Effect of continuous vs pulsed iontophoresis of treprostinil on skin blood flow

Kotzki, Sylvain; Roustit, Matthieu; Arnaud, Claire; Godin‐Ribuot, Diane; Cracowski, Jean‐Luc

doi:10.1016/j.ejps.2015.02.012

Cited by 12 publications

(11 citation statements)

References 28 publications

(34 reference statements)

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“…When an EMLA cream is applied across human skin for surgical procedures, it takes about 1–2 hours to achieve effective analgesia. Studies on healthy volunteers have shown that satisfactory analgesia when 135 μg/cm 2 amount of 2.5% lidocaine present in the EMLA cream has systemically absorbed/permeated through the human skin . In this study, instead of using EMLA cream, we have prepared lidocaine HCL drug at two different concentrations viz: 2.5 and 5%.…”

Section: Discussionmentioning

confidence: 99%

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Effective permeation of 2.5 and 5% lidocaine hydrochloride in human skin using iontophoresis technique

et al. 2018

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Section: Discussionmentioning

confidence: 99%

“…Apart from delivering lidocaine HCL, modulated IOP has also been used to deliver other drugs. Kotzki et al ., reported that modulated IOP of treprostinil across anesthetized rats has significantly enhanced the cutaneous blood flow and proposes to use modulated IOP technique on humans . Raiman et al .…”

Section: Introductionmentioning

confidence: 99%

Effective permeation of 2.5 and 5% lidocaine hydrochloride in human skin using iontophoresis technique

et al. 2018

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“…Iontophoresis involves the application of physiologically acceptable electrical currents (0.1–1.0 mA/cm 2 ) to drive charged permeants into the skin through electrostatic effects and make ionic drugs pass through the skin into the body by its potential gradient [ 5 , 20 , 58 , 68 , 69 , 70 , 71 ]. Unlike other transdermal enhancement methodologies, it acts mainly by involving a second driving force, the electrical potential gradient as companion to the concentration gradient across the skin since uncharged species can also be delivered through electroosmosis ( Figure 8 ) [ 5 , 70 ].…”

Section: Techniques For Enhancement Of Skin Permeabilisationmentioning

confidence: 99%

“…Several factors affect iontophoretic TDD, including pH of the donor solution, electrode type, buffer concentration, current strength and the type of current employed [ 20 , 69 , 72 , 73 ]. The molecular size of the solute/drug is an important factor in determining its feasibility for successful iontophoretic delivery.…”

Section: Techniques For Enhancement Of Skin Permeabilisationmentioning

confidence: 99%

Transdermal Drug Delivery: Innovative Pharmaceutical Developments Based on Disruption of the Barrier Properties of the Stratum Corneum

2015

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The skin offers an accessible and convenient site for the administration of medications. To this end, the field of transdermal drug delivery, aimed at developing safe and efficacious means of delivering medications across the skin, has in the past and continues to garner much time and investment with the continuous advancement of new and innovative approaches. This review details the progress and current status of the transdermal drug delivery field and describes numerous pharmaceutical developments which have been employed to overcome limitations associated with skin delivery systems. Advantages and disadvantages of the various approaches are detailed, commercially marketed products are highlighted and particular attention is paid to the emerging field of microneedle technologies.

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“…Effective topical therapies which act locally on the digits, and which are free from systemic side effects, are badly needed. It is encouraging that both preclinical and human studies are exploring topical delivery systems, including with iontophoresis, to improve blood flow [66,67,68]. An exciting potential development is the prospect of being able to apply local therapies to ulcers to induce angiogenesis and promote healing: a study in UCD-206 chickens showed that application of VEGF 121 -fibrin in a gel matrix improved This prospective study of 623 patients (59 centres from 14 countries) reported that among the 468 patients with a previous history of digital ulceration, the three strongest predictors of new ulcers over 6 months were (at baseline) the mean number of capillaries/mm in the middle finger of the dominant hand, the number of digital ulcers, and the presence of critical ischaemia.…”

Section: Topical Therapiesmentioning

confidence: 99%

Recent advances in the pathogenesis and management of Raynaud's phenomenon and digital ulcers

Herrick

2016

Current Opinion in Rheumatology

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Purpose of review: Systemic sclerosis (SSc)-related digital vasculopathy can progress from severe Raynaud's phenomenon (RP) to digital ulceration, is a major cause of pain and disability, and impacts negatively on quality of life. Current treatments are often ineffective and poorly tolerated. This review summarises some of the progress which has been made in the last 12 to 18 months in terms of our understanding of disease process, measurement and treatment. Recent findings:The most important findings include that we can now better predict which patients with SSc are most likely to develop digital ulcers. In terms of treatment, a multicentre trial showed that the phosphodiesterase inhibitor sildenafil confers some benefit in SSc-related digital ulceration.Topical therapies are being explored: iontophoresis of vasodilators increases local blood flow, and in an avian model, VEGF 121 fibrin applied in a gel matrix improved wound healing. A number of challenges confront clinicians and scientists with an interest in SSc-related digital vasculopathy, specific questions being:1. What mechanisms drive the digital vasculopathy and lead to structural as well as functional change? 2. Can we predict which patients progress to digital ulceration? 3. Can we measure disease process reliably (in terms of both RP and digital ulcers), to provide outcome measures to facilitate clinical trials?4. Are we making progress in developing safe and effective treatments, for both severe RP and SScrelated digital ulceration?In this review I shall outline developments over the last 12-18 months in answering these four questions, under the headings of pathophysiology, predictors of digital ulceration, measurement of disease process, and management. Under each heading I shall consider firstly RP and secondly digital ulceration, although this is a false distinction because both are part of the spectum of SSc-digital vasculopathy. PATHOPHYSIOLOGY Raynaud's phenomenonThe pathophysiology of RP is complex and most likely involves an interplay between vascular factors, neural control mechanisms and intravascular factors [6]. Flavahan, in a recent review [7**], describes thermoregulatory mechanisms as central to an understanding of RP, highlighting the role of arteriovenous anastomoses, and how local cooling leads to increased activity of alpha 2 -adrenoceptors, resulting in reduced blood flow. In patients with SSc, structural microvascular changes mean that upstream vasoconstriction can irretrievably compromise nutritional blood flow and lead to tissue injury [7**,8]. The review also gives a framework for targetted therapeutic interventions [7**]. Digital ulcerationA commonly held view is that fingertip ulceration is ischaemic, whereas ulceration over the extensor surfaces of fingers is 'traumatic'. To date there has been very little direct evidence to support this theory. However, a study by Ruaro et al [9*] of 20 patients with SSc and fingertip ulcers demonstrated that blood flow is reduced at the site of fingertip ulcers (and improves wit...

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Effect of continuous vs pulsed iontophoresis of treprostinil on skin blood flow

Cited by 12 publications

References 28 publications

Effective permeation of 2.5 and 5% lidocaine hydrochloride in human skin using iontophoresis technique

Effective permeation of 2.5 and 5% lidocaine hydrochloride in human skin using iontophoresis technique

Transdermal Drug Delivery: Innovative Pharmaceutical Developments Based on Disruption of the Barrier Properties of the Stratum Corneum

Recent advances in the pathogenesis and management of Raynaud's phenomenon and digital ulcers

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