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Table of Contents


	Preface	ix
	Introduction	xi
	Book Outline	xv
	About the Author	xvii
1	What is Clinical Pharmaceutics?	1
	Introduction	1
	Physical Concepts	2
	The Nature of the Dosage Form and Outcomes	18
	Quality of Effect	19
	Ingredients in Dosage Forms and their Influence on Outcomes	22
	Conclusion	23
	References	24
2	Excipients: Not Always Inert	27
	Introduction	27
	Usually But Not Always Inert	27
	E-Numbers	31
	Cross-Reactivity	33
	Dyes Used in Lymph Node Identification	33
	Non-Ionic Surfactants	33
	Polyoxyethylene Glycols (PEGs)	35
	Adjuvants as Therapeutic Substances	35
	Talc as Therapeutic Agent and Excipient	37
	Active Excipients in Multiple Therapies	39
	Conclusions	39
	References	39
3	Thinking Chemically	41
	Introduction	41
	The Chemistry of Drugs and Clinical Pharmaceutics	42
	Chemical Nomenclature	47
	Surface-Active Drugs	49
	Acids and Bases	49
	Structural Similarities Between Drugs	52
	Cross-Reactivity	52
	Beta-Lactam Antibiotics and the Formation of Oligomers	56
	The Bisphosphonates	57
	Hydrophobic and Hydrophilic Statins	58
	Photochemical Reactions and Photoinduced Reactions	59
	Chelation and Tetracyclines	64
	Sugammedex: a Cyclodextrin Derivative	64
	Conclusions	66
	References	67
4	Looking at Formulations	69
	Introduction	69
	Protein Drugs and Formulations	70
	Monoclonal Antibodies (MAbs)	73
	Amphotericin B Formulations	74
	A Doxorubicin Formulation: Doxil	78
	A Propofol Formulation: Diprivan	78
	Long-Acting Depot Injections	80
	Raft-Producing Oral Formulations	83
	Etoposide (Vepesid, VP 16 and Etoposide Phosphate)	84
	Paclitaxel	86
	Eutectic Mixtures of Local Anaesthetics	87
	Ciclosporin (Cyclosporin)	87
	Lupron Depot; Prostap SR and Prostap 3	90
	Zoladex	90
	Fluoroquinolone Eye Drops	91
	Lonsys: Lontophoretic Transdermal Device for Fentanyl	93
	Parenterals	93
	Chloramphenicol	95
	Materials Used in Drug Delivery	95
	Conclusions	97
	References	98
5	Adverse Events and Formulations and Devices	101
	Introduction	101
	Dosage Form Type	103
	Reactions to Impurities	105
	Abnormal Bioavailability, High or Low	114
	Testing for Adverse Effects	114
	Nanosystems	116
	Conclusions	118
	References	119
6	Paediatric, Geriatric and Special Formulations	121
	Introduction	121
	Extemporaneous Formulations	122
	Effect of Formulation and Presentation: a Case from the Literature	124
	Extemporaneous Formulations and Performance	126
	The Elderly and their Medication	126
	Enteral Feeding	128
	Drug Interactions with Nutrient Formulations	131
	Conclusions	131
	References	131
7	Generic Medicines: Conventional Drugs and Biologicals	133
	Introduction	133
	Regulatory Statements on Generic Products	134
	Generics: a Question of Quality	135
	Specific Conditions and Generics	137
	Reading and Deconstructing the Literature on Bioequivalence	139
	Antiretroviral Drugs	139
	Bioequivalence of Ophthalmic Products	141
	The Case of Sevoflurane	141
	Generic Biologicals (Biologics)	144
	Conclusions	146
	References	148
8	The Future: Delivery Systems for Modern Therapeutics	151
	Introduction	151
	Personalised Medicine and Medicines	151
	Drug Delivery and Personalised Medicines	152
	Technologies	155
	Nanotechnology	160
	Cell-Based Therapies	165
	Gene Therapy	168
	Conclusions	169
	References	169
	Index	173