Topical Chitosan-Based Thermo-Responsive Scaffold Provides Dexketoprofen Trometamol Controlled Release for 24 h Use

Chronic and non-healing wounds demand personalized and more effective therapies for treating complications and improving patient compliance. Concerning that, this work aims to develop a suitable chitosan-based thermo-responsive scaffold to provide 24 h controlled release of Dexketoprofen trometamol (DKT). Three formulation prototypes were developed using chitosan (F1), 2:1 chitosan: PVA (F2), and 1:1 chitosan:gelatin (F3). Compatibility tests were done by DSC, TG, and FT-IR. SEM was employed to examine the morphology of the surface and inner layers from the scaffolds. In vitro release studies were performed at 32 °C and 38 °C, and the profiles were later adjusted to different kinetic models for the best formulation. F3 showed the most controlled release of DKT at 32 °C for 24 h (77.75 ± 2.72%) and reduced the burst release in the initial 6 h (40.18 ± 1.00%). The formulation exhibited a lower critical solution temperature (LCST) at 34.96 °C, and due to this phase transition, an increased release was observed at 38 °C (88.52 ± 2.07% at 12 h). The release profile for this formulation fits with Hixson–Crowell and Korsmeyer–Peppas kinetic models at both temperatures. Therefore, the developed scaffold for DKT delivery performs adequate controlled release, thereby; it can potentially overcome adherence issues and complications in wound healing applications.

Local application of non-steroidal anti-inflammatory drugs: advantages and disadvantages

The article presents literature data on the efficacy and safety of dexketoprofen trometamol gel when applied locally and comparative characteristics of this pharmacological agent with other transdermal forms of nonsteroidal anti-inflammatory drugs. It was found that dexketoprofen when applied topically in the form of a gel has a high ability to accumulate in the skin, muscle and nervous (neurons, myelin and hypothalamus) tissues which causes a good anti-inflammatory, anti-edema and analgesic effect of this drug. Dexketoprofen showed a low level of accumulation in the cartilage without stimulating degenerative changes in cartilage tissue, as it does not inhibit the synthesis of proteoglycans by chondrocytes. At the same time, dexketoprofen had a low capacity for accumulation in blood cells and in internal organs demonstrating a low pro-bability of systemic side effects.

Chitosan-Based Thermo-Responsive Scaffold for Wound Heal-ing Provides Dexketoprofen Trometamol Controlled Release for 24 Hour-Use

Chronic and non-healing wounds demand personalized and more effective therapies for treating complications and improve patient adherence. This work aims to develop a suitable chitosan-based scaffold to provide 24 hours controlled release of DKT, by taking advantage of chitosan’s thermo-responsive behavior as well as local hyperthermia in wounds. Three formulation prototypes were developed using chitosan (F1), 2:1 chitosan: PVA (F2), and 1:1 chitosan:gelatin (F3). Compatibility tests were done by DSC, TG, and IR spectroscopy. SEM was employed to examine the morphology of the surface and inner layers from the scaffolds. In vitro release studies were performed at 32 °C and 38 °C to evaluate the release profiles, which were later adjusted to different kinetic models for the best formulation. F3 showed the most controlled release of DKT at 32 °C for 24 hours (77.75 ± 2.72 %), and reduced the burst release in the initial 6 hours (40.18 ± 1.00 %), while at 38 °C the release reached 88.52 ± 2.07 % at 12 hours. The release profile for this formulation fits with Hixson-Crowell and Korsmeyer-Peppas kinetic models at both temperatures. Therefore, the developed chitosan/gelatin thermo-responsive scaffold provides a suitable system for wound healing with a controlled release of DKT for 24 hour-use, which can overcome adherence issues and wound complications.

What’s new for the clinician? - Excerpts from and summaries of recently published papers

Extraction of third molars is one of the most common procedures performed by oral surgeons. Generally, these surgeries do not encounter difficulties but at times can result in complications. Postoperative complications may include swelling, pain, trismus, prolonged bleeding, dry socket, infection and sensory alterations of the inferior alveolar nerve or lingual nerve. For the swelling, the most common therapies include corticosteroids, non-steroid anti-inflammatory drugs (NSAIDs), or a combination of these agents. Elastic bandage application (Kinesio taping) is a technique that originates from sports sciences. Studies have reported its beneficial effects on swelling and trismus symptoms after oral and maxillofacial surgeries.1It has been claimed that elastic tapes reduce postoperative swelling by creating space between the dermis and fascia layers and thus increasing lymphatic and blood flow.1 Their alleviating effect on postoperative pain is due to dermal stimulation.1 Erdil and colleagues (2021)1 reported on a trail that sought to compare the effectiveness of submucosal dexamethasone injection, a therapeutic elastic bandage (Kinesio tape), and an NSAID (dexketoprofen trometamol) on postoperative swelling, trismus, pain following third molar surgery and alterations in the quality of life in the first postoperative week.

Choice of optimal non-steroidal anti-inflammatory drug from position of cardiologist

Non-steroidal anti-inflammatory drugs (NSAIDs) are a large and extremely heterogeneous group of drugs that have a single mechanism of action and therapeutic activity. The article lists their main subgroups by chemical structure and selectivity of action, describes the most typical side effects due to the pharmacodynamic characteristics of drugs, explains the reasons for their formation, and describes the cardiovascular complications they cause. Taking into account the lack of the desired safety of classical NSAIDs for cardiological practice, the possibility of optimizing their tolerance with the help of modern generations of cyclooxygenase inhibitors, namely the dextrorotatory S-enantiomer of ketoprofen – dexketoprofen trometamol (Dexketoprofen-SZ, «Severnaya Zvezda», Russia) was considered. The drug is distinguished by high efficiency and low risk of cardiovascular toxicity, which makes it widely used in symptomatic therapy of cardiac patients.