Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, 2193, South Africa.
J Pharm Sci. 2014 Feb;103(2):353-66. doi: 10.1002/jps.23829. Epub 2013 Dec 20.
Chronic pain poses a major concern to modern medicine and is frequently undertreated, causing suffering and disability. Patient-controlled analgesia, although successful, does have limitations. Transdermal delivery is the pivot to which analgesic research in drug delivery has centralized, especially with the confines of needle phobias and associated pain related to traditional injections, and the existing limitations associated with oral drug delivery. Highlighted within is the possibility of further developing transdermal drug delivery for chronic pain treatment using iontophoresis-based microneedle array patches. A concerted effort was made to review critically all available therapies designed for the treatment of chronic pain. The drug delivery systems developed for this purpose and nondrug routes are elaborated on, in a systematic manner. Recent developments and future goals in transdermal delivery as a means to overcome the individual limitations of the aforementioned delivery routes are represented as well. The approval of patch-like devices that contain both the microelectronic-processing mechanism and the active medicament in a small portable device is still awaited by the pharmaceutical industry. This anticipated platform may provide transdermal electro-activated and electro-modulated drug delivery systems a feasible attempt in chronic pain treatment. Iontophoresis has been proven an effective mode used to administer ionized drugs in physiotherapeutic, diagnostic, and dermatological applications and may be an encouraging probability for the development of devices and aids in the treatment of chronic pain.
慢性疼痛是现代医学关注的主要问题，常常治疗不足，导致患者痛苦和残疾。尽管患者自控镇痛技术取得了成功，但也存在局限性。经皮给药是药物输送中镇痛研究的中心，特别是考虑到针恐惧症和传统注射相关疼痛的限制，以及与口服药物输送相关的现有局限性。本文强调了利用基于电渗的微针阵列贴片进一步开发用于治疗慢性疼痛的经皮药物输送的可能性。本文努力全面审查了所有旨在治疗慢性疼痛的现有疗法。以系统的方式详细阐述了为此目的开发的药物输送系统和非药物途径。还介绍了经皮输送作为克服上述输送途径的个体局限性的手段的最新进展和未来目标。制药行业仍在等待包含微电子处理机制和小型便携式设备中活性药物的类似贴片设备的批准。该预期平台可能为经皮电激活和电调节药物输送系统提供治疗慢性疼痛的可行尝试。电渗已被证明是一种有效的模式，可用于理疗、诊断和皮肤病学应用中的离子药物给药，并且可能是开发治疗慢性疼痛的设备和辅助工具的令人鼓舞的可能性。
