In situ gelling drug delivery systems for periodontal anaesthesia

In this thesis local anaesthetic formulations based on PEO-PPO-PEO block copolymers (PEO and PPO being poly(ethylene oxide) and poly(propylene oxide), respectively) or nonionic cellulose ethers undergoing temperature- or dilution-induced thickening were investigated. The aim of the work was to develop formulations which can be easily administered to the periodontal pocket, stay at the application site, give a fast onset of anaesthesia and have a duration sufficient to perform periodontal scaling procedures. Emulsions, (mixed) micellar solutions and microemulsions fulfilling the requirements stated above were achieved by combining the active ingredients lidocaine and prilocaine with the nonionic block copolymers Lutrol® F127 and Lutrol® F68. The critical micellisation and gelation temperatures of the systems were found to be interconnected and influenced by the total polymer concentration and the polymer mixture composition, as well as the presence of cosolutes and pH. A low-viscous isotropic phase that turns into a high-viscous hexagonal phase as the water content increases was found by combining Lutrol® F68, water, a eutectic mixture of lidocaine and prilocaine and Akoline MCM. The system has a slower release rate compared to the microemulsion formulation which might make it suitable for indications where a longer duration is needed. Finally, a temperature-induced gelling system was achieved by adding lidocaine and prilocaine to mixtures of ethyl(hydroxyethyl)cellulose (EHEC) and sodium dodecyl sulfate (SDS), hexadecyltrimethylammonium bromide (CTAB) or myristoylcholine bromide systems at, or just below, the surfactant concentration found to give a maximum viscosity increase at room temperature. In particular, the myristoylcholine bromide system may be interesting considering its antibacterial properties and biodegradability

Supercritical solvent impregnation of poly(ɛ-caprolactone)/poly(oxyethylene-b-oxypropylene-b-oxyethylene) and poly(ɛ-caprolactone)/poly(ethylene-vinyl acetate) blends for controlled release applications

Poly(ɛ-caprolactone) blends were successfully impregnated with timolol maleate, an anti-glaucoma drug, using a supercritical solvent impregnation (SSI) technique. Supercritical fluid impregnation efficiency results suggested that the best impregnating conditions were obtained when a cosolvent was used and when specific drug–polymer interactions occurred as a consequence of different chemical structures due to polymer blending. Pressure can be either a favourable factor, when there is enough drug affinity for the polymers, or an unfavourable factor when weaker bonding is involved. In order to determine the relative hydrophilicity/hydrophobicity of the blends, contact angle analysis was performed, while crystallinity determination was also useful to understand the obtained release profiles. Drug loading, heterogeneous/homogeneous dispersion of drug inside the matrix, hydrophilicity, crystallinity, all seem to influence the obtained drug release rates. The “in vitro” release results suggested that a sustained drug release rate can be obtained by changing the SSI operational conditions and by modulating the composition of blends, as a mean to control crystallinity, hydrophilicity and drug affinity for the polymer matrix. After a first day burst release, all samples showed a sustained release profile (1.2–4 μg/(ml day), corresponding to a mass of 3–10 μg/day) which is between the therapeutic and toxic levels of timolol maleate, during a period of 1 month. These drug-loaded polymeric matrices can be a feasible alternative treatment modality for the conventional repeated daily administration of eye drops

Nonionic cellulose ethers as potential drug delivery systems for periodontal anesthesia

Nonionic cellulose ethers displaying a lower consolute temperature, or cloud-point, close to body temperature were investigated as potential carrier systems for the delivery of local anesthetic agents to the periodontal pocket. The interaction between the polymers, i.e., ethyl(hydroxyethyl)cellulose (EHEC) and hydrophobically modified EHEC (HM-EHEC), and ionic surfactants was determined in the absence and in the presence of the local anesthetic agents lidocaine and prilocaine. The cloud-point and rheology data indicate interactions between the polymer and both anionic and cationic surfactants. More precisely, a number of ionic surfactants were found to result in an increase in cloud-point at higher surfactant concentrations, a surfactant-concentration-dependent thickening, and a temperature-induced gelation upon heating. Upon addition of the local anesthetic agents lidocaine and prilocaine in their uncharged form to EHEC and HM-EHEC, in the absence of surfactants, only minor interaction with the polymer could be inferred. However, these substances were found to affect the polymer-surfactant interaction. In particular, the drug release rate in vitro as well as the stability and temperature-dependent viscosity were followed for an EHEC/SDS system and EHEC/myristoylcholine bromide system upon addition of lidocaine and prilocaine. The data indicate a possibility of formulating a local anesthetic drug delivery system suitable for administration into the periodontal pocket where at least small amounts of active ingredients can be incorporated into the system without severely affecting the gelation behavior. The results found for the cationic myristoylcholine bromide system are particularly interesting for the application in focus here since this surfactant is antibacterial and readily biodegradable.</p

Micellization and gelation in block copolymer systems containing local anesthetics

A formulation consisting of a eutectic mixture of lidocaine and prilocaine, Lutrol(R) F68 and Lutrol(R) F127, suitable for anesthetizing the periodontal pocket has previously been developed. This consists of discrete micelles with a diameter of 20-30 nm and has a suitable gelation temperature, a good release profile and excellent long-term stability. In this study, the unimer/micelle transition and gel formation of the formulation, in its concentrated state, are investigated using differential scanning calorimetry (DSC), dye solubilization, rheology, and nuclear magnetic resonance (NMR) self-diffusion. The critical micellization temperature (cmt) and gelation temperature are found to be interconnected and influenced by cosolutes, such as electrolytes and hydrophobic substances, the latter as found particularly for the eutectic mixture of the local anesthetic agents lidocaine and prilocaine. Both cmt and the gelation temperature decrease with increasing pH of the system, i.e. at reduced solubility of the active ingredients. Moreover, both cmt and the gelation temperature increase upon diluting the system with water. The ratio between the two block copolymers present in the system also has an impact on both cmt and the gelation temperature, resulting in a decrease in onset tt temperature of both processes with an increase of Lutrol(R) F127, The amount of the active ingredients present in the micelle phase depends on the pH of thc system bring approximately 0% w/w at pH 5, 50-60% w/w at pH 7.8 and 80% w/w at pH 9.</p

Stabilization of a thermosetting emulsion system using ionic and nonionic surfactants

Ways of achieving a suitable local anesthetic formulation for use in the periodontal cavity were investigated in this study. By choosing poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide) block copolymers as excipients, formulations which are low viscosity fluids at room temperature and rigid elastic gels at body temperature are obtained. Despite the solubilizing capacity of these polymers, formulations containing Lutrol(R) F127 (EO99PO65EO99) and the active ingredients lidocaine and prilocaine at the desired concentrations, i.e. approximately 25 mg g(-1) of each component, are unstable. In order to achieve a more stable formulation a second surfactant can be added to the system since it could help both to solubilize the hydrophobic active ingredients and to stabilize the droplets of lidocaine and prilocaine from flocculation and coalescence. Thus, formulations containing local anesthetic compounds comprising the oil phase, a block copolymer giving the system unique rheological properties, and a suitable second surfactant were evaluated with regard to rheological behavior, drug release properties and stability. The system needs to be balanced regarding the concentration of polymer, active ingredients and surfactant in order to achieve a formulation with suitable properties. Stable formulations with appropriate characteristics for the application in focus here were obtained with anionic, cationic and nonionic surfactants.</p

Local anaesthetic block copolymer system undergoing phase transition on dilution with water

The possibility of formulating a local anaesthetic system displaying in situ gelation on dilution with water, as well as its dependence on concentration of active ingredients and pH was investigated. For this purpose Lutrol F68, water, a eutectic mixture of lidocaine and prilocaine and Akoline MCM were mixed in different ratios and investigated using crossed polarisers, small-angle X-ray diffraction, rheology, conductivity and NMR self-diffusion measurements. In particular, an isotropic phase of low viscosity turning into a high viscous hexagonal phase upon dilution with water was found. The increase in viscosity is only weakly dependent on temperature in the temperature range of 20-37 degrees C. The rheology and in vitro drug release of these systems were studied and the elastic modulus was found to be fairly independent of concentration of active ingredients and pH in the investigated region. The in vitro release of lidocaine and prilocaine was found to increase with increasing concentration of the active ingredients and with decreasing pH, the latter as a consequence of the pH-dependent ionisation of these substances. The behaviour of the system is promising from a pharmaceutical point of view, since the isotropic low-viscous phase can be injected into, e.g. a periodontal pocket where the presence of saliva will cause a temporal transition into a rigid hexagonal phase thus making the formulation stay at the application site. At even higher water content, either as a result of longer application time or rinsing with water, the hexagonal phase is effectively dissolved through transformation to a water-rich micellar phase</p