Physiological Pharmaceutics

ContentsxvAdrenocorticosteroids .................................................................................................. 244Leukotriene inhibitors ................................................................................................. 244Other bronchodilating agents ...................................................................................... 244Mucolytics ................................................................................................................... 244Systemically-absorbed drugs ........................................................................................ 245REFERENCES ....................................................................................................................... 24511. Ocular Drug Delivery ............................................................................................... 249INTRODUCTION ................................................................................................................ 250STRUCTURE OF THE EYE ................................................................................................. 251The cornea ................................................................................................................... 251The conjunctiva and sclera .......................................................................................... 252The choroid and retina ................................................................................................ 252The aqueous humor ..................................................................................................... 252The eyelids ................................................................................................................... 253The precorneal tear film .............................................................................................. 253Blood-eye barriers ........................................................................................................ 256FACTORS AFFECTING DRUG PERMEATION ................................................................. 257Ionization and pH ....................................................................................................... 257Protein binding ............................................................................................................ 258Pigmentation and drug effects ..................................................................................... 258Drug distribution in the eye ........................................................................................ 259Drug penetration through the sclera and conjunctiva ................................................ 259FACTORS INFLUENCING DRUG RETENTION .............................................................. 260Proper placement of the eyedrops ............................................................................... 260Influence of instilled volume ....................................................................................... 261Preservatives ................................................................................................................. 261Effect of systemically administered drugs .................................................................... 262ROUTES OF DRUG ADMINISTRATION .......................................................................... 262Topical administration ................................................................................................. 262Intraocular drug delivery ............................................................................................. 266Systemic administration ............................................................................................... 268CONCLUSIONS ................................................................................................................... 269REFERENCES ....................................................................................................................... 26912. Vaginal and Interuterine Drug Delivery .................................................................... 271ANATOMY AND PHYSIOLOGY ....................................................................................... 272Mucosa ........................................................................................................................ 273Blood and nerve supply ............................................................................................... 275Uterine and vaginal fluid ............................................................................................. 275pH ................................................................................................................................ 275Enzymatic activity ........................................................................................................ 276Mucus .......................................................................................................................... 276Menstruation ............................................................................................................... 276Menopause ................................................................................................................... 277Disorders of the vagina ............................................................................................... 277DRUG ABSORPTION THROUGH THE VAGINA/UTERUS ............................................. 277DRUG DELIVERY ................................................................................................................ 277Vaginal ......................................................................................................................... 277Intrauterine Devices ..................................................................................................... 279CONCLUSION ..................................................................................................................... 280REFERENCES ....................................................................................................................... 280GLOSSARY ........................................................................................................................... 283INDEX .................................................................................................................................. 299