Question

Need 600 Words long correct Answer:

Assignment: Choosing a drug delivery system for the best patient outcome

As a Pharmacist you have been asked to recommend a drug delivery system that can be administered for a patient. You will need to communicate to your peers and other healthcare providers why you have chosen this particular drug delivery system for this patient. You will need to:

A. Choose a disease state that you would like to research.

B. Decide on your patient profile/case study.

C. Justify your reasons why you have chosen this particular drug delivery system for your patient.

Tips and Hints:

Think about all the information we have covered in lectures about the choice of drug delivery system.

Research your chosen disease state and what pharmacotherapy is used.

Think clearly about your chosen case study

Answer 1

Answer:

(word count~ 600 words)

Introduction:

Drug delivery systems involves the administration of drugs using technologies that control the location of the release of the drug and / or the rate of the drug release enhancing its efficacy and efficiency and preventing potential side effects..

The drug delivery systems should be used judicially in situations where the drugs need to be given at specific sites or to prevent the side effects of the drugs .

The commonest examples of drug delivery systems:

The commonly used delivery systems by patients are use of powdered drug inhalers in asthma, use of fentanyl /diclofenac transdermal patches for pain, use of enteric coated Aspirin, use of enteric coated sulfasalazine in inflammatory bowel diseaseand so on.

The drug delivery system for best patient outcome discussed here is the use of liposomal technology to deliver a drug.In this technology, drug is coated by phospholipid/cholesterol bilayer to make a spherical vesicle containing the drug.

The disease for which the drug delivery system is researched in this discussion is Invasive Candidiasis which is associated with high rates of mortality and morbidity.

The patient profile/case study.

The antifungal amphotericin B prescription for the treatment for adult burns male patient,age 34, admitted in ICU for Invasive candidiasis, candida confirmed on blood culture.

Patient with prolonged total parenteral nutrition through central venous line, with slightly elevated blood urea [BUN 24mg/dl] and serum creatinine [1.5mg/dl.] levels.

Drug delivery system recommendation for the patient.

The use of antifungal liposomal amphotericin B or ambisome..

The drug delivery system recommended for the invasive Candidiasis for the above patient is liposomal drug delivery system and involves the nanotechnology drug delivery application.

Justification for the choice of the particular delivery system.

Amphotericin B is a drug of choice for invasive candidiasis. However it is a highly nephrotoxic drug and is also associated with infusion related fever,chills and other reactions.

The liposomal amphotericin B has definite advantage over the non liposomal amphotericin B formulation and these advantages justify the reasons for choice of this drug delivery system for the cure of this disease in presence of mild renal impairment.

The Advantages of liposomal amphotericin B over non liposomal amphotericin B are

1. The liposomal amphotericin B easily reaches the fungal cell wall and binds strongly to the fungal cell wall inhibiting ergosterol synthesis and treats the fungal infectionThe Lipid encapsulation of the drugs and site specific targeting helps to decrease the accumulation of the drug within the healthy tissues by preventing toxic side effects caused by the non specific binding to human cholesterol. Fungal lipases release the drug from the liposomes making the drug concentrated in the fungal cells with less side effects,

2. Liposomal amphotericin B administration has a lesser incidence of nephrotoxicity. As the patient has slightly elevated blood urea and creatinine levels, the patient will benefit from Liposomal amphotericin B administration in that the patient will not experience the high nephrotoxicity which is commonly associated with nonliposomal amphotericin B formulation.

3 The.patient will also experiencing significantly lower rates of infusion related chills or rigors with Liposomal amphotericin B as compared to the normal amphotericinB

4. Due to decreased toxicity and better tolerance, there is a higher chance that the patient will be able to tolerate the therapy without significant side effects and complete the therapy with the Liposomal amphotericin B as compared to amphotericin B.

Thus by recommending the use of liposomal drug delivery system for amphotericin B drug, the risk of nephrotoxicity and infusion related reactions is decreased and patient outcomes are improved.

The other diseases where the liposomal formulation can be used successfully are in febrile neutropenia patients,cryptococcal meningitis, disseminated aspergillosis and visceral leishmaniasis.