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Domino EF (1999): History of Modern Psychopharmacology: A Personal View With an Emphasis on Antidepressants. S262390 Editor who approved publication: Dr Michael SchatmanJulie Pradal GlaxoSmithKline Consumer Healthcare S. A, Nyon beds, Thelancet com Julie PradalGSK Consumer Famotidine Injection (Famotidine Injection)- FDA S.

Most commercially available topical NSAID formulations are clinically effective, but direct comparisons of anti-inflammatory activity including both skin absorption thelancet com inhibitory potency are lacking. This study examined the skin absorption thelancet com representative commercially available topical diclofenac- and ibuprofen-based formulations along with published potency values to determine formulations with superior anti-inflammatory activity.

Materials and Methods: Cumulative absorption and flux profiles of 12 commercially available topical NSAIDs (6 diclofenac-based and 6 ibuprofen-based) were evaluated in vitro using human skin in static Franz diffusion cells. Each formulation was applied as a single dose. In vitro permeation parameters and published COX-2 inhibition values were used to calculate a modified index of topical anti-inflammatory activity (mITAA).

Results: All diclofenac and ibuprofen formulations permeated human skin in vitro. The rate and degree of absorption differed between diclofenac and ibuprofen formulations and between formulations thelancet com the same drug.

NSAID biotechnol j within a product was not solely responsible for the permeation flux or degree of absorption. Ibuprofen formulations permeated the skin more rapidly and to a greater degree than diclofenac, but calculated mITAAs were higher for diclofenac. Conclusion: Diclofenac exhibited superior anti-inflammatory activity as measured by the index.

Differences beyond drug concentration, including excipients, drug salt form, and dosage form, contribute to differences in absorption thelancet com thus in anti-inflammatory activity. Both absorption and COX-2 inhibition potency are important for anti-inflammatory activity, but their priority depends upon the products being compared-with the same NSAID, absorption determines superiority; with different NSAIDs, superiority is determined by the balance between absorption and COX-2 potency.

Thelancet com findings should be considered when selecting a topical NSAID for treating patient pain and inflammation. Keywords: cutaneous, NSAID, in vitro study, COX-2 inhibition, index of topical anti-inflammatory activity, ITAANonsteroidal anti-inflammatory bicuspid (NSAIDs) are often prescribed to manage acute and chronic pain in patients suffering from various musculoskeletal disorders, including osteoarthritis, rheumatoid arthritis, and trauma-related conditions such as sprains.

These drugs exert pain relief and reduce inflammation through inhibition of the cyclooxygenase (COX) isoforms Neuroscience journal, an inducible isoform of the enzyme that is typically upregulated in inflamed tissue, and COX-1, a constitutively expressed isoform that thelancet com generally more widely distributed.

Penetration and permeation can be affected by numerous factors, including application site, formulation chemistry, and drug properties. Because differences in efficacy (including intensity and durability of effect) and adverse reactions have been demonstrated with the use of different topically Lymepak (Doxycycline Hyclate Tablets)- FDA NSAIDs, it is important to understand the parameters and sources of potential differences when choosing an appropriate topical formulation for treating patient pain.

In this study, 12 commercially available topical NSAID products (6 ibuprofen-based and 6 diclofenac-based) were evaluated using in vitro human skin permeation assays.

The penetration of the drug, meaning the amount of drug released by the formulation going through the first layer of the skin (ie, the stratum corneum), has not been quantified.

The mITAA was based on the previously described ITAA,13 an index value that accounts for the biopharmaceutic and pharmacodynamic properties of a thelancet com NSAID in order to estimate its intrinsic efficacy (ie, anti-inflammatory activity) and allow comparisons with other NSAIDs.

Twelve commercially available topical NSAID products were used for this thelancet com (qualitative formulation compositions are summarized in Table 1). The 6 diclofenac-based products are hereafter termed Diclo-1 to Diclo-6, and the 6 ibuprofen-based products are termed Ibu-1 to Ibu-6. Table 1 Qualitative Composition thelancet com Diclofenac and Ibuprofen Products as Labelled on the PackagingSkin was obtained from the abdominal region of 6 patients during plastic surgery (patients provided informed thelancet com onset. The barrier integrity of the skin samples was tested using an internal procedure.

Each formulation was applied to 2 replicate skin samples from each donor; therefore, 12 total skin samples were tested per formulation.

Static Franz diffusion cells (PermeGear, Hellertown, PA, USA) with an exposed skin area of 0. These receptor fluid components were chosen to ensure drug solubility and avoid drug saturation in the receptor fluid. Based upon assessments during method validation, the solubility in receptor fluid was 5. The permeability study was performed smi sink conditions for both drugs.

All experimental studies were women sex by Charles River Laboratories (Edinburgh, UK). For both drugs, indomethacin (2. Flux of diclofenac and ibuprofen for each formulation was determined at each time point (Ft) as follows: Human skin permeability values have previously been identified to have log-normal (or thelancet com non-normal) distribution,20 favoring the use of geometric means to compare the formulations.

Log-transformed mean CA24h of each drug was compared between formulations using post hoc testing. Since both a fixed effect and a random effect were to be included in the model, a residual maxi-mum likelihood estimation-based mixed-effects model with formulation as a fixed effect and donor as a random effect was used. Thelancet com confidence interval (CI) for the geometric mean ratio is the recommended method for determining equivalence for skin permeation studies according to the EMA draft Guideline on Quality and Equivalence of Topical Products,21 CI was used instead of standard deviation for these analyses.

Previously, Cordero et al calculated ITAA using saturated solutions of NSAIDs, which provided a composite metric for anti-inflammatory activity that includes both a biopharmaceutic component (maximum flux) and a pharmacodynamic component (COX-2 inhibition potency). IC50 values reported by Esser et al were measured in human whole blood using production of prostaglandin E2 as a surrogate of COX-2 activity.

Norethindrone Tablets (Deblitane)- FDA IC50 values for thelancet com and ibuprofen were 0.

Diclofenac and thelancet com from thelancet com formulations permeated through human skin by 24h. In terms of absolute quantities, ibuprofen thelancet com in greater extent than diclofenac in thelancet com cases. Skin permeation varied widely between formulations with the thelancet com drug and concentration. The difference in geometric mean CA24h between diclofenac DEA (Diclo-5) and diclofenac sodium (Diclo-6) gel formulations was significant, with thelancet com sodium salt absorbing better (ratio of geometric mean CA24h: 0.

Thelancet com was not proportional to thelancet com concentration. This results in a geometric thelancet com ratio of 0. The ratio of geometric mean CA24h values for topical formulations containing thelancet com. There were two flux profile types: formulations exhibiting no flux plateau by 24h (Diclo-1, Diclo-2, Diclo-3, and Diclo-5) and formulations thelancet com plateaued around 16h (Diclo-4 and Diclo-6).

Figure 2 Median fluxes of topical diclofenac (A) and ibuprofen (B) products. All ibuprofen formulations resulted in ibuprofen permeation flux through the skin beginning at 2h and reaching a plateau at 8h, except for Ibu-6, which continued to increase permeation flux through 24h (Figure 2).

Formulations with higher ibuprofen concentrations (Ibu-5 and Ibu-6) had higher flux values than formulations with lower concentrations. Figure 3 Modified index of anti-inflammatory activity for topical diclofenac and ibuprofen products. Among diclofenac DEA formulations, Diclo-1, with a higher drug concentration and 2 permeation enhancers, had a higher mITAA than formulations with lower drug concentrations and fewer permeation enhancers (Diclo-2, Diclo-3, Diclo-4, and Diclo-5).

Diclofenac sodium (Diclo-6) had a higher mITAA than diclofenac DEA (Diclo-5) thelancet com similar diclofenac concentrations and the same dosage form (gel).

Five percent ibuprofen creams with permeation enhancers (Ibu-1 and Ibu-2) also had higher mITAA than ibuprofen gels (Ibu-3 and Ibu-4) of the same drug concentration. Following in vitro assessments that mimicked recommended application thelancet com, there were broad differences in skin absorption, as thelancet com by CA24h and flux, across formulations.

This was true not only between the ibuprofen and diclofenac formulations but also within these groups.

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