International Journal of Pharmaceutical Sciences and Nanotechnology Volume 3 • Issue 1 • April – June 2010 Research Paper In vitro Passive and Iontophoretically Assisted Transport of Salbutamol sulphate through Hairless Mice Skin Abdul Faruk*, Gurpreet Singh and Mohan Paul Singh Ishar
Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India.
ABSTRACT: Investigations were carried out to ascertain the relative importance of the described mechanism in iontophoretic transport using an ionizable drug salbutamol sulphate, which has two pKa values 9.3 (for amino group) and 10.3 (for phenolic group). Ionization of salbutamol sulphate varies with pH, hence the rate and extent of transport across the skin can be enhanced, controlled and manipulated by the application of factors like anodal and cathodal current at varied pH of donor solution and current densities. To determine these parameters, experiments were performed and data was collected at 7.4, 9.3, 10.3 and 11 pH using 4mg/ml drug concentration and 0.3mA/cm2 current density for 6 hours. After establishing the pH for optimum transport of drug, effect of current density (0.1, 0.2, 0.3 and 0.4 mA/cm2) on the transport of drug (keeping drug concentration constant) were investigated. Passive diffusion of salbutamol sulphate was maximal at pH 10.3 and 9.3, when unionized form of drug was 50%. Anodal iontophoresis at pH 7.4 was most effective (significant result, p < 0.05) in transport of drug across skin as compared to cathodal iontophoresis at pH 11. The effect of current density on steady state flux by salbutamol sulphate during anodal iontophoresis at 7.4 pH showed 2.26 and 28.05µg/cm2/h at 0.0 i.e., passive diffusion and 0.4 mA/cm2, respectively. Thus, flux was enhanced nearly 12 times during anodal iontophoresis. KEYWORDS: Iontophoresis; transport; steady state flux; current density; salbutamol sulphate Introduction
flux induced by iontophoresis may be controlled by manipulating the current density and applied concentration
The skin has been identified as a route of drug of drug in the delivery system (Pillai et al., 2004, Artusi et
administration for decades. Several drug delivery system
has been developed for utilizing this route and the ultimate goal is to ensure that compounds are delivered preferably
In this study, we investigated in-vitro passive and
at a specific rate to the systemic circulation. Topical drug
iontophoretic delivery of salbutamol sulphate in hairless
delivery system has some limitations, arising mainly from
mice skin. Investigations were aimed at understanding: (i)
excellent barrier properties of stratum corneum. how pH of the donor solution affects the permeation of Iontophoresis has potential to overcome many barriers
drug during passive diffusion and iontophoretic transport,
associated with transdermal delivery of drugs and it
and to what extent the transport of the drug was enhanced
broadens the spectrum of drugs that can be delivered via
by iontophoresis? It has been reported that ionization rate
skin, increases systemic treatment efficacy, therefore, this
of drugs plays an important role in permeability through
method of transport is in high demand for increasing
skin (Kamath et al., 1995, Kochhar et al., 2004). The
permeation (Droog et al., 2003, De Graaff et al., 2003,
effect of pH of the aqueous vehicle on the rate and extent
through human stratum corneum has been investigated for
Iontophoresis uses a small electrical current to enhance
a number of drugs such as lidocaine (Siddiqui et al., 1985),
the transport of both ionic and nonionic molecules across
thyrotropin releasing hormone, (Bumette et al., 1986),
the skin in controlled and programmable manner (Nair et
amphotericin, (Roberts et al., 1989), gonadotropin
al., 2003, Kalia et al., 2004). The enhancement of drug due
releasing hormone (Miller et al., 1990), certain alkanols
to this method results from a number of possible and alkanoic acids (DelTerzo et al., 1989), verapamil mechanisms including the ion-electric field interaction
(Wearly et al., 1990), calcitonin (Morimoto et al., 1992),
(electrorepulsion) (Kalia et al., 2004), convective flow
leuprolide (Kochhar et al., 2004), buprenorphine (Bose et
(electro-osmosis) (Wang et al., 2005) and current-induced
al., 2001), Glibenclamide (Takahashi et al.,2001),
(Pillai et al., 2004) increase in skin permeability. The drug
pilocarpine (Huang et al., 1995). The rate of penetration was greatest at the pH where drug exists mainly in ionized form. The importance of pH in the enhancement of solute
* For correspondence: Abdul Faruk,
transport by iontophoresis has also been proven for other
solutes. The pH changes become particularly significant
812 International Journal of Pharmaceutical Sciences and Nanotechnology Volume 3 • Issue 1 • April - June 2010
for protein and peptide drugs since the pH of the solution
Materials and Methods
determines the charge on these molecules. For example, insulin has been shown to have greater skin permeability at
Materials
a pH below its isoelectric pH than at a pH above its
The constant current source (0-4 mA, at a resistive load of
isoelectric point (Siddiqui et al., 1987).
5 Kilo ohm) was designed by University Instrumentation
in-vitro passive and electrically assisted
Science Centre (USIC), Guru Nanak Dev University,
transport of salbutamol sulphate was investigated to study
Amritsar, India and was assembled by M/S B. S.
the various parameters affecting the permeation of drug
Electronics, Amritsar, India. Two different electrodes of
across different synthetic membranes (Bayon et al, 1993).
platinum wire (99 % pure, 0.5 mm dia) were connected to
Later in 1998, Tuncer et al., had stressed the role of ion
the load points of constant current device. Generous gift
complexant on the iontophoretic transport of salbutamol
sample of salbutamol sulphate was obtained from CIPLA,
(Tuncer et al, 1998). These reported studies were aimed to
Mumbai, India and analytical grade chemicals such as
investigate and to determine for their possible application
disodium hydrogen phosphate, sodium acid phosphate,
in transdermal drug delivery system. The present work
sodium hydroxide, potassium hydrogen orthophosphate
relates to the determination of the effect of iontophoretic
were procured from Qualigens fine chemicals, Mumbai.
parameters in the permeation of salbutamol sulphate across
Preparation of Buffers
animal skin. Since salbutamol sulphate has ampoteric properties (Ijzerman et al., 1984), it can exist as cation,
Donor buffer: Phosphate buffer was prepared by placing
anion and uncharged molecule in proportions that depend
50 ml of 0.2 M monobasic potassium phosphate in a 200
on the pH of the solution. Therefore, significant role of
ml volumetric flask. The specified volumes of 65.1, 75.2
different ionization behavior of the drug at different pH
and 88.2 ml of 0.2 M sodium hydroxide was added to it
and quantitative effect of the size of the iontophoretic
and volumes were made up to 200 ml in each case with
current in passive and electrically modulated transport
deionized water for the preparation of solution of pH 9.3,
were investigated for the development of iontophoretic
induced drug delivery of salbutamol sulphate for Receptor buffer: The buffer used for receptor solution (pH therapeutic benefit.
7.4) was prepared by dissolving 2.1 g of sodium acid phosphate and 4.4 g of sodium chloride in deionized water.
Since different pH conditions are involved in the experimental protocol it is, therefore, very important to
In vivo transport studies
verify the stability of salbutamol sulphate. Malkki et al., studied the decomposition of salbutamol sulphate in aq.
Skin diffusion experiments were carried out on full-
Solution (Malkki et al., 1990). The result showed that rate
thickness skin from hairless mice (7-19 week old, supplied
of decomposition of salbutamol obeyed apparent 1st order
from animal house of Guru Nanak Dev University,
kinetics w.r.t salbutamol sulphate. The reaction rate
Amritsar). The experiments using animal were carried out
increased with increasing initial concentration and elevated
as per the ethical guidelines and housed at appropriate
temperature. Another study by Malkki et al., in 1995
conditions of temperature 25 ± 2oC, relative humidity 50 ±
revealed that decomposition of salbutamol sulphate was
5 %, 12 hour light and 12 hour dark side (CPCSEA No 226) (Care, 2003). Mice were sacrificed by cervical
less in phosphate buffer even at higher temperature (85 oC)
dislocation. The abdominal skin was excised and whole
(Malkki et al in 1995). It is because of this reason donor
thickness of skin was removed; excess adipose tissue was
buffer of sufficient strength and high initial drug removed by gentle scraping and was immediately mounted
concentration (4mg/ml) was chosen in the present between donor and receptor half cells horizontally with the
stratum corneum facing the donor half cell (dermal side
The studies were conducted at different pH conditions
down) on franz diffusion cells (Leboulanger et al., 2004).
A thin film of silicone gelly was spread on the lapped glass
which affect both nature and degree of ionization of
surface of cell to provide a watertight seal. The cells were
salbutamol sulphate and which in turn, will affect the
clamped and immersed in water bath at 35 ± 0.5 0C, placed
permeation. (i) The study tried to ascertain how do current
on the magnetic stirrers (Charro MB, 2008). The maximum
densities affect the efficiency of drug transport and
capacity of each of the donor and receiver compartments
(ii) how delivery rate can be manipulated and controlled by
was 5.0 ml and the surface area of skin exposed to the
varying pH and current densities? With these twin
solution was 2.855 cm2. The medium of the diffusion cell was stirred at the rate of 25 rpm using small magnetic
objectives in mind, salbutamol sulphate was chosen as a
beads. To see the effect of pH on the transport of
model drug to understand in-depth the parameters affecting
salbutamol sulphate four different pH i.e., 7.4, 9.3, 10.3
the permeation as this molecule having two pKa values 9.3
and 11 were selected using 4.0 mg/ml drug concentration
and 10.3 corresponding to amino group and phenolic
and 0.3 mA/cm2 current density for 6 hours. After
Abdul Faruk et al. : In VitroPassive and Iontophoretically Assisted Transport of…
obtaining the optimum transport of drug at particular pH,
All statistical analysis of the data was done by ANOVA
effect of current density (0.1, 0.2, 0.3, and 0.4 mA/cm2)
and student’s paired t-test as appropriate. The level of
was then observed on the transport of drug. For passive
diffusion, this assembly was used as such i.e., without applying current. Iontophoresis was carried out by Results
inserting platinum wire electrodes. Anodal iontophoresis was carried out by inserting anode in the donor Effect of pH compartment and cathode in receiver compartment. Table 1 shows that the steady state flux during
Cathodal iontophoresis was done by reversing the polarity.
iontophoresis is greater than the corresponding passive diffusion at all pH i.e., 7.4, 9.3, 10.3 and 11. The anodal
Parameters evaluated
iontophoretic flux was significantly higher (Student ‘t’ test,
Sample analysis was done at 276 nm (λmax) using p < 0.05) at pH 7.4, 9.3 and 10.3 than passive diffusion of Shimadzu UV-VIS spectrophotometer (model-1601, drug at corresponding pH. At pH 11 anodal iontophoretic Japan) for measuring the drug concentration (Faruk et al.,
flux was not significantly different (p > 0.05) from passive
diffusion. The flux obtained at cathodal iontophoresis was
The drug concentration was corrected for sampling
significantly higher (p < 0.05) at pH 11, 10.3 and 9.3 but
effects according to the equation-I described by Hayton
was insignificant at pH 7.4 (p > 0.05) than corresponding
passive flux at same pH. Anodal iontophoretic flux was significantly higher compared to corresponding cathodal
C´n = Cn (Vt / Vt-Vs) (C´n-1 / C n-1) ….(1)
flux at pH 7.4 and pH 9.3, but at pH 10.3 and 11 cathodal
iontophoretic flux was significantly higher than
n is the corrected concentration of the nth
corresponding anodal flux. The permeability coefficient of
n is the measured concentration of drug in the nth
salbutamol sulphate at different pH during passive
n-1 is the corrected concentration of (n-1)th
diffusion and iontophoresis, shown in table 2, indicates
n-1 is the measured concentration of drug in the
that permeability coefficient of drug increased during
t is the total volume of the donor solution
iontophoresis (anodal and cathodal) at all pH compared to
s is the volume of the sample withdrawn. The
cumulative amount of drug permeated per unit area is
the corresponding values for passive diffusion. Increase in
plotted against time (all experiments were performed thrice
the pH of the donor solution from 7.4 to 11, there was
and results were expressed as mean ± S.D) and the slope of
decrease in the permeability coefficient of drug during
the linear portion of the plot gives the steady state flux
anodal iontophoresis, while during cathodal iontophoresis
(µg/cm2/h). (Julraht et al., 1995). The permeability permeability coefficient of drug was increased. coeficient (K
Enhancement in flux (Table 3) due to anodal iontophoresis
p) was calculated as Kp = Jss/Cv. Where, Jss is
(E1) was maximum at pH 7.4 (11 folds) and it decreases
drug (unionized and ionized) in donor half cell. with increase of pH from 7.4 to 11. The cathodal Enhancement factor was calculated as E = J
iontophoretic flux enhancement (E2) was maximum at pH
is the flux of the drug during iontophoresis, and J
11 (4 folds) and it decreased with the decrease of pH from
flux of drug during passive diffusion (Williams et al.,
11 to 7.4 (Fig. 1). The relationship between fraction of
1994). Fraction change in flux is determined by deducting
ionized drug and fraction change in flux is shown in
the passive flux from iontophoretic flux and then divided
table 4. The highest fraction change in flux was observed
at pH 7.4 during anodal iontophoresis, where 99% of
salbutamol sulphate existed in cationic form. Despite the
Fraction ionized (degree of ionization) was calculated
fact that there is 99% ionization at pH 11, fraction change
on the basis of Henderson Hasselbalch equation (Martin et
in flux was minimal during cathodal iontophoresis, where
99% of salbutamol sulphate existed as anionic form.
Table 1 Effect of pH on steady state flux of salbutamol sulphate through hair less mice skin during passive
diffusion and iontophoresis at 0.3mA/cm2 current density.
Steady state flux (µg/cm2/h) Passive* Anodal* Cathodal*
*All values are expressed as mean ± S.D; n = 3
814 International Journal of Pharmaceutical Sciences and Nanotechnology Volume 3 • Issue 1 • April - June 2010 Table 2 Permeability coefficient of salbutamol sulphate at different pHs during passive diffusion and Permeability coefficient, Kp.(cm/h) 10-2 Passive Anodal Cathodal Table 3 Enhancement factor for salbutamol sulphate at different pH. Enhancement factor E1 (Anodal) E2 (Cathodal)
Where, E 1= Ja / Jp and E 2 = Jc / Jp Ja, Jc and Jp are the steady state flux during anodal, cathodal iontophoresis and passive diffusion, respectively
Table 4 Effect of pHs on the fraction of ionized and fraction change in the flux of salbutamol sulphate. Fraction ionized Fraction change in flux Anodal Cathodal Effect of current density
For passive diffusion, the results show an increase in
Fig. 2 shows a linear relationship between the steady state
the steady state flux with the increase in the pH from 7.4 to
flux and current density for anodal iontophoresis at pH 7.4
10.3 and there is decrease of flux at pH 11. Salbutamol
and cathodal iontophoresis at pH 11 respectively. It is
sulphate has two pKa values 9.3 and 10.3, corresponding to
evident that increase in current density resulted in amino and phenolic group, respectively. Hence the drug increased transport of the drug. The respective flux at 0.0
would be 99%, 50%, 50% and 99% ionized at pH 7.4,
and 0.4 mA/cm2 current densities was 2.26 and 28.05
9.3, 10.3 and 11 respectively. The ionization behaviors of
µg/cm2/h during anodal iontophoresis at pH 7.4, where as
amino group and phenolic group of salbutamol sulphate
for cathodal iontophoresis at pH 11 steady state flux was
are entirely different at varied pH. At pH 7.4 and 9.3
6.69 and 37.94 µg/cm2/h (Table 5). This, enhanced the flux
amino group is ionized (cationic form), while at pH 10.3
nearly 12 and 6 times during anodal and cathodal
and 11 phenolic group is ionized (anionic form). At pH
10.3 and 9.3, 50 % of the drug would be in unionized form
Discussion
(Table 4). Steady state flux at pH 9.3 and 10.3 was not significantly different (p > 0.05) but at pH 7.4 and 11
Commonly observed electrochemical decomposition of
steady state flux was significantly different (p < 0.05) for
water with the production of H+ and OH- at the anode and
passive diffusion. It means that transport of drug across
cathode respectively takes place with platinum wire as
animal skin occurs even at 50% of salbutamol drug is in
electrode which causes the pH of the donor compartment to increase during cathodal iontophoresis, therefore, ionic
unionized form may be through lipophilic biological
strength of the donor medium kept high to give sufficient
membrane. The result complied with the pH partition
buffering capacity (Davis et al., 2002).
Abdul Faruk et al. : In VitroPassive and Iontophoretically Assisted Transport of… Table 5 Effect of current densities on the steady state flux of salbutamol sulphate. S.No Current Steady state flux (µg/cm2/h) (mA/cm2) Anodal (pH 7.4)* Cathodal
*All values are expressed as mean ± S.D; n=3
Enhanced iontophoretic transport of drug at pH 7.4 and
Long term application of current leads to the
11 may be due to increased ionic mobility caused by 99%
dissipation of heat which in turn increase lipid fluidity and
ionization of salbutamol at these pH (Table 4). Nernst-
thus changes in the integrity of the skin structure (Burnette
Plank equation verifies this phenomenon (Swarbrick et al.,
et al., 1988), with the result permeability of the skin is
1984) and therefore, maximum flux obtained at pH 7.4
altered (Hamann et al., 2006, Delgado-Charro et al., 2001)
during anodal iontophoresis at pH 11 during cathodal
This may be the reason for increased permeability
coefficient of drug during iontophoresis (anodal and cathodal) at all pH compared to the corresponding values
When the pH of the donor solution is decreased from
pH 11 to 7.4, it results in a higher anodal iontophoretic flux i.e., greater transport of drug at pH 7.4 of donor solution.
The results of the effect of pH on the steady state flux
The reason for this may be explained on the basis of
is shown in Fig. 1. It is clear that both the form of drug
permselective nature of the skin. The epidermis of the skin
species i.e., unionized and ionized can permeate through
above pH 4.2 (isoelectric point) acquire negative fixed
rat epidermis may be through intracellular (Marro et al., 2001) and intercellular routes (Siddiqui et al., 1985a).
charge density in the pore, there by causing accumulation of positive ion concentration (counter ions) in the pores.
The data in table 2 and 5 indicate that at higher pH
This leads to the movement of cations from the donor
(pH 11) and higher current density, the membrane damage
solution in the direction of counter ions transfer is greater than at lower pH (pH 7.4) and lower current (convective flow) facilitating anodal iontophoretic flux and
density. The results of the effect of current densities on the
impeding cathodal iontophoretic flux. Therefore, combined
transport of salbutamol sulphate both during anodal and
effect of electrical and convective transport was observed
cathodal iontophoresis suggest a direct relationship
between flux and current density for which values of R2 is 0.9746 and 0.9859 respectively. This relationship can well
Theoretically it was assumed that anodal iontophoretic
be validated with the help of Nernst-Plank equation
flux at pH 11 and cathodal iontophoresis at pH 7.4 would
be negligible due to respective attraction of cations and anions by the electrode, but it demonstrated significant
The enhancement in the cathodal flux at pH 11 is
value. The transport of drug under these circumstances can
predominantly due to convective solvent flow. The
be understood by the fundamental principle of electroosmotic volume flow increases with an increase in electroosmosis (Roberts et al., 1997).
current density (Mudry et al., 2007), which leads to
Another reason for the maximum iontophoretic flux
increase in the flux of the drug. By increasing current
enhancement and fraction change in flux at pH 7.4 are
density the electrical resistance decreases with time
better explained from the view of model proposed by Sims
(Mudry et al., 2007, Pikal et al., 1990), therefore, flux
and Higuchi (Sims et al., 1990), wherein transport of
during later stage is more. The steady state reaches quickly
ionized and non ionized drug moiety occurs from aqueous
(Fig. 2) at higher current densities than at low current
pore pathways and through the parallel lipoidal phase of
densities. At pH 11, the rate of increase in the flux with
the stratum corneum by the process of diffusion and
current is more during cathodal iontophoresis. This is also
partition respectively. Therefore, in general term it is stated
supported by greater delivery efficiency of salbutamol at
that when pore pathways dominate (due to iontophoretic
pH 11 than pH 7.4 during cathodal and anodal
treatment), the difference between passive flux and iontophoresis, respectively. The results indicate that by iontophoretic flux become larger (Santi et al., 1996). The
proper selection of donor solution, pH and type of
result comply with the paper published previously iontophoresis (cathodal or anodal), the efficiency of drug (Srinivasan et al., 1990, Pikal et al., 2001).
delivery can be increased. Appropriate drug counter ion
816 International Journal of Pharmaceutical Sciences and Nanotechnology Volume 3 • Issue 1 • April - June 2010
can minimize generation of the electro-chemicals and
Bayon Rodriguez AM, Corish J, Corrigan OI. In vitro passive and
extraneous ions in the donor reservoir during iontophoresis
iontophoretically assisted transport of salbutamol sulphate
and hence increase the efficiency of drug delivery
across synthetic membranes. Drug Dev Ind Pharm. 1993;
Bose S, Ravis WR, Lin YJ, Zhang L, Hofmann GA, Banga AK.
Conclusion
Electrically-assisted transdermal delivery of buprenorphine. J
In summary, the delivery of ionizable drug (salbutamol
sulphate) using iontophoresis can be manipulated, Bumette RR, Marrero D. Comparison between the iontophoretic
controlled and optimized, considering the following points:
and passive transport of thyrotropin releasing hormone across
1. Iontophoresis (anodal and cathodal) enhances the
excised nude mouse skin. J Pharm Sci. 1986; 75: 738-743.
transport of salbutamol sulphate through hairless
Burnette RR, Orgipattanakal B. Characterization of pore transport
mice skin as compared to passive diffusion.
properties and tissue alteration of excised human skin during
2. Passive diffusion of salbutamol sulphate was
iontophores. J Pharm Sci.1988; 77: 132-137.
Care V. CPCSEA Guidelines for laboratory animal facility. Indn
3. Anodal iontophoresis at pH 7.4 was more effective
in transport of salbutamol sulphate across skin as compared to cathodal iontophoresis at pH 11.
Charro MB, In vitro optimization of dexamethasone phosphate
delivery by iontophoresis. Phys Ther. 2008; 88: 1177–1185.
4. The transport steady state flux and permeability
coefficient of drug were increased with increase in
Davis KA, Anseth KS. Controlled release from cross linked
current densities (for both anodal and cathodal
degradable networks, Crit Rev Ther Drug Carr Syst. 2002;
iontophoresis). The flux of the drug showed linear
De Graaff AM, Li GL, van Aelst AC, Bouwstra JA. Combined
The investigation has probed a number of aspects
chemical and electrical enhancement modulates stratum
pertinent to salbutamol sulphate delivery across the skin.
corneum structure. J Cont Rel. 2003; 90: 49-58.
The ability to enhance transport of drug is established
Delgado-Charro MB, Guy RH. Transdermal iontophoresis for
using different variables, and the patterns of behaviour
controlled drug delivery and non-invasive monitoring. STP
observed are found to be reasonably consistent. The
findings of the present investigation could be further
DelTerzo S, Behl CR, Nash RA. Iontophoretic transport of a
utilized for better optimization in the process of
homologous series of ionized and nonionized model
development of complete iontophoretic drug delivery
compounds: influence of hydrophobicity and mechanistic
interpretation. Pharm Res.1989; 6:85-90.
Acknowledgement
Droog EJ, Sjoberg F. Non specific vasodilation during
transdermal iontophoresis. Microvascular Res. 2003; 65: 172-
Financial support was provided by All India Council for
Technical Education, New Delhi under R & D scheme for the project on iontophoresis.
Faruk A, Singh G, Ishar MPS. Effect of drug concentration and
permeation enhancer on iontophoretic transport of salbutamol
sulphate in vitro. Int J Pharm Sci and Nanotech. 2009;
References
Artusi M, Nicoli S, Colombo P, Bettini R, Sacchi A, and Sanli P.
Hamann H, Hodges M, Evans B. Effectiveness of iontophoresis
Effect of chemical enhancers and iontophoresis on
of anti-inflammatory medications in the treatment of common
thiocolchicoside permeation across rabbit and human skin in
musculoskeletal inflammatory conditions: a systematic
vitro. J Pharm Sci. 2004; 93: 2431-2438.
review. Phys Ther Rev. 2006; 11: 190-194.
Banga AK, Bose S, Ghosh TK. Iontophoresis and Hayton WL, Chen T. Correction of perfusate concentration
electroporation: comparisons and contrasts. Int J Pharm.
samples removal. J Pharm Sci. 1982; 71: 820-821.
Abdul Faruk et al. : In VitroPassive and Iontophoretically Assisted Transport of…
Huang, YY, Wu SM, Wang CY, Jiang TS. A strategy to optimize
Mudry B, Carrupt PA, Guy RH, Delgado-Charro MB.
the operation conditions in iontophoretic transdermal delivery
Quantitative structure-permeation relationship for
of pilocarpine. Drug Dev Ind Pharm. 1995; 21:1631-48.
iontophoretic transport across the skin. J Cont Rel. 2007; 122:
Ijzerman AP, Bultsma T, Timmerman H, Zaagsma J. The
ionization of β-adrenoceptor agonists: a method for
Mudry B, Guy RH, Delgado-Charro MB. Prediction of
unravelling ionization schemes. J Pharm Pharmacol. 1984;
iontophoretic transport across the skin. J Cont Rel. 2006; 111:
Julraht K, Keith AP, James AW. Development of a transdermal
Nair VB, Panchagnula R. Effect of iontophoresis and fatty acids
delivery device for melatoin in vitro studies. Drug Dev Ind
on permeation of Arginine Vasopression through rat skin.
Kalia YN, Naik A, Garrison J, Guy RH. Iontophoretic drug
Pikal MJ, Shah S. Transport mechanisms in iontophoresis II.
delivery. Adv Drug Deliv Rev. 2004; 56: 619-58.
Electroosmotic flow and transference number measurements
for hairless mouse skin. Pharm Res. 1990; 7: 213-21.
Kamath SS, Gangarosa LP. Electrophoretic evaluation of the
mobility of drugs suitable for iontophoresis. Exp Clin
Pikal MJ. The role of electroosmotic flow in transdermal
iontophoresis. Adv Drug Deliv Rev. 2001: 46; 281-305.
Kochhar C, Imanidis G. In vitro transdermal iontophoretic
Pillai O, Nair V, Panchagnula R. Transdermal iontophoresis of
delivery of leuprolide under constant current application. J
insulin: IV. Influence of chemical enhancers. Int J Pharm
Leboulanger B, Guy RH, Delgado-Charro MB. Non-invasive
Roberts MS, Lai PM, Cross SE Yoshida NH. Solute structure as a
monitoring of phenytoin by reverse iontophoresis. Eur J
determinant of iontophoresic transport. In: Potts RO, Guy
RH, eds. Mechanisms of Transdermal Drug Delivery. New
York: Marcel Dekker Inc; 1997. p.291-349.
Lelawongs P, Liu JC, Chien YW. Transdermal iontophoretic
delivery of arginine-vasopressin (II): Evaluation of electrical
Roberts MS, Singh J, Yoshida NH, Currie KI. in “Prediction of
Percutaneous Absorption”, , Scott, R. C.; Guy R. H.;
and operational factors. Int J Pharm. 1990; 61: 179-188.
Hadgraft, J. (Eds.), IBC Technical Services, London, 1989;pp
Malkki L, Tammilehto S. Decomposition of salbutamol in
aqueous solutions. I. The effect of pH, temperature and drug
Santi P, Guy RH. Reverse iontophoresis: parameters determining
concentration. Int J Pharm, 1990; 63: 17-22.
electroosmotic flow, I: pH and ionic strength. J Cont Rel.
Malkki L, Purra K, Kahkonen K, Tarnmilehto S. Decomposition
of salbutamol in aqueous solutions. II. The effect of buffer
Siddiqui O, Roberts MS, Polack AE. The effect of iontophoresis
species, pH, buffer concentration and antioxidants. Int J
and vehicle pH on the in-vitro permeation of lignocaine
through human stratum corneum. J Pharm Pharmacol. 1985;
Marro D, Kalia YN, Delgado-Charro MB, Guy RH.
Contributions of electromigration and electroosmosis to
Siddiqui O, Roberts MS, Polack AE. Topical absorption of
iontophoretic drug delivery. Pharm Res. 2001; 18: 1701-
methotrexate: Role of dermal transport. Int J Pharm. 1985a;
Martin A, Swarbrick J, Canmarata A. Physical Pharmacy, 3rd.
Siddiqui O, Sun Y, Liu JC, Chien YW. Facilitated transdermal
Lea & Febiger , Philadelphia; 1983. p-222, 421.
transport of insulin. J Pharm Sci. 1987; 76: 341-345.
Miller LL, Kolaskie CJ, Smith GA, Rivier J. Transdermal
Sims SM, Higuchi WI. Base line studies on iontophoretic
iontophoresis of gonadotropin releasing hormone and two
transport in hairless mouse skin: the effect applied voltage
analogues. J Pharm Sci. 1990; 79: 490-493.
drop and pH on the iontophoresis of a model weak
Morimoto K, Iwakura Y, Nakatani E, Miyazaki M, Tojima H.
electrolyte. J Memb Sci. 1990; 49: 305-320.
Effects of proteolytic enzyme inhibitors as absorption
Srinivasan, Higuchi WI. A. model for iontophoretic incorporating
enhancers on the transdermal iontophoretic delivery of
the effect of convective solvent flow. Int J Pharm. 1990: 60;
calcitonin in rats. J Pharm Pharmacol. 1992; 44:216-218.
818 International Journal of Pharmaceutical Sciences and Nanotechnology Volume 3 • Issue 1 • April - June 2010
Swarbrick J, Lee G, Brom J, Gensmantel WP. Drug permeation
Wang Y, Thakur R, Fan Q, Michniak B. Transdermal
through human skin II. Permeability of ionizable compounds.
iontophoresis: combination strategies to improve transdermal iontophoretic drug delivery. Eur J Pharm Biopharm. 2005;
Takahashi Y, Iwata M, Mahila Y. Enhancing effect of switching
Wearly LL, Chein YW. Iontophoretic trandermal permeation of
iontophoresis on transdermal absorption of
verapamil(III) : effect of binding and concentration gradient
glibenclamide.Yakugaku Zasshi, 2001; 121: 161-166.
on reversibility of skin permeation rate. Int. J. Pharm. 1990; 59: 87-94.
Tuncer DI, John PW, Hadgraft J. Effect of ion complexants on
the iontophoresis of salbutamol. Int J Pharm. 1998; 167: 229–
Williams AC, Barry BW. Terpenes and the lipid-protein
partitioning theory of skin penetration enhancement. Pharm
List of Medical Practitioners Licenced by Medical Council of Mauritius Other Names Address1 ABBASAKOOR ABBASAKOOR ABDOOLATIFF ABEELUCK ABOOBAKAR ABOOBAKAR ABOOBAKAR ABOOBAKER AHLUWALIA ALLEEMUDDER ALLYBOCUS ALLYBOCUS ALLYBOKUS AMATHALLY AMATHALLY AMBASTHA AMEERUDDEN 59, Residence St. Daniel, Arrian Street, R. Brunes Beau Bassin26, Bis, H
REHABILITATION PROTOCOL FOR SHOULDERS AFTER ROTATOR CUFF REPAIR Sling immobilization for six weeks (unless explicitly directed otherwise) 24 hours a day. T-shirt to be worn with sling ( NOT cut up the side) to protect skin in the axilla while in the sling. A T-shirt is to be worn under Polar Care (cold ice pad) at al times to protect the skin and prevent cold burns. To put on the t-shi