Drug delivery is a concept heavily integrated with dosage form and route of administration, the latter sometimes being considered part of the definition.[9] While route of administration is often used interchangeably with drug delivery, the two are separate concepts. Route of administration refers to the path a drug takes to enter the body,[10] whereas drug delivery also encompasses the engineering of delivery systems and can include different dosage forms and devices used to deliver a drug through the same route.[11] Common routes of administration include oral, parenteral (injected), sublingual, topical, transdermal, nasal, ocular, rectal, and vaginal, however, drug delivery is not limited to these routes and there may be several ways to deliver medications through other routes.[12]
Since the approval of the first controlled-release formulation in the 1950s, research into new delivery systems has been progressing, as opposed to new drug development which has been declining.[13][14][15] Several factors may be contributing to this shift in focus. One of the driving factors is the high cost of developing new drugs. A 2013 review found the cost of developing a delivery system was only 10% of the cost of developing a new pharmaceutical.[16] A more recent study found the median cost of bringing a new drug to market was $985 million in 2020, but did not look at the cost of developing drug delivery systems.[17] Other factors that have potentially influenced the increase in drug delivery system development may include the increasing prevalence of both chronic and infectious diseases,[15][18] as well as a general increased understanding of the pharmacology, pharmacokinetics, and pharmacodynamics of many drugs.[3]
Nanotechnology is a broad field of research and development that deals with the manipulation of matter at the atomic or subatomic level. It is used in fields such as medicine, energy, aerospace engineering, and more. One of the applications of nanotechnology in drug delivery. This is a process by which nanoparticles are used to carry and deliver drugs to a specific area in the body. There are several advantages of using nanotechnology for drug delivery, including precise targeting of specific cells, increased drug potency, and lowered toxicity to the cells that are targeted. Nanoparticles can also carry vaccines to cells that might be hard to reach with traditional delivery methods. However, there are some concerns with the use of nanoparticles for drug delivery. Some studies have shown that nanoparticles may contribute to the development of tumors in other parts of the body. There is also growing concern that nanoparticles may have harmful effects on the environment. Despite these potential drawbacks, the use of nanotechnology in drug delivery is still a promising area for future research.[21]
Targeted drug delivery is the delivery of a drug to its target site without having an effect on other tissues.[22] Interest in targeted drug delivery has grown drastically due to its potential implications in the treatment of cancers and other chronic diseases.[23][24][25] In order to achieve efficient targeted delivery, the designed system must avoid the host's defense mechanisms and circulate to its intended site of action.[26] A number of drug carriers have been studied to effectively target specific tissues, including liposomes, nanogels, and other nanotechnologies.[20][23][27]
Controlled or modified-release formulations alter the rate and timing at which a drug is liberated, in order to produce adequate or sustained drug concentrations.[28] The first controlled-release (CR) formulation that was developed was Dexedrine in the 1950s.[13] This period of time saw more drugs being formulated as CR, as well as the introduction of transdermal patches to allow drugs to slowly absorb through the skin.[29] Since then, countless other CR products have been developed to account for the physiochemical properties of different drugs, such as depot injections for antipsychotics and sex hormones that require dosing once every few months.[30][31]
Since the late 1990s, most of the research around CR formulations has been focused on implementing nanoparticles to decrease the rate of drug clearance.[13][29]
Modulated drug release and zero-order drug release
Many scientists worked to create oral formulations that could maintain a constant drug level because of the ability of drug release at a zero-order rate.blood's concentration. However, a few physiological restrictions made it challenging to create such oral formulations. First, because the lower parts of the intestine have a decreased capacity for absorption, the medication absorption typically declines as an oral formulation moves from the stomach to the intestine. The decreased drug amount released from the formulation over time frequently made this condition worse. Phenylpropanolamine HCl release from was the only instance of sustaining consistent blood concentration for roughly 16 hours.[32]
Pharmaceutical preparations containing peptides, proteins, antibodies, genes, or other biologic components often face absorption issues due to their large sizes or electrostatic charges, and may be susceptible to enzymatic degradation once they have entered the body.[3][11] For these reasons, recent efforts in drug delivery have been focused on methods to avoid these issues through the use of liposomes, nanoparticles, fusion proteins, protein-cage nanoparticles, exploiting routes for the delivery of biologicals that toxins use and many others.[3][33][34][35][36] Intracellular delivery of macromolecules by chemical carriers is most advanced for RNA, as known from RNA-based COVID-19 vaccines, while proteins have also been delivered into cells in vivo and DNA is routinely delivered in vitro.[37][38][39] Among the various routes of administration the oral route is most favored by patients. For most biologic drugs, however, oral bioavailability is too low to reach a therapeutic level. Advanced delivery systems such as formulations containing permeation enhancers or enzyme inhibitors, lipid-based nanocarriers and microneedles will likely enhance oral bioavailability of these drugs sufficiently.[40][41]
Drug delivery systems have been around for many years, but there are a few recent applications of drug delivery that warrant
1. Drug delivery to the brain: Many drugs can be harmful when administered systemically; the brain is very sensitive to medications and can easily cause damage if a drug is administered directly into the bloodstream. As new drug formulations are being developed for brain diseases, including Alzheimer's disease and Parkinson's disease, researchers are working on ways to deliver drugs into the brain that do not cause damage to healthy tissue. For example, scientists have developed nanoparticles that can cross the protective blood-brain barrier and deliver drugs directly to the brain.[42][43]