The growing field of Personalized therapy and newer approaches for dosage forms related to Personalization for the safe and effective treatment of patients. The field of personalized medicine aims at converting the term of "one drug fits all " approach to Personalized therapy. Thus, shifting emphasis in medicine from reaction to prevention.
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Dosage forms for Personalized Medicine
1. Dosage Forms for
Personalized Medicine
Presented by:
Songhita Mukhopadhyay
Reg No.180603003
MPharm Pharmaceutics
Dept.of Pharmaceutics
Under the guidance of:
Shaila Angela Lewis
Associate Professor-Senior Scale
Dept.of Pharmaceutics
2. Contents
⢠Personalized medicine: Emergence
⢠Need for Personalized medicine
⢠Pharmacogenomics and Gene testing
ď Pharmacogenomics
ď Pharmacogenetic tests
⢠Categories of patients for personalized medicine
⢠Dosage forms
⢠Recent advances in the field of personalized
medicine
⢠Personalized medicine in India
⢠Key gaps and barriers
2
3. Personalized Medicine: Emergence
⢠Variability in drug response
⢠individual drug therapy.
⢠predictive outcome
⢠Pharmacogenetics
⢠molecular underpinnings of drug response.
⢠patientâs gene variations
⢠selection of drugs or treatment protocols
⢠Personalized medicine (PM)
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5. Need for Personalized Medicine
⢠Patient care
ď early diagnosis
ď risk assessment
ď cost effective
⢠Device and drug manufacturers
ď develop agents
ď targeted to patient groups
ď do not respond to medications as intended
ď the traditional health systems have failed.
⢠hospitals, health care providers, and health plan
sponsors
ď Innovation
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6. Can PM be referred to as
simple medicine?
⢠Treat diseases by molecular profiles
⢠linked databases
⢠patientsâ genomic information
⢠pay for tests and treatments
⢠genetic tests
⢠safety and efficacy of an approved drug
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7. Pharmacogenomics and Gene Testing
⢠Pharmacogenetics- genetic variations in individuals
⢠affect their response to medications.
⢠Pharmacogenomics- broader study
⢠genetic variations
⢠drug development.
⢠Studying sequence variations in candidate genes.
⢠Identify disease susceptibility genes
⢠representing potential new drug targets.
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21. ⢠Fast-Dispersing, fast dissolving or
fast melting tablets:
ďDifficulty in swallowing.
ďEg. Olanzapine and risperidone- Fast dissolving-
conventional tabletting-Frosta TM system-freeze
drying.
ďFloss method-fibrous matrix made from mix of
excipients-FLASHDOSE R- Fuisz Technologies
ďZydis TM- Selegiline- R.P. Scherer
21
22. ⢠Oral film technology:
ďSystemic medicines to be delivered in thin strip.
ďPolymer coatings containing API for transdermal
drug delivery-transition to oral thin film.
ďAqueous polymer matrices- wide molecular range-
flexibility to achieve certain physical properties.
ďSpecific API loading.
ďDisintegrates on a patientâs tongue- matter of
seconds.
ďEg.Theraflu (Dextromethorphan) and
Triaminic(Diphenhydramine HCl) thin strips by
Novartis Consumer Health Care
22
23. ⢠Combination Dose System:
ďąTwo or more regulated components-
ďCombination of drug and device
ďbiological product and device
ďdrug and biological product
ďdrug, device and biological product.
Eg. HIV treatment include Combivir TM (Zidovudine
and lamivudine) (GSK)
Pfizerâs Caduet TM (Amlodipine and atorvastatin)
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24. ⢠Mini-Tablets:
ďMatrix mini tablets based on starch/ microcellulose
wax mixtures.
ďDifferent dose levels can be administered-changing
number of mini tablets within a capsule for adults
or using single units for children.
ďPossible to utilize fast-dissolving mini-tablets to
prepare liquid dosages.
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26. ď3DP- Breakaway tablet
ďTablet breaks up into two parts after dissolution of
the fixative joining the parts together.
ďUseful in combination therapy where relative doses
need to be varied according to the patient.
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27. ⢠Microdose systems:
ďPotent drugs to be administered.
ďSolid drug forms incorporated into micro or
nanoparticles- drug in volatile solvent- microdoses
can be applied to the matrix.
ďFilms- RapidFilm TM-water soluble polymers such
as HPMC, HPC, and PVP- drugs incorporated into
the system-matrix forms platform-loading of drugs
at will.
ďDrug release- passive- dissolution of the matrix or
dissolution of the drug or a combination of
processes.
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29. Pharmacogenomic studies of oral
antidiabetic drugs
⢠T2DM patients
⢠similar requirements of antidiabetic regimens
⢠variability exists in drug disposition, glycemic
response, tolerability
⢠during treatment
⢠Pharmacogenomics
⢠Non-genomic modifications
⢠Pharmacoepigenomics
29
30. Whole-genome sequencing
methods in familial cancer
⢠FCVPPv2 (Family Cancer Variant Prioritization
Pipeline version 2).
⢠Family with history of a papillary thyroid cancer.
⢠one variant, amino acid change G573R
⢠CPXM1 gene
⢠adipogenesis and extracellular matrix
remodelling
⢠tumour suppressor in breast cancer.
⢠prediction of predisposing variants for high-risk
cancer families.
30
32. Personalized Medicine in India
⢠Young but rapidly advancing field of healthcare.
⢠Positive Bioscience with Medanta
Indiaâs first personal genomics clinic
32
⢠Start-up company Xcode Lifesciences
⢠InDNA technology
⢠coronary, diabetes and obesity.
⢠Order the test online
⢠saliva kit will be shipped to the customer.
⢠DNA extracted from the saliva
allelic information.
33. 33
⢠NutraGene
⢠countryâs first commercial
genetic test for type 2
diabetes.
⢠Screens DNA variations
⢠replicated as risk factors for
type 2 diabetes.
⢠Avesthagen
⢠AVESTAGENOME Project.
⢠System biology-based study of the
Parsi population
⢠determine the genetic basis of
longevity and
⢠age-related disorders.
34. Key gaps and barriers
⢠Millions of genetic variations may exist.
⢠how one person responds to a medication- many
genes interacting with each other.
⢠Complicated genetic map
⢠Expensive and time-consuming.
⢠Pharmacogenomic testing not yet widely available
and it remains an uncertain science.
34
35. References
⢠Randy Vogenberg F et.al-Personalized medicine: Part 1:Evolution and Development into
Theranostics; P T. 2010 Oct; 35(10).
⢠Mancinelli L et.al-Pharmacogenomics: The Promise of Personalized Medicine; AAPS PharmSci
2000; 2 (1) Article 4.
⢠Eichelbaum M et.al- PHARMACOGENOMICS AND INDIVIDUALIZED DRUG THERAPY; Annu. Rev.
Med. 2006. 57:119â37.
⢠Modern Pharmaceutics-Vol 2 âApplication and advances by Florence and Siemann; Drugs and
Pharmaceutical Sciences- 5th edition-Vol 189; Marcel Dekker.
⢠Vangelis G et.al-Pharmacogenomics of oral antidiabetic medications: current data and
pharmacoepigenomic perspective; Future Medicine Ltd Pharmacogenomics (2011) 12(8), 1161â
1191.
⢠Kumar A et.al-Familial Cancer Variant Prioritization Pipeline version 2 (FCVPPv2) applied to a
papillary thyroid cancer family; Scientific Reports (2018) 8:11635.
⢠Vondrak B et.al Dissolvable films for flexible product format in drug delivery. Pharm Technol
Suppl 2008 (April) (www.pharmtech.com).
⢠De Brabander C, et.al. Matrix minitablets based on starch/microcellulose wax mixtures. Int J
Pharm 2000; 199:195-203.
⢠Huang W, et.al. Levofloxacin implants with predetermined microstructure fabricated by thee
dimensional printing. Int J Pharm 2007; 339:33-38
⢠http://persalth.com/personalized-medicine/personalized-medicine-in-india/personalized-
medicine-in-india/
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Hypersensitivity reactions associated with abacavir can be severe and potentially fatal. Symptoms include fever, rash, vomiting, and shortness of breath. They typically appear within the first 42 days of treatment (11 days median onset).
HLA-B*57:01 significantly increases the risk of hypersensitivity reactions when abacavir is administered. Approximately 6% of Caucasians and 2-3% of African Americans carry this allele in the human leukocyte antigen B (HLA-B) gene. The HLA-B gene plays an important role in how the immune system recognizes and responds to pathogens, and mediates hypersensitivity reactions. HLA-B*57:01 has been found to be associated with abacavir hypersensitivity across different ethnicities, including Caucasians, Hispanics, and individuals of African origin (2, 3).
Screening for the HLA-B*57:01 allele before starting abacavir therapy is recommended for all patients according to the FDA drug label for abacavir (Table 1). Even if previously tolerated, screening should happen before restarting abacavir therapy if HLA-B*57:01 status is unknown. Abacavir is contraindicated in HLA-B*5701-positive patients, and in patients with a prior hypersensitivity reaction to abacavir.
Goetz et al. showed that patients carrying the CYP2D6 *4/*4 genotype have a higher risk of disease relapse and a lower incidence of adverse drug reactions, due to the lower metabolic activation of tamoxifen to endoxifen [3]. Schroth et al. analysed 206 patients receiving adjuvant tamoxifen monotherapy and 280 patients not receiving tamoxifen therapy (71 months median follow-up), and concluded that genotyping for CYP2D6 *4, *5, *10 and *41 variants help identify patients who will have little benefit from adjuvant tamoxifen therapy [4