Oral local drug delivery and new perspectives in oral drug formulation.

Modern pharmaceutical science has provided us with a wide range of substances to be administered with a wide large variety of dosage forms. Local drug delivery systems have been used for a long time; in particular, for the local therapy of diseases affecting the oral cavity. Although these diseases are often extremely responsive to local therapy, the mouth often presents various difficulties in the application of topical compounds (owing to saliva and the mouth's different functions), resulting in a short retention time of dosage forms with a consequent low therapeutic efficacy. To resolve these limitations, research today concentrates on the development of bioadhesive formulations. This review focuses on the permeability features of oral mucosa, the rationale of oral local drug delivery, and new potential bioadhesive local delivery systems. Furthermore, the most promising mucoadhesive systems proposed to locally treat oral diseases are discussed.

Chronic kidney disease: pharmacological considerations for the dentist.

BACKGROUND: Patients with chronic kidney disease (CKD) represent a challenge for the dentist seeking to prescribe medications. Understanding the medical management of renal insufficiency and the pharmacokinetics of common dental drugs will aid clinicians in safely treating these patients. TYPES OF STUDIES REVIEWED: The authors reviewed the literature concerning the medical and pharmacological management of CKD. They reviewed the pharmacokinetic effects of drugs described in case reports and research articles and obtained from them recommendations regarding the use of drugs and adjustment of dosages. CLINICAL IMPLICATIONS: Because CKD is progressive, patients have varying levels of renal function but do not yet have end-stage renal disease. Some drugs that dentists prescribe commonly may worsen a patient's renal function, lead to drug toxicity or both. Managing the care of patients and prescribing medications tailored to their needs begin with a recognition of the patient with renal disease at risk of developing adverse effects. Clinicians can identify these patients from information obtained in their medical histories and from the drugs they may be taking. CONCLUSIONS: To treat patients with kidney disease, clinicians must recognize those at risk, have knowledge of the pharmacokinetic changes that occur and recognize that adjustment of drug dosages often is needed.

Pharmacology and the elderly.

UNLABELLED: This paper describes the impact of ageing on an individual's ability to process drugs. It considers adverse drug reactions in the elderly and discusses prescribing for the older dental patient. CLINICAL RELEVANCE: Many older dental patients will be suffering from medical conditions or taking prescribed or non-prescribed drugs. These can influence the impact of drugs prescribed by dentists.

Drug interactions in dentistry.

UNLABELLED: An increasing number of our patients are on medication of various types. This increase in prescribed medicines also raises the significant issue of potential drug interactions between those drugs used in dental practice and those taken by the patient. This article addresses those interactions and, where appropriate, puts them into perspective and attempts to quantify the risk. Mechanisms of relevant drug interactions are also discussed. Certain categories of drugs are more likely to be involved in interactions and again these are highlighted. Drug interactions relevant to dentistry can for the most part be prevented. A careful drug history should be taken from each patient and updated on a regular basis. CLINICAL RELEVANCE: This article highlights drug interactions that can arise in dental practice and how they can be avoided and managed.

[Dry plant extracts in the prescription of dental hydrogels with Carbopol 971P]. / Suche ekstrakty roslinne w recepturze hydrozeli stomatologicznych z Carbopolem 971P.

The study assumption was to work out a prescription for dental anti-inflammatory hydrogel on Carbopol 971P base. Dry plant extracts (sage, horsetail) and nonsteroidal anti-inflammatory drug (sodium ibuprofen) were introduced into the prescription of a model hydrogel. The aim of the study was to estimate pharmaceutical availability of the applied therapeutic agents and to test their effect on physicochemical properties of the produced form of a drug. The physicochemical parameters of the produced preparation were tested. Viscosity tests were performed using cone-plate digital rheometer. Extensometric method was used to test extensibility. pH measurements were performed by direct immersing the electrode connected with pH-meter into the hydrogel samples of uniform mass. Pharmaceutical availability of therapeutic agents contained in hydrogel (active components of plant extracts, sodium ibuprofen) was estimated. The rate of the process of mass exchange was tested by spectrophotometric method determining the quantity of therapeutic agents diffusing into acceptor fluid at the same time intervals. Sodium ibuprofen is better released from the hydrogel containing horsetail extract (815.5 c.u.) than from the hydrogel of parallel prescription containing sage extract (640.8 c.u.). Hydrogels containing dry extract from horsetail have greater extensibility and lower structural viscosity as well as the value of yield stress than equivalent hydrogels containing sage extract. Introduction of sodium ibuprofen into the prescription of hydrogels with plant extracts modifies rheological parameters (greater extensibility, lower viscosity of the preparation). The tests of the kinetics of therapeutic agents release demonstrated that the presence of sodium ibuprofen in the prescription of hydrogels exerts an influence on the decrease of the effectiveness of the release of active substances contained in these extracts.