These are exciting times when there are new drug delivery system either already here or slated to arrive shortly, targeted drugs for diseases and constant and easy health monitoring now available. Research and development is constantly on finding new drugs as also ways so that patients can have them painlessly and so that they reach the body in the desired doses without any problems. With the digital revolution, wireless technology coupled with the internet allows for a patient’s physical condition to be constantly monitored without much effort. The advent of smartphones is another weapon the medical arsenal and helps people in myriad ways that had not even been thought of before.
Implants to monitor conditions
All kinds of implants can be placed inside the body without any pain or interference of bodily functions, collect data and even transmit it to the doctor. Pacemakers in the heart already do this, except that they do it on a regular basis and not on continual one. Currently these implants are meant only for short term use to monitor heart or the brain that is involved in epilepsy, seizures or Parkinson’s but in the future these may have more varied application and be easily available.
Some of these devices are already in use, like the camera in a capsule that you swallow and that sends images of its passage to the stomach, replacing the need for a semi-invasive and uncomfortable procedure like the endoscopy. Most people who suffer from diabetes have to do blood tests at regular intervals and then take insulin according to the results. New medical devices like a sensor that can be placed under the skin can make the process much easier. It can monitor blood glucose levels constantly and let the patient know when it is time to take insulin or how much. In fact the new insulin pumps replace injections too as they use a tiny tube to deliver the required insulin.
Of course electronic devices need to bypass the body’s own immune system that will detect the devices and treat them as intruders and for this research is still going on so that the body does not reject the item and so that it will last for longer inside the body. Currently many items have to be frequently replaced because of rapid degradation.
New targeted drug delivery systems
One of the major drawback of orally ingested drugs, even time release ones, is that they have to go through the stomach and the digestive system. Here they are attacked by acids and suffer some amount of degradation. They also cause many side effects. While medicines which are injected work faster as they go directly into the blood stream, allergic and other unwanted reaction also occur quicker. Both drug delivery systems have their drawbacks.
The latest drug delivery systems, most of which are still under research, are tightly targeted and reach only the part of the body they are supposed to. They are more effective in a lesser dosage and cause fewer or no side effects. Among the new systems under research are:
Embedded carbon nanofibres – North Carolina University researchers are currently working on the technique of using embedded carbon nanofibres. The nanofibres were grown in a lab on an aluminum substrate and then liquid silicone polymers added. These were then spun so that the silicone formed a layer with the nanofibres sticking out, but perpendicular to the surface. This was cured and the aluminum layer was dissolved, leaving the membrane intact. The nanoscale needles can then be coated with the drug, the membrane made into a deflated balloon and inserted where required. When the balloon is inflated the needles jut out and pierce the cells, ensuring targeted drug delivery. The balloon can then be withdrawn.
DuraSite2 – this is a new drug delivery system patented by InSite Vision specifically for use in the eye. Currently all eye drops face a major retention problem as eyes naturally blink away the medicines, retaining a minuscule amount. This means that patients have to use more of the medicine and more often. InSite Vision then came up with a solution: using a biocompatible and non toxic polymer to hold the drug, which is suspended in the liquid. With each blink, the drug actually comes into contact with the eyes and the conjunctiva thanks to the polymer instead of being removed by the tear drops and the medicine can then stay for up to six hours on the eye, improving efficacy and reducing the necessity of repeated dosages. Broad spectrum antibiotics like azithromycin and besifloxacin were used in research trials and showed improve efficacy with even a single use per day, ensuring better patient compliance.
New lung cancer drug delivery system – Researchers at the Oregon State University, Rutgers University and the Cancer Institute of New Jersey, working together, have found a new targeted system of chemotherapeutic drugs for lung cancer that only need to be inhaled to work. This obviates the other side effects of chemotherapy and also presents a targeted system that works much better. This new drug delivery system uses nanostructured lipid nanocarriers,which are tiny particles much smaller than dust particles that are easily inhaled and attack the cancer cells.This carrier system delivers the anticancer drug, which then works more efficiently and eliminates the tumors instead of just suppressing the cancer.
Mechanical drug delivery system – Researchers at MANA (NIMS International Center for Materials Nanoarchitectonics) in Japan developed a gel material that can contain drugs and can be introduced under the skin safely. It can release the drug when gentle pressure is applied or by rubbing the area and offers a safe on-demand drug delivery system, though it does require the patient to apply the pressure. The gel comprises calcium alginate, which is a naturally-derived component contained in algae and cyclodextrin, which is a saccharide and which contains the drug.
Shape of nanoparticles improves drug delivery – Research conducted by Erkki Ruoslahti, M.D. Ph.D.of Sanford-Burnham Medical Research Institute’s added to work done by Samir Mitragotri, Ph.D., at the University of California, Santa Barbara, found that making rod-shaped nanoparticles — or nanorods — as against to rounded ones made them more effective. This supposedly works as the nanorods have a larger surface area and this makes them easy to bind with the endothelial cells resulting in improved cell adhesion and faster working. When these particles are engineered with antibodies, they can work in specific areas and can be used for very targeted chemotherapy.
Smartphone apps for health monitoring
There are many new apps for health monitoring of various conditions. Apart from apps that monitor your fitness goals, exercise and diet, there are apps that can help in measuring the heart rate by switching on the camera in the phone. These are not precisely accurate, but reasonably so and can point to heart problems as they arise. Then there are apps that can serve as reminders for when you need your medicines refilled and some of them can even send the refill orders to the pharmacy.
Apps can also monitor if you mix medicines that can react with one another or with food, especially if you are taking many different medications. If you have chronic health conditions like diabetes or asthma which requires you to take medicines at scheduled times, you can get apps for those. Many other apps are targeted towards those who suffer from chronic disease conditions like arthritis, lupus, fibromyalgia, depression, multiple sclerosis and more. More apps are on the anvil that will be able to measure blood sugar, blood pressure and even the eyes that give an indication of certain diseases.
Wearable devices are useful for regular, quick and more accurate health monitoring. Among the devices available are wearable devices for glucose monitoring, ECG, EKG, blood pressure and oximeters. Cardiac monitoring can help detect cardiac arrhythmias or heart disease. At times, the smarter devices can transmit data directly to doctors using Bluetooth connectivity. Smart clothing that can be used for medical monitoring is also going to be launched. Insoles with sensors can be used by sports people as well as patient monitoring. If a patient is reasonably healthy he can go about his daily activities without worrying. For patients who are in a serious condition, constant monitoring allows the doctor to check the patient remotely.
Medicines and health devices have made very rapid advancements in the last 50 years or so. On the one hand there are huge machines that require their own rooms and trained technicians to operate to check out incipient or hidden problems inside the body like ultrasound, CAT, MRI and PET machines that allow doctors to practically ‘see’ inside the body and on the other there are small smartphones that a person can use on his own to check on his health. All this means that doctors find it easier to diagnose and treat conditions and people can take better care of their health.