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TheScientificWorldJOURNAL (ISSN 1537-744X) |
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Title: |
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Anesthetic Related Advances with Cyclodextrins |
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Authors: |
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Welliver, Mark ; McDonough, John |
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Journal: |
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TheScientificWorldJOURNAL |
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Year: |
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2007 |
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Volume: |
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7 |
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Page Range: |
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364-371 |
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Article Type: |
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Review Article |
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Handling Editor: |
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John O'Donnell |
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Domains: |
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Medical Care
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Surgery
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Anesthesiology
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DOI: |
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10.1100/tsw.2007.83 |
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Synopsis: |
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Cyclodextrins are large unique molecules that only recently have found pharmacologic application. Cyclodextrins are water soluble and may encapsulate lipophilic molecules or drugs and promote water dissolution. These properties of aqueous solubility coupled with lipid binding are two pharmacologically attractive abilities of cyclodextrins. Many drugs do not possess aqueous solubility and require organic solvents that are irritating and toxic. Cyclodextrins, composed of glucose, offer a safe more effective alternative. Multiple drugs marketed throughout the world currently use cyclodextrin encapsulation in their commercial preparation to improve drug delivery. Cisapride, chloramphenicol, dexamethasone, dextromethoraphan, diphenhydramine, hydrocortisone, itraconazole, nitroglycerin and many others all have successfully employed cyclodextrins in their formulations to facilitate drug delivery. Extensive study has concluded that cyclodextrins are safe and efficacious for oral, intravenous, and intramuscular delivery methods. The International Pharmaceutical Excipient Council (IPEC) standardized the pharmacopoeia entry of cyclodextrins as excipients in the mid 1990s. Excipients do not exert a pharmacological effect but are used to dissolve, stabilize, color or in some way enhance the preparation of a compound. Multiple anesthetic drugs are under study with cyclodextrins for improved solubilization and effectiveness. A modified gamma cyclodextrin, sugammadex, is also being developed not as an excipient, but as a reversal agent for aminosteroid neuromuscular blocking agents. |
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Keywords: |
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cyclodextrins, modified cyclodextrin, encapsulation, inclusion complex, host-guest assembly |
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Abstract |
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Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent advances have been described as novel and revolutionary. A review of current research coupled with an understanding of cyclodextrin properties is necessary to fully appreciate the current uses and future potentials of these unique molecules. |
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