RECENT ADVANCES AND FUTURE PROSPECTS OF NON-INVASIVE INSULIN DELIVERY SYSTEMS

Non-invasive insulin delivery systems have been of global interest. The goal of many studies was to optimize suitable delivery formulation capable of producing comparable insulin bioavailability and safety that match or supersedes conventional delivery by the invasive subcutaneous (SC) injections. Historically, Pfizer marketed the first insulin inhaler Exubera® in 2006 which was later retracted from the market before completing the two years. In recent years, Afrezza®, a new inhalator, and Oral-Lyn™, a buccal spray, have been introduced to the market. While Afrezza® lost the marketing and distribution support from Sanofi, Oral-Lyn™ have not secured US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) marketing approval yet. Different technologies to improve insulin’s permeation and absorption through different routes are in the pipelines. This review discusses several non-invasive strategies that have been appropriately tested and duly approved by the FDA. Other delivery systems are in different phases of development, ranging from in vitro studies to phase 3 clinical trials, providing indications towards the prospects of next-generation delivery systems. This review covers studies published in the past 10 y using Scopus, Clinicaltrials.gov, PubMed and Google scholar databases. The outcomes of this review indicate that the door is still open for more innovative, efficient and convenient non-invasive insulin delivery systems than currently available which may take several years before we can see a game changer in the market

Recent Challenges in Insulin Delivery Systems: A Review

Relatively, a large percentage of world population is affected by diabetes mellitus, out of which approximately 5-10% with type 1 diabetes while the remaining 90% with type 2. Insulin administration is essential for type 1 patients while it is required at later stage by the patients of type 2. Current insulin delivery systems are available as transdermal injections which may be considered as invasive. Several non-invasive approaches for insulin delivery are being pursued by pharmaceutical companies to reduce the pain, and hypoglycemic incidences associated with injections in order to improve patient compliance. While any new insulin delivery system requires health authorities' approval, to provide long term safety profile and insuring patients' acceptance. The inhalation delivery system Exubera® has already become clinically available in the United States and Europe for patients with diabetes as non-invasive delivery system

Evaluation of Certain Pharmaceutical Quality Attributes of Lisinopril Split Tablets

Tablet splitting is an accepted practice for the administration of drugs for a variety of reasons, including dose adjustment, ease of swallowing and cost savings. The purpose of this study was to evaluate the physical properties of lisinopril tablets as a result of splitting the tablets either by hand or with a splitting device. The impact of the splitting technique of lisinopril (Zestril® tablets, 20 mg) on certain physical parameters such as weight variation, friability, disintegration, dissolution and drug content were studied. Splitting the tablets either by hand or with a splitter resulted in a minute but statistically significant average weight loss of <0.25% of the tablet to the surrounding environment. The variability in the weight of the hand-split tablet halves was more pronounced (37 out of 40 tablet halves varied by more than 10% from the mean weight) than when using the tablet splitter (3 out of 40 tablet halves). The dissolution and drug content of the hand-split tablets were therefore affected because of weight differences. However, the pharmacopoeia requirements for friability and disintegration time were met. Hand splitting of tablets can result in an inaccurate dose and may present clinical safety issues, especially for drugs with a narrow therapeutic window in which large fluctuations in drug concentrations are undesirable. It is recommended to use tablets with the exact desired dose, but if this is not an option, then a tablet splitter could be used

Factors affecting pharmacist’s practice.

Factors affecting pharmacist’s practice.</p

Evaluation of bloodletting cupping therapy in the management of hypertension

Background: Bloodletting cupping therapy (Hijama) is a traditional alternative medicine practiced in different cultures. Claims about the therapeutic efficacy of Hijama in hypertension are contradictory. The aim of this project was to determine if Hijama therapy is beneficial in the treatment of patients with hypertension. Materials and Methods: In this retrospective study, 60 files for patients treated for hypertension, aged 40–60 years and whose systolic blood pressure (SBP) is at least 140mm Hg, were used. The data from 30 patient files were obtained from three licensed Hijama centers (study group), whereas data from the rest of 30 patient files were collected from a hospital (control group). The data from Hijama centers included age, date of Hijama therapy, and blood pressure measured before each Hijama session. Both diastolic blood pressure (DBP) and SBP data were obtained over 3-month period. Results: The results showed a significant reduction in SBP (P value < 0.01) over three sessions of wet cupping (from 149.2 to 130.8mm Hg), but this was not significant for DBP over three sessions (P = 0.074). The study also found that the mean SBP in the study group was 9.6mm Hg less than that in the control group (130.8 vs. 140.4mm Hg, P = 0.019), whereas there was no significant difference in DBP between the study group and the control group (87.0 vs. 86.0mm Hg, P = 0.75). Conclusions: Our study shows clear relationship between Hijama and the reduction and control of SBP in patients with hypertension. Therefore, Hijama can be used as an adjunct to conventional therapy, which may allow downtitration of given doses of antihypertensive drugs. The possible association of SBP reduction by Hijama and pain reduction needs an investigation