powder Absence of preservatives Local application of drug stability of formulation 26 Nasal Drug Delivery System FORMULATION • Active Drug • Surfactant • Co-solvent • Propellant 4/12/2016 Nasal Aerosols Eg:-BUDESONIDE NASAL AEROSOL INHALER. 27 EVALUATION Nasal Drug Delivery System Chamber consist of U-shaped tubing system, usually made of glass, filled with experimental solution. Barrier used are excised nasal mucosa from rats or rabbits. Drug solution is introduced into the mucosal side of the chamber and samples were collected from receiver chamber. 4/12/2016 IN VITRO NASAL PERMEATION STUDIES USSING CHAMBER :(Hans Ussing) 28 EX VIVO NASAL PERFUSION MODEL 4/12/2016 Nasal Drug Delivery System 29 Fig- Experimental setup for ex-vivo nasal perfusion studies IN VIVO NASAL ABSORPTION STUDIES The rat is anaesthetized by intraperitoneal injection of sodium pentobarbital. An incision is made in the neck and the trachea is cannulated with a polyethylene tube. The passage of the nasopalatine tract is sealed so that the drug solution is not drained from the nasal cavity through the mouth. The blood samples are collected from the femoral vein. Nasal Drug Delivery System RAT MODEL 4/12/2016 1. 30 Rabbits anaesthetized by intramuscular injection of a combination of ketamine and xylazine. The rabbit's head is held in an upright position and the drug solution is administered by nasal spray into each nostril. The blood samples are collected by an indwelling catheter in the marginal ear vein or artery. Nasal Drug Delivery System RABBIT MODEL 4/12/2016 2. 31 The dog is anaesthetized by intravenous injection of sodium thiopental and the anesthesia is maintained with sodium Phenobarbital. A positive pressure pump through a cuffed endotracheal tube gives the ventilation. The blood sampling is carried out from the jugular vein. Nasal Drug Delivery System DOG MODEL 4/12/2016 3. 32 Practical and suitable for investigating nasal delivery formulations. Male in-house bred sheep are employed since they are free from nasal infections. 5. • • • MONKEY MODEL The monkey is tranquillized by intramuscular injection of ketamine hydrochloride or anaesthetized by intravenous injection of sodium Phenobarbital. The head of the monkey is held in an upright position and the drug solution is administered into each nostril. The blood samples are collected through an indwelling catheter in the vein. Nasal Drug Delivery System SHEEP MODEL 4/12/2016 4. 33 APPLICATION OF NASAL DRUG DELIVERY SYSTEMS EX.. Progesterone, estradiol, propranolol, nitroglycerin, sodium chromoglyate, etc. Eg. Insulin, Calcitonin, Pituitary hormones etc. 3. Delivery of Diagnostic Drugs Phenolsulfonphthaline-For diagnosis of kidney functions Secretin-For diagnosis of pancreatic disorders Pentagastrin-For diagnosis of secretory functions of gastric acid. Cerulin-For diagnosis of Gallbladder function Vital dyes-Trypan blue and Evans blue (it can not enter in cranium because they can not pass through sheath) Nasal Drug Delivery System 2. Delivery of peptide-based pharmaceuticals 4/12/2016 1. Delivery of non-peptide pharmaceuticals 34 4. Delivery of drugs to Brain: For Treatment of Parkinson’sdisease,Alzheimer disease. For Delivery of MSH,ACTH,Insulin to brain 4/12/2016 Nasal mucosa is the first site of contacts with inhaled pathogens Nasal passages are rich in lymphoid tissue Creation of both mucosal and systemic immune responses Non injectable Nasal Drug Delivery System 5. Delivery of Vaccines : Examples: Nasal Vaccines are Prepared for Measels,pertussis,meningitis and Influenza virus because these pathogens enter into the body through nasal mucosa. Nasal delivery of vaccines produces both local and systemic immune response. 35 Marketed Preparations Delivery Action Indications Azelastine Astelin (Meda) Duonase (Cipla) Nasal spray Local Allergic rhinitis Beclometasone Beconase Nasal spray Local Hay fever Nasal Drug Delivery System Brands 4/12/2016 Drug (Glaxo) Ciclesonide Zetonna (Sunovion pharma) Nasal aerosol Local Allergies Xylomethazolin e Otrivin (novartis) Nasal spray Nasal gel Local Congestion Sinusitis Oxytocin Syntocinon (novartis) Nasal spray Systemic Labor pain Nasal gel Nasal spray Systemic Pernicious Anaemia (B12 def) Cynocobalamin Nascobal e (par. pharma) , 36 CONCLUSION Studies are going on improving the efficiency of the nasal route. Outcome of these studies is that we can utilise it for treatment of diabetes, osteoporosis, infertility. Nasal drug delivery offers such benefits as - Rapid onset of action with lower dose & minimal side effects It has an advantage of site-specific delivery with improved therapeutic effects. Allowing systemic administration without significant degradation. Nasal Drug Delivery System Nasal route is attractive for the delivery of the many drugs and vaccines. 4/12/2016 Nasal drug delivery system offers flexibility for multiple formulations ranging from nasal drop to suspension spray 37 REFERENCES Nasal Drug Delivery System 4/12/2016 Y.W.Chein, K.S.E. Su and S.F.Chang. “Nasal systemic drug delivery” Dekker, 1989, 27-34,89,199. Anya M.Hillery, Andrew W.Lloyd, James Swarbrick. “Drug Delivery and Targeting for Pharmacists and Pharmaceutical Scientists” published by Taylor & Francis, 2001, 215-243. M.E. Aulton “ Pharmaceutics – The science of dosage form design” Churchill Livingston., 2002, 494. Y.W.Chein, “ Novel drug delivery systems”, Marcel Dekker Inc.50 (2), 1982, 229260. Latika Nasare* , Kamlesh Niranjane, Anuradha Nagdevte, Sumedh Mohril “Nasal drug delivery system : An Emerging Approach For Brain Targeting’’ Review Article of WJPPS. M.Alagusundaram*, B.Chengaiah, K.Gnanaprakash, S.Ramkanth, C.Madhusudhana Chetty, D.Dhachinamoorthi “Nasal drug delivery system - an overview” Review Article of IJIPRS. RAHISUDDIN*, PRAMOD K SHARMA, GARIMA GARG, AND MOHD SALIM “REVIEW ON NASAL DRUG DELIVERY SYSTEM WITH RECENT ADVANCEMNT” Review Article of IJPPS. Shivam Upadhyay, Ankit Parikh, Pratik Joshi, U M Upadhyay and N P Chotai “Intranasal drug delivery system- A glimpse to become maestro” Review Article of38 JAPS. 4/12/2016 Nasal Drug Delivery System 39