Scuola di Scienze del Farmaco e dei Prodotti della Salute, Via Madonna delle Carceri, 9, 62032 Camerino (MC), Italy.
Curr Pharm Des. 2013;19(3):510-26.
Pharmacological treatment of disorders affecting the central nervous system (CNS) is a complex task. Different parameters may negatively influence effective targeting of the CNS and drug compliance, for example, poor brain-blood barrier (BBB) permeability, patient forgetfulness or neglect, and lack of collaboration between caregivers and patients. Pharmaceutical science is constantly looking for new administration strategies for efficient drug delivery to the CNS that could obviate these problems. Drugs can reach the brain through the skin, nasal cavity and oral cavity, and while effective transport of drugs from skin and nasal cavity to the CNS has been documented, these studies did not stimulate the introduction of a substantial number of new drug formulations to treat CNS disorders. Nasal drug delivery, generally used to administer locally acting molecules, is not common for systemic administration, although the possibility and importance of such systemic administration is suggested by several studies. This paper reviewed different anatomical and pharmaceutical factors related to drug administration through the nasal route, and explored whether nasal delivery of selected CNS drugs could improve their pharmacokinetics and patient compliance. This route offers attractive advantages, and pharmaceutical scientists and anatomists should collaborate to improve CNS drug compliance and to increase the number of compounds that can be administered intranasally.
治疗影响中枢神经系统 (CNS) 的疾病的药物治疗是一项复杂的任务。例如，血脑屏障 (BBB) 通透性差、患者健忘或忽视以及护理人员和患者之间缺乏协作等不同参数可能会对中枢神经系统的有效靶向和药物依从性产生负面影响。制药科学一直在寻找新的给药策略，以实现高效的药物输送到中枢神经系统，从而可以避免这些问题。药物可以通过皮肤、鼻腔和口腔到达大脑，虽然已经有文献证明药物从皮肤和鼻腔有效输送到中枢神经系统，但这些研究并没有激发大量新的药物制剂来治疗中枢神经系统疾病。鼻腔给药通常用于局部作用分子，不常用于全身给药，尽管有几项研究表明这种全身给药的可能性和重要性。本文综述了与鼻腔给药相关的不同解剖学和药物学因素，并探讨了是否可以通过鼻腔给予选定的中枢神经系统药物来改善其药代动力学和患者顺应性。该途径具有吸引力的优势，制药科学家和解剖学家应合作改善中枢神经系统药物的顺应性，并增加可经鼻腔给予的化合物数量。
