Kaur I P, Singh M, Kanwar M
University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India.
Int J Pharm. 2000 Apr 20;199(2):119-27. doi: 10.1016/s0378-5173(00)00359-8.
The orally administered acetazolamide has a limited use in glaucoma due to the systemic side effects associated with its use. It has been reported to show little effect on the intraocular pressure (IOP) of human and rabbit eyes upon topical application, probably owing to its poor bioavailability and instability at pH >5.0. In order to enhance the bioavailability of the drug, contact time between the drug molecules and the ocular surface was increased using high viscosity, water soluble polymers (PVA, HPMC), and by incorporating acetazolamide into an in situ-forming ophthalmic drug delivery system. Moreover, a penetration enhancer (EDTA) was also used in these formulations to increase the extent of absorption of the drug. Acetazolamide at a concentration of 10% was used and the formulations (eyedrop suspensions) were evaluated for their in vitro release pattern. The effect of these formulations on the IOP in normotensive conscious rabbits was also investigated. These formulations were found to be therapeutically effective with a peak effect at 2 h. A fall in IOP of up to 46.4% was observed with repeated administration of one of the formulation containing PVA, EDTA and Tween 80 (MK-5). Results indicated that a topical effect of acetazolamide can be observed if the formulation, (a) contains a suitable polymer-to increase the residence time; (b) a penetration enhancer-as acetazolamide has a low permeability coefficient i.e. 4. 1x10(-6) cm/s [Duffel, M.W., Ing. I.S., Segarra, T.M., Dixson, J.A., Barfknecht, C.F., Schoenwald, R.D., 1986. J. Med. Chem. 29, 1488-1494]; and (c) pH of the formulation is maintained at the point of maximum stability (pH< or =5.0).
口服乙酰唑胺在青光眼治疗中的应用有限,因为其使用会产生全身副作用。据报道,局部应用时,它对人眼和兔眼的眼压几乎没有影响,这可能是由于其生物利用度低以及在pH>5.0时不稳定。为了提高药物的生物利用度,使用高粘度水溶性聚合物(聚乙烯醇、羟丙基甲基纤维素)增加药物分子与眼表的接触时间,并将乙酰唑胺纳入原位形成的眼用药物递送系统。此外,还在这些制剂中使用了渗透促进剂(乙二胺四乙酸)以增加药物的吸收程度。使用浓度为10%的乙酰唑胺,并对制剂(滴眼剂混悬液)的体外释放模式进行评估。还研究了这些制剂对正常血压清醒兔眼压的影响。发现这些制剂具有治疗效果,在2小时时达到峰值效应。重复给药含聚乙烯醇、乙二胺四乙酸和吐温80的一种制剂(MK-5)后,眼压下降高达46.4%。结果表明,如果制剂(a)含有合适的聚合物以增加停留时间;(b)含有渗透促进剂——因为乙酰唑胺的渗透系数较低,即4.1×10⁻⁶cm/s[达费尔,M.W.,英格,I.S.,塞加拉,T.M.,迪克森,J.A.,巴尔夫克内希特,C.F.,舍恩瓦尔德,R.D.,1986。《药物化学杂志》29,1488 - 1494];以及(c)制剂的pH维持在最大稳定性点(pH≤5.0),则可观察到乙酰唑胺的局部作用。