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Keywords = local transdermal therapy

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13 pages, 653 KiB  
Review
Topical Percutaneous Drug Delivery for Allergic Diseases: A Novel Strategy for Site-Directed Pharmacologic Modulation
by Mitsuhiro Kamimura, Hiroaki Todo, Kenji Sugibayashi and Koichiro Asano
Pharmaceutics 2025, 17(7), 867; https://doi.org/10.3390/pharmaceutics17070867 - 2 Jul 2025
Viewed by 351
Abstract
Topical percutaneous drug delivery has recently emerged as a novel strategy for the treatment of allergic diseases, offering targeted drug delivery to mucosal tissues adjacent to the skin. Unlike conventional topical approaches that act on the skin surface or mucosal membranes, topical percutaneous [...] Read more.
Topical percutaneous drug delivery has recently emerged as a novel strategy for the treatment of allergic diseases, offering targeted drug delivery to mucosal tissues adjacent to the skin. Unlike conventional topical approaches that act on the skin surface or mucosal membranes, topical percutaneous drug delivery enables non-invasive pharmacologic modulation of deeper structures such as the conjunctiva, nasal mucosa, and trachea. This review explores the rationale, pharmacokinetic foundation, clinical data, and future prospects of transdermal therapy in allergic conjunctivitis, allergic rhinitis, and asthma-related cough. In allergic conjunctivitis, eyelid-based transdermal delivery of antihistamines such as diphenhydramine and epinastine has shown rapid and long-lasting symptom relief, with epinastine cream recently approved in Japan following a randomized controlled trial (RCT) demonstrating its efficacy. Preclinical and clinical pharmacokinetic studies support the eyelid’s unique permeability and sustained drug release profile, reinforcing its utility as a delivery site for ocular therapies. In allergic rhinitis, diphenhydramine application to the nasal ala demonstrated symptomatic improvement in patients intolerant to intranasal therapies, though anatomical separation from the inflamed turbinates may limit consistent efficacy. Similarly, cervical tracheal application of steroids and antihistamines has shown potential benefit in asthma-related cough, especially for patients refractory to inhaled treatments, despite anatomical and depth-related limitations. Overall, site-specific anatomy, skin permeability, and disease localization are critical factors in determining therapeutic outcomes. While trans-eyelid therapy is supported by robust data, studies on the nasal ala and trachea remain limited to small-scale pilot trials. No major adverse events have been reported with nasal or tracheal application, but eyelid sensitivity requires formulation caution. To validate this promising modality, further RCTs, pharmacokinetic analyses, and formulation optimization are warranted. Topical percutaneous drug delivery holds potential as a non-invasive, site-directed alternative for managing allergic diseases beyond dermatologic indications. Full article
(This article belongs to the Section Drug Delivery and Controlled Release)
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14 pages, 7525 KiB  
Article
Novel Molecular Weight Gradient Hyaluronate Dissolving Microneedles for Sustained Intralesional Delivery and Photodynamic Activation of Hematoporphyrin in Port-Wine Stain Therapy
by Xueli Peng, Chenxin Yan, Nengquan Fan, Chaoguo Sun, Suohui Zhang and Yunhua Gao
Polymers 2025, 17(9), 1238; https://doi.org/10.3390/polym17091238 - 1 May 2025
Viewed by 545
Abstract
Port-wine stain (PWS), a progressive congenital vascular malformation characterized by ectatic dermal capillaries, demonstrates age-dependent lesion expansion and chromatic intensification, resulting in significant psychosocial comorbidity. While systemic hematoporphyrin (HP) administration remains the clinical paradigm for photodynamic therapy (PDT), its therapeutic utility is severely [...] Read more.
Port-wine stain (PWS), a progressive congenital vascular malformation characterized by ectatic dermal capillaries, demonstrates age-dependent lesion expansion and chromatic intensification, resulting in significant psychosocial comorbidity. While systemic hematoporphyrin (HP) administration remains the clinical paradigm for photodynamic therapy (PDT), its therapeutic utility is severely constrained by non-targeted biodistribution. Pharmacokinetic analyses reveal prolonged dermal retention and suboptimal lesion accumulation, predisposing 42% of patients to phototoxic reactions. To address these limitations, this work creatively suggested a local targeted drug delivery method based on soluble microneedles in response to the difficulties mentioned above. The rational design of a molecular weight (MW) HA gradient system enabled the engineering of ternary nanocomposite microneedles with enhanced biomechanical integrity (0.49 N/needle) and superior HP loading capacity, which collectively facilitated spatiotemporally controlled transdermal delivery of hematoporphyrin with complete dissolution within 30 min. The release performance, skin permeability, and storage stability of hematoporphyrin dissolving microneedles (HP-DMNs) have all been demonstrated in vitro. This study applies soluble microneedle technology to the delivery of HP in PWS for the first time. It avoids the risk of systemic exposure through precise local administration. It uses the rapid dissolution properties of microneedles to achieve high concentration and rapid release of drugs in skin lesions. This study provides a new strategy for sustained intralesional release and rapid drug delivery treatment of PWS and provides novel ideas for the development of new formulations of HP and related photosensitizers. Full article
(This article belongs to the Special Issue Polymers and Their Role in Drug Delivery, 2nd Edition)
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25 pages, 7859 KiB  
Review
Topical and Transdermal Delivery of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) for Inflammation and Pain: Current Trends and Future Directions in Delivery Systems
by Kalliopi Drosopoulou, Ramonna I. Kosheleva, Anna Ofrydopoulou, Alexandros Tsoupras and Athanassios Mitropoulos
Processes 2025, 13(3), 907; https://doi.org/10.3390/pr13030907 - 19 Mar 2025
Cited by 1 | Viewed by 2104
Abstract
The use of topical and transdermal drug delivery systems for nonsteroidal anti-inflammatory drugs (NSAIDs) has transformed pain management, inflammation, and skin conditions. This analysis highlights the topical and transdermal applications of ibuprofen, ketoprofen, and flurbiprofen, highlighting their excellent skin permeability and localized pain [...] Read more.
The use of topical and transdermal drug delivery systems for nonsteroidal anti-inflammatory drugs (NSAIDs) has transformed pain management, inflammation, and skin conditions. This analysis highlights the topical and transdermal applications of ibuprofen, ketoprofen, and flurbiprofen, highlighting their excellent skin permeability and localized pain relief, as well as an evaluation of their safety in such applications. Their compatibility with diverse formulations, minimal systemic side effects, and widespread use in commercial products makes them ideal candidates for skin research and targeted therapy. Advances in transdermal delivery processes, such as the use of chemical enhancers, Solid Lipid Nanoparticles, vesicular systems, and hydrogels, have enhanced NSAID penetration and bioavailability. Physical techniques like iontophoresis and sonophoresis further enhance the transport of drugs across the stratum corneum of the skin. These approaches and processes enable more efficient and localized treatment of inflammatory conditions. The review emphasizes the need for continued innovation, interdisciplinary processes, and collaboration to overcome existing challenges. Future developments in nanotechnology and advanced drug delivery systems have the capability to enhance the effectiveness and safety of NSAIDs, paving the way for novel therapeutic solutions in managing pain and inflammation. Full article
(This article belongs to the Section Materials Processes)
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10 pages, 1207 KiB  
Article
Transdermal Drug Delivery of Tazarotene: Determining Tazarotene’s Potential in Local Transdermal Therapy
by Helena Hamzehpour, Ástrós Óskarsdóttir, Helgi Jónsson, Fjóla Jónsdóttir, Ólafur E. Sigurjónsson and Bergthora S. Snorradottir
Pharmaceutics 2024, 16(1), 64; https://doi.org/10.3390/pharmaceutics16010064 - 31 Dec 2023
Cited by 2 | Viewed by 3043
Abstract
Retinoid-based drugs, while effective, are associated with systemic toxicity. Topical alternatives offer a safer option, and tazarotene, a third-generation synthetic retinoid, holds promise. This study investigates tazarotene’s transdermal delivery potential, focusing on its application for joint-related conditions. The aim of this study was [...] Read more.
Retinoid-based drugs, while effective, are associated with systemic toxicity. Topical alternatives offer a safer option, and tazarotene, a third-generation synthetic retinoid, holds promise. This study investigates tazarotene’s transdermal delivery potential, focusing on its application for joint-related conditions. The aim of this study was to investigate the suitability of tazarotene as a candidate for transdermal delivery into joints. In vitro permeation studies, using porcine skin, assessed tazarotene’s transdermal drug delivery from solution and gel formulations. A tape-stripping analysis determined stratum corneum retention and a pilot study using porcine joints assessed tazarotene’s ability to reach articular cartilage. Ultra Performance Liquid Chromatography coupled with a mass detector method was used to quantify tazarotene and tazarotenic acid permeation. The results validate that tazarotene can permeate porcine skin and accumulate in articular cartilage in detectable amounts. The detection of tazarotene and tazarotenic acid in both the in vitro permeation studies and the pilot study on porcine joints validate the drug’s potential therapeutic use for hand osteoarthritis. This study lays the groundwork for future research, contributing insights into tazarotene’s potential for transdermal drug delivery and guiding further exploration in topical retinoid applications. Full article
(This article belongs to the Special Issue Novel Technologies for Buccal and Transdermal Drug Delivery)
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14 pages, 2416 KiB  
Article
Non-Invasive Assessment of Skin Surface Proteins of Psoriasis Vulgaris Patients in Response to Biological Therapy
by Kadri Orro, Kristiina Salk, Anna Merkulova, Kristi Abram, Maire Karelson, Tanel Traks, Toomas Neuman, Pieter Spee and Külli Kingo
Int. J. Mol. Sci. 2023, 24(22), 16248; https://doi.org/10.3390/ijms242216248 - 13 Nov 2023
Cited by 2 | Viewed by 1792
Abstract
Measurements of skin surface biomarkers have enormous value for the detailed assessment of skin conditions, both for clinical application and in skin care. The main goals of the current study were to assess whether expression patterns of skin surface hBD-1, hBD-2, IL-1α, CXCL-1, [...] Read more.
Measurements of skin surface biomarkers have enormous value for the detailed assessment of skin conditions, both for clinical application and in skin care. The main goals of the current study were to assess whether expression patterns of skin surface hBD-1, hBD-2, IL-1α, CXCL-1, and CXCL-8, examples of proteins known to be involved in psoriasis pathology, are associated with disease severity and whether expression patterns of these proteins on the skin surface can be used to measure pharmacodynamic effects of biological therapy. In this observational study using transdermal analysis patch (TAP), levels of skin surface IL-1α, hBD-1, hBD-2, CXCL-1/2, and CXCL-8 of psoriasis vulgaris (PV) patients over biological therapy were assessed. The Psoriasis Area Severity Index (PASI) and local score for erythema, induration, and desquamation were determined from the exact same skin area as FibroTx TAP measurements. Thirty-seven adult PV patients were included, of which twenty-three were subjected to anti-TNF-α, seven to anti-IL-17A, and seven to anti-IL12/IL-23 therapy. Significantly higher levels of hBD-1, hBD-2, CXCL-1/2, and CXCL-8 were detected on lesional skin compared to the non-lesional skin of the PV patients. In contrast, lower levels of IL-1α were found in lesional skin compared to non-lesional skin. In addition, we observed that the biomarker expression levels correlate with disease severity. Further, we confirmed that changes in the expression levels of skin surface biomarkers during biological therapy correlate with treatment response. Biomarker expression patterns in response to treatment differed somewhat between treatment subtypes. We observed that, in the case of anti-TNF-α therapy, an increase after a steady decrease in the expression levels of CXCL-1/2 and CXCL-8 occurred before the change in clinical scores. Moreover, response kinetics of skin surface proteins differs between the applied therapies—hBD2 expression responds quickly to anti-IL-17A therapy, CXCL-1/2 to anti-IL-12/23, and levels of CXCL-8 are rapidly down-regulated by IL-17A and IL-12/23 therapy. Our findings confirm that the skin surface hBD-2, IL-1α, CXCL-1/2, and CXCL-8 are markers for the psoriasis severity. Further, data obtained during this study give the basis for the conclusion that skin surface proteins CXCL-1/2 and CXCL-8 may have value as therapeutic biomarkers, thus confirming that measuring the ‘molecular root’ of inflammation appears to have value in scoring disease severity on its own. Full article
(This article belongs to the Special Issue Molecular Mechanisms of Treating Psoriasis)
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31 pages, 2329 KiB  
Review
Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas
by Arvind Hariharan and Simon D. Tran
Pharmaceutics 2023, 15(7), 1844; https://doi.org/10.3390/pharmaceutics15071844 - 28 Jun 2023
Cited by 15 | Viewed by 3471
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world, with surgery, radiotherapy, chemotherapy, and immunotherapy being the primary treatment modalities. The treatment for HNSCC has evolved over time, due to which the prognosis has improved [...] Read more.
Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world, with surgery, radiotherapy, chemotherapy, and immunotherapy being the primary treatment modalities. The treatment for HNSCC has evolved over time, due to which the prognosis has improved drastically. Despite the varied treatment options, major challenges persist. HNSCC chemotherapeutic and immunotherapeutic drugs are usually administered systemically, which could affect the patient’s quality of life due to the associated side effects. Moreover, the systemic administration of salivary stimulating agents for the treatment of radiation-induced xerostomia is associated with toxicities. Localized drug delivery systems (LDDS) are gaining importance, as they have the potential to provide non-invasive, patient-friendly alternatives to cancer therapy with reduced dose-limiting toxicities. LDDSs involve directly delivering a drug to the tissue or organ affected by the disease. Some of the common localized routes of administration include the transdermal and transmucosal drug delivery system (DDSs). This review will attempt to explore the different treatment options using LDDSs for the treatment of HNSCC and radiotherapy-induced damage and their potential to provide a better experience for patients, as well as the obstacles that need to be addressed to render them successful. Full article
(This article belongs to the Section Drug Delivery and Controlled Release)
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39 pages, 11766 KiB  
Review
Innovative Strategies for Hair Regrowth and Skin Visualization
by Qiuying Mai, Yanhua Han, Guopan Cheng, Rui Ma, Zhao Yan, Xiaojia Chen, Guangtao Yu, Tongkai Chen and Shu Zhang
Pharmaceutics 2023, 15(4), 1201; https://doi.org/10.3390/pharmaceutics15041201 - 10 Apr 2023
Cited by 12 | Viewed by 10117
Abstract
Today, about 50% of men and 15–30% of women are estimated to face hair-related problems, which create a significant psychological burden. Conventional treatments, including drug therapy and transplantation, remain the main strategies for the clinical management of these problems. However, these treatments are [...] Read more.
Today, about 50% of men and 15–30% of women are estimated to face hair-related problems, which create a significant psychological burden. Conventional treatments, including drug therapy and transplantation, remain the main strategies for the clinical management of these problems. However, these treatments are hindered by challenges such as drug-induced adverse effects and poor drug penetration due to the skin’s barrier. Therefore, various efforts have been undertaken to enhance drug permeation based on the mechanisms of hair regrowth. Notably, understanding the delivery and diffusion of topically administered drugs is essential in hair loss research. This review focuses on the advancement of transdermal strategies for hair regrowth, particularly those involving external stimulation and regeneration (topical administration) as well as microneedles (transdermal delivery). Furthermore, it also describes the natural products that have become alternative agents to prevent hair loss. In addition, given that skin visualization is necessary for hair regrowth as it provides information on drug localization within the skin’s structure, this review also discusses skin visualization strategies. Finally, it details the relevant patents and clinical trials in these areas. Together, this review highlights the innovative strategies for skin visualization and hair regrowth, aiming to provide novel ideas to researchers studying hair regrowth in the future. Full article
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27 pages, 4230 KiB  
Review
Revolutionizing Therapeutic Delivery with Microneedle Technology for Tumor Treatment
by Vaibhavi Meghraj Desai, Sakshi Priya, Srividya Gorantla and Gautam Singhvi
Pharmaceutics 2023, 15(1), 14; https://doi.org/10.3390/pharmaceutics15010014 - 21 Dec 2022
Cited by 21 | Viewed by 5044
Abstract
The tumor is an uncontrolled growth of tissue that can be localized (benign) or possesses the capability of metastasis (malignant). The conventional methods of tumor diagnosis, such as acupuncture, endoscopy, and histopathology, and treatment methods, such as injections, chemotherapy, surgery, and radiotherapy, are [...] Read more.
The tumor is an uncontrolled growth of tissue that can be localized (benign) or possesses the capability of metastasis (malignant). The conventional methods of tumor diagnosis, such as acupuncture, endoscopy, and histopathology, and treatment methods, such as injections, chemotherapy, surgery, and radiotherapy, are invasive, expensive, and pose severe safety and management issues for the patients. Microneedle technology is a recently developed approach for active transdermal drug delivery. It is minimally invasive, self-administrable, bypasses the first-pass effect, and effectively delivers chemotherapeutics and drugs at low doses, thus, overcoming the drawbacks of conventional delivery systems. This review provides an idea of the types, materials utilized in the fabrication, and techniques used for the preparation of microneedles (MNs), as well as their application in tumor diagnosis and treatment. Additionally, emphasis is given to the case studies related to MNs-assisted tumor therapy, such as photothermal therapy, gene therapy, photodynamic therapy, chemotherapy, immunotherapy, and various combination therapies. MNs also serve as a tool for diagnosis by the bio-sampling of blood and interstitial skin fluid, as well as biosensing various cancer biomarkers. The combined therapy and diagnostics provide theranostic MNs for enhanced and personalized tumor therapy. The limitations and prospects of MNs development are also discussed. Full article
(This article belongs to the Special Issue New Trends for Transdermal and Dermal Delivery)
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21 pages, 8609 KiB  
Article
A Shape-Adaptive Gallic Acid Driven Multifunctional Adhesive Hydrogel Loaded with Scolopin2 for Wound Repair
by Huan Chen, Tingting Zheng, Chenyang Wu, Jinrui Wang, Fan Ye, Mengyao Cui, Shuhui Sun, Yun Zhang, Ying Li and Zhengqi Dong
Pharmaceuticals 2022, 15(11), 1422; https://doi.org/10.3390/ph15111422 - 17 Nov 2022
Cited by 9 | Viewed by 2877
Abstract
Wound healing is one of the major challenges in the biomedical fields. The conventional single drug treatment has unsatisfactory efficacy, and the drug delivery effectiveness is restricted by the short retention on the wound. Herein, we develop a multifunctional adhesive hydrogel that can [...] Read more.
Wound healing is one of the major challenges in the biomedical fields. The conventional single drug treatment has unsatisfactory efficacy, and the drug delivery effectiveness is restricted by the short retention on the wound. Herein, we develop a multifunctional adhesive hydrogel that can realize robust adhesion, transdermal delivery, and combination therapy for wound healing. Multifunctional hydrogels (CS-GA-S) are mixed with chitosan-gallic acid (CS-GA), sodium periodate, and centipede peptide-scolopin2, which slowly releases scolopin2 in the layer of the dermis. The released scolopin2 induces the pro-angiogenesis of skin wounds and enables excellent antibacterial effects. Separately, GA as a natural reactive-oxygen-species-scavenger promotes antioxidation, and further enables excellent antibacterial effects and wet tissue adhesion due to a Schiff base and Michael addition reaction for accelerating wound healing. Once adhered to the wound, the precursor solution becomes both a physically and covalently cross-linked network hydrogel, which has potential advantages for wound healing with ease of use, external environment-isolating, and minimal tissue damage. The therapeutic effects of CS-GA-S on wound healing are demonstrated with the full thickness cutaneous wounds of a mouse model. The significant improvement of wound healing is achieved for mice treated with CS-GA-S. This preparation reduces wound system exposure, prolongs local drug residence time, and improves efficacy. Accordingly, with the incorporation of scolopin2 into the shape-adaptive CS-GA hydrogel, the composite hydrogel possesses multi-functions of mechanical adhesion, drug therapy, and skin wound healing. Overall, such an injectable or sprayable hydrogel plays an effective role in emergency wound treatment with the advantage of convenience and portability. Full article
(This article belongs to the Special Issue Hydrogels in Biomedical Applications)
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16 pages, 3430 KiB  
Article
A Promising Cutaneous Leishmaniasis Treatment with a Nanoemulsion-Based Cream with a Generic Pentavalent Antimony (Ulamina) as the Active Ingredient
by Johnny Bullón, Laura Márquez, José Alejandro Fernández, César Scorzza, José Vicente Scorza, Jimmy Rodríguez, Atilio Cordero, Francia Véjar, Sonia Koteich-Khatib and Ana Forgiarini
Cosmetics 2021, 8(4), 115; https://doi.org/10.3390/cosmetics8040115 - 3 Dec 2021
Cited by 4 | Viewed by 5453
Abstract
Leishmania parasites are the etiological agents of Leishmaniasis, a tropical disease that affects around 15 million people in about 90 countries. The chosen therapy for this disease is based on antimony V compounds, such as meglumine antimoniate. It can be administered as a [...] Read more.
Leishmania parasites are the etiological agents of Leishmaniasis, a tropical disease that affects around 15 million people in about 90 countries. The chosen therapy for this disease is based on antimony V compounds, such as meglumine antimoniate. It can be administered as a parenteral, subcutaneous or perilesional form as successive infiltrations with pre-established doses localized in the border of the granuloma that characterizes the wound of Cutaneous Leishmaniasis (CL). Herein, a topical pharmaceutical recipe, such as an emulsion, is proposed to eliminate the trauma caused by administering the medicine in parenteral form to the face or other difficult access zones. The evaluation of this vehicle was performed by analyzing parameters such as pH, viscosity, homogeneity and droplet size distribution. Furthermore, the effectiveness of the emulsion was proved by in vitro experiments using Strat-M synthetic membranes, showing that the transdermal passage of the antimonial complex is guaranteed. Moreover, complete healing of the wound has been attained in patients with CL, as shown with two clinical cases in this article. Full article
(This article belongs to the Special Issue Feature Papers in Cosmetics in 2021)
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19 pages, 4668 KiB  
Article
Efficacy of Emu Oil Transfersomes for Local Transdermal Delivery of 4-OH Tamoxifen in the Treatment of Breast Cancer
by Usha Sundralingam, Srikumar Chakravarthi, Ammu Kutty Radhakrishnan, Saravanan Muniyandy and Uma D. Palanisamy
Pharmaceutics 2020, 12(9), 807; https://doi.org/10.3390/pharmaceutics12090807 - 25 Aug 2020
Cited by 28 | Viewed by 4191
Abstract
Oral tamoxifen used in the prevention and treatment of ductal carcinoma in situ (DCIS) (estrogen-positive) patients has limited acceptance, due to its adverse side effects. The efficacy of tamoxifen is related to its major metabolite, 4-hydroxytamoxifen. Local transdermal therapy of 4-hydroxytamoxifen to the [...] Read more.
Oral tamoxifen used in the prevention and treatment of ductal carcinoma in situ (DCIS) (estrogen-positive) patients has limited acceptance, due to its adverse side effects. The efficacy of tamoxifen is related to its major metabolite, 4-hydroxytamoxifen. Local transdermal therapy of 4-hydroxytamoxifen to the breast might avert the toxicity of oral tamoxifen, while maintaining efficacy. We aim to study the skin irritancy, as well as to evaluate the efficacy of the developed transfersome formulations, with/without emu oil, using a syngeneic mouse model of breast cancer. We also quantified tamoxifen/4-hydroxytamoxifen concentrations in blood plasma and performed histopathology. The skin irritancy test showed that the pure emu oil and transfersome formulations with or without the emu oil did not cause skin irritancy in the animals studied. A sensitive and specific LC–MS/MS method for the quantification of tamoxifen and 4-hydroxytamoxifen was developed and validated. Studies on tumor volume and necrosis (histopathology) using the breast cancer mouse model showed that the 4-OHT transfersomal formulations, with and without emu oil, showed comparable efficacy with that of orally administered tamoxifen. However, the transfersomal formulations, with and without emu oil, resulted in significantly lower (10.24 ± 0.07 and 32.45 ± 0.48 ng/mL, respectively) plasma concentrations of 4-hydroxytamoxifen, compared to the oral tamoxifen (TAMX) group (634.42 ± 7.54 ng/mL). This study demonstrated the potential use of emu oil in a local transdermal formulation for the treatment of breast cancer and its reduced adverse effects. Full article
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16 pages, 777 KiB  
Review
Transdermal and Topical Drug Administration in the Treatment of Pain
by Wojciech Leppert, Malgorzata Malec–Milewska, Renata Zajaczkowska and Jerzy Wordliczek
Molecules 2018, 23(3), 681; https://doi.org/10.3390/molecules23030681 - 17 Mar 2018
Cited by 146 | Viewed by 23454
Abstract
The comprehensive treatment of pain is multidimodal, with pharmacotherapy playing a key role. An effective therapy for pain depends on the intensity and type of pain, the patients’ age, comorbidities, and appropriate choice of analgesic, its dose and route of administration. This review [...] Read more.
The comprehensive treatment of pain is multidimodal, with pharmacotherapy playing a key role. An effective therapy for pain depends on the intensity and type of pain, the patients’ age, comorbidities, and appropriate choice of analgesic, its dose and route of administration. This review is aimed at presenting current knowledge on analgesics administered by transdermal and topical routes for physicians, nurses, pharmacists, and other health care professionals dealing with patients suffering from pain. Analgesics administered transdermally or topically act through different mechanisms. Opioids administered transdermally are absorbed into vessels located in subcutaneous tissue and, subsequently, are conveyed in the blood to opioid receptors localized in the central and peripheral nervous system. Non–steroidal anti–inflammatory drugs (NSAIDs) applied topically render analgesia mainly through a high concentration in the structures of the joint and a provision of local anti–inflammatory effects. Topically administered drugs such as lidocaine and capsaicin in patches, capsaicin in cream, EMLA cream, and creams containing antidepressants (i.e., doxepin, amitriptyline) act mainly locally in tissues through receptors and/or ion channels. Transdermal and topical routes offer some advantages over systemic analgesic administration. Analgesics administered topically have a much better profile for adverse effects as they relieve local pain with minimal systemic effects. The transdermal route apart from the above-mentioned advantages and provision of long period of analgesia may be more convenient, especially for patients who are unable to take drugs orally. Topically and transdermally administered opioids are characterised by a lower risk of addiction compared to oral and parenteral routes. Full article
(This article belongs to the Special Issue Medicinal Chemistry in Europe)
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