Collins R, Paul Z, Reynolds D B, Short R F, Wasuwanich S
Wright State University, Department of Biomedical Engineering, Dayton, Ohio 45435, USA.
Biomed Sci Instrum. 1997;33:137-42.
Chronic diseases and pathological medical conditions requiring the administration of longterm pharmaceutical dosages have in the past been treated by oral administrations of tablets, pills and capsules or through the use of creams and ointments, suppositories, aerosols, and injectables. Such forms of drug delivery, which are still currently used today, provide a prompt release of the drug, but with significant fluctuations in the drug levels within various regions of the body. Repeated administrations of the drug are often needed, at rather precise intervals of time, in order to maintain these levels within a relatively narrow therapeutic range as a means of assuring effectiveness at the low end and of minimizing adverse effects at the higher end of the fluctuation spectrum. Recent technical advances now permit one to control the rate of drug delivery. The required therapeutic levels may thus be maintained over long periods of months and years through implanted rate-controlled drug release capsules. Two such novel drug delivery systems currently employed are implanted erodible polymeric and ceramic capsules. Mathematical modeling and computer simulations can be very effective in improving and optimizing the performance of the self-regulating release of therapeutic drugs into specific regions of the body. Further development is needed for the optimal design of such capsules. It is in this area, in particular, that a review will be presented of the mathematical modeling techniques susceptible to refine the development of a reliable tool for designing and predicting the resulting pharmaceutical dosages as a function of time and space. Of primary importance in such models are the time-varying effective permeability of the capsule to the various molecules composing the drug, the effective solubility and diffusion coefficients of the drug and its metabolites in the surrounding tissues and fluids and, finally, the uptake of the drug at the target organ. Mathematical models are presented for the diffusional release of a solute from an erodible matrix in which the initial drug loading c0 is greater than the solubility limit cs. An inward moving diffusional front separates the reservoir (unextracted region) containing the undissolved drug from the partially extracted region. The mathematical formulation of such moving boundary problems has wide application to heat transfer with melting phase transitions and diffusion-controlled growth of particles, in addition to our topic of controlled-release drug delivery. In spite of this diversity of applications, only a very few mathematical descriptions have been published for the analysis of release kinetics of a dispersed solute from polymeric or ceramic matrices. In these rare instances, perfect sink conditions are assumed, while matrix swelling, concentration-dependence of the solute diffusion coefficient and the external mass transfer resistance have been largely neglected. The ultimate goal of such an investigation is to provide a reliable design tool for the fabrication of specialized implantable capsule/drug combinations which will deliver pre-specified and reproducible dosages over a wide spectrum of conditions and required durations of therapeutic treatment. Such a mathematical/computational tool can also prove effective in the prediction of suitable dosages for other drugs of differing chemical and molecular properties which have not been subjected to time-consuming animal laboratory testing. Finally, such models may permit more realistic scaling of the required dosages of therapeutic drug for variations in diverse factors such as body weight or organ size and capacity of the patient (clinical medicine) or animal (veterinary medicine for farm animals). Additional applications of controlled-release drug delivery for insecticide and pesticide use in agriculture, and the control of pollution in lakes, rivers, marshes, etc. in which a pre-programmed dose-time schedule is necessary, further
过去,需要长期服用药物剂量的慢性疾病和病理性医疗状况是通过口服片剂、丸剂和胶囊,或使用乳膏、软膏、栓剂、气雾剂和注射剂来治疗的。这些目前仍在使用的药物递送形式能使药物迅速释放,但体内不同区域的药物水平会有显著波动。为了将这些水平维持在相对较窄的治疗范围内,以确保在波动范围低端的有效性并在高端将不良反应降至最低,通常需要以相当精确的时间间隔重复给药。最近的技术进步使人们能够控制药物递送速率。因此,通过植入的速率控制药物释放胶囊,可以在数月甚至数年的长时间内维持所需的治疗水平。目前采用的两种此类新型药物递送系统是可植入的可蚀性聚合物胶囊和陶瓷胶囊。数学建模和计算机模拟在改善和优化治疗药物向身体特定区域的自我调节释放性能方面非常有效。此类胶囊的优化设计还需要进一步发展。特别是在这个领域,将介绍一些数学建模技术,这些技术易于改进,从而开发出一种可靠的工具,用于设计和预测作为时间和空间函数的最终药物剂量。在这些模型中,最重要的是胶囊对构成药物的各种分子的随时间变化的有效渗透率、药物及其代谢物在周围组织和流体中的有效溶解度和扩散系数,以及最终药物在靶器官的摄取。本文给出了溶质从可蚀性基质中扩散释放的数学模型,其中初始药物负载量c0大于溶解度极限cs。一个向内移动的扩散前沿将含有未溶解药物的储库(未提取区域)与部分提取区域分隔开。除了我们的控释药物递送主题外,此类移动边界问题的数学公式在具有熔化相变的热传递和颗粒的扩散控制生长中也有广泛应用。尽管应用多样,但针对从聚合物或陶瓷基质中分散溶质的释放动力学分析,仅发表了极少数数学描述。在这些罕见的情况下,假定存在完美的汇条件,而基质膨胀、溶质扩散系数的浓度依赖性和外部传质阻力在很大程度上被忽略了。此类研究的最终目标是为制造专门的可植入胶囊/药物组合提供一种可靠的设计工具,该组合将在广泛的条件和所需的治疗持续时间内递送预先指定且可重复的剂量。这样的数学/计算工具在预测其他具有不同化学和分子性质、尚未经过耗时的动物实验室测试的药物的合适剂量方面也可能有效。最后,此类模型可能允许根据体重、器官大小或患者(临床医学)或动物(农场动物兽医学)的容量等多种因素的变化,更实际地调整治疗药物所需的剂量。控释药物递送在农业中用于杀虫剂和农药,以及在湖泊、河流、沼泽等中控制污染(其中需要预先设定剂量 - 时间计划)的其他应用,进一步……