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药物输送创新应对儿科和老年人群体的全球健康挑战(通过提高患者依从性)。

Drug Delivery Innovations to Address Global Health Challenges for Pediatric and Geriatric Populations (Through Improvements in Patient Compliance).

机构信息

Department of Pharmaceutical, Chemical and Environmental Sciences, Faculty of Engineering and Science, University of Greenwich, Medway, Central Avenue, Chatham Maritime, Kent ME4 4TB, UK.

出版信息

J Pharm Sci. 2017 Nov;106(11):3188-3198. doi: 10.1016/j.xphs.2017.07.009. Epub 2017 Jul 20.

Abstract

Despite significant advances in pharmaceutical and biotechnological drug discovery, the global population is plagued with many challenging diseases. These are further compounded by anticipated explosion in an ageing population, which presents several problems such as polypharmacy, dysphagia, and neurologic conditions, resulting in noncompliance and disease complications. For antibiotics, poor compliance, can result in development of drug-resistant infections which can be fatal. Furthermore, children, especially, in developing countries die unnecessarily from easily treatable diseases (e.g., malaria), due to poor compliance arising from bitter taste and inability to swallow currently available medication. Although some of these challenges require the discovery of new drug compounds, a significant number can be resolved by employing pharmaceutics approaches to reduce the incidence of poor patient compliance. Such solutions are expected to make swallowing easier and reduce the need to swallow several solid medications, which is difficult for vulnerable pediatric and geriatric patients. This commentary will explore the current state of the art in the use of drug delivery innovations to overcome some of these challenges, taking cues from relevant regulatory agencies such as the Food and Drug Administration, the European Medicines Agency, World Health Organization, and the peer-reviewed scientific and clinical literature.

摘要

尽管在药物发现方面取得了重大进展,但全球人口仍受到许多挑战性疾病的困扰。预计人口老龄化的爆炸式增长将使这些问题更加复杂,例如多种药物治疗、吞咽困难和神经疾病,导致不遵医嘱和疾病并发症。对于抗生素来说,不遵医嘱可能导致耐药感染,从而危及生命。此外,由于目前可获得的药物味道苦且难以吞咽,儿童,尤其是发展中国家的儿童,由于不遵医嘱,许多本可轻易治愈的疾病(如疟疾)导致不必要的死亡。虽然这些挑战中的一些需要发现新的药物化合物,但通过采用药剂学方法来降低患者不遵医嘱的发生率,可以解决相当数量的问题。这些解决方案有望使吞咽变得更容易,并减少对吞咽几种固体药物的需求,这对脆弱的儿科和老年患者来说是困难的。这篇评论将从相关监管机构(如美国食品和药物管理局、欧洲药品管理局、世界卫生组织以及同行评议的科学和临床文献)中寻找线索,探讨利用药物输送创新来克服其中一些挑战的最新技术状态。

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