Children have often been treated as small adults in relation to drug formulation, but research has now shown this not to be the case. Therefore, there is a push from regulatory bodies to provide drug formulations specifically tailored towards the needs of this fragmented population. Orally dissolving films (ODFs) have been identified as an emerging opportunity, to bridge this gap. Therefore, the aim of this study was to prepare ODFs containing topiramate, an antiepileptic drug, using solvent casting method as a potential alternative to oral tablets/powders for paediatrics. For this purpose, a Design of Experiment (DoE) was employed to optimise formulation parameters. 24 formulations were prepared by changing the polymer type (HPMC, Guar-Gum or PEO), concentration (0.4%-1.2%w/v); plasticizer type (glycerol\sorbitol) and concentration (0.1–0.3%w/v). Disintegration time, content-uniformity, film quality and thickness uniformity were the responses. Surface and molecular profiling were conducted on the optimal formulation (N4). TGA and XRD results demonstrated the stability of materials upon production into films, while the SEM images showed smooth films that proved to be resilient due to good mechanical properties. HPMC-glycerine based ODFs are presented as an effective dosage form to enhance the ease of administration and patient compliance of topiramate, specifically for paediatric patients.
The aim of this work was to investigate alternative safe and effective permeation enhancers for buccal peptide delivery. Basic amino acids improved insulin solubility in water while 200 and 400 μg/mL lysine significantly increased insulin solubility in HBSS. Permeability data showed a significant improvement in insulin permeation especially for 10 μg/mL of lysine (p < 0.05) and 10 μg/mL histidine (p < 0.001), 100 μg/mL of glutamic acid (p < 0.05) and 200 μg/mL of glutamic acid and aspartic acid (p < 0.001) without affecting cell integrity; in contrast to sodium deoxycholate which enhanced insulin permeability but was toxic to the cells. It was hypothesized that both amino acids and insulin were ionised at buccal cavity pH and able to form stable ion pairs which penetrated the cells as one entity; while possibly triggering amino acid nutrient transporters on cell surfaces. Evidence of these transport mechanisms was seen with reduction of insulin transport at suboptimal temperatures as well as with basal-to-apical vectoral transport, and confocal imaging of transcellular insulin transport. These results obtained for insulin are the first indication of a possible amino acid mediated transport of insulin via formation of insulin-amino acid neutral complexes by the ion pairing mechanism.
Antibiotic eyedrops typically require frequent instillation due to the eye's defensive mechanisms limiting drugs from reaching target sites. This may risk patient non-adherence and treatment inefficacy. The aim of this study was to develop a biocompatible and fully soluble ocular film insert to enhance the delivery of levofloxacin, as well as the handling procedure for its administration; based on the anatomical dimensions and physiological conditions of the human eye. Inserts were prepared by solvent casting method, using HPMC, sodium alginate, gelatin, PEG 400, and levofloxacin solution, and characterised for various physicochemical properties (e.g., uniformity of weight and thickness, loss on dryness, swelling index, water uptake and surface pH). Mechanical properties were assessed and compared against a commercially available buccal film formulation. Uniformity of content and release profile of inserts were assessed by means of a validated analytical method. Antibacterial effectiveness was studied by adapted disc diffusion method on Staphylococcus aureus and Pseudomonas aeruginosa. The formulation including HPMC E15 (1250 mg), low viscosity sodium alginate (750 mg), type A gelatin (250 mg) and PEG 400 (2.5 mL) and 0.1% levofloxacin solution, resulted in high quality inserts, exhibiting uniformity of mass, thickness, and levofloxacin content, that comply with Pharmacopeial standards. Inserts were able to withstand unilinear and repeated mechanical stresses, suggesting suitability for manipulation linked to eye administration. The fully soluble levofloxacin-loaded inserts exhibited good physicochemical and mechanical characteristics, indicating good compatibility with ocular environment and administration procedure. Consistent levofloxacin content and biphasic release pattern showed immediate and sustained antimicrobial efficacy, consistently above the minimum inhibitory concentrations for the model species tested. This work also presents an experimental framework that can be adapted for designing and testing ocular drug delivery systems accounting for anatomical and physiological characteristics of the eye.
During the global COVID-19 pandemic, hospitals faced tremendous pressure to cope with the emergency preparedness situations needed to cater for the influx of patients while maintaining their essential services. This study aimed to assess the level of readiness of hospitals in Jordan to respond to the COVID-19 pandemic using the WHO hospital readiness checklist. A cross-sectional survey using the modified and validated checklist was conducted in Jordan between 15 May and 15 June 2021. The checklist entailed ten key response functions with a total of 60 activities. Data from 22 hospitals were collected through a structured survey process by two surveyors for each hospital. The overall readiness score of hospitals was 1.77 ± 0.20, with a lower overall score in the northern region (1.65 ± 0.24) than the middle (1.86 ± 0.07) or southern (1.84 ± 0.14) regions. The diagnosis response function scored highest (1.95); but despite efforts, contingency plan development was not met by most hospitals, with a total score ≤ 1.45. Provision of psychological support and occupational health support to ensure the wellbeing of staff scored below average. Outcomes from this survey exposed gaps while offering a framework for upcoming endeavors to improve hospital readiness for any potential pandemic.