• Article highlight
  • Article tables
  • Article images

Article History

Received : 15-07-2022

Accepted : 02-08-2022



Article Metrics




Downlaod Files

   


Article Access statistics

Viewed: 354

PDF Downloaded: 363


Get Permission Yadav, Jha, Jat, and Jain: Present scenario of pulsatile drug delivery system


Introduction

Conventional oral formulations are the top leading dosage form in global market. It is the preferential route for drug administration and management. The oral controlled-release systems show a distinctive model of drug targets to liberate in which the drug absorption is sustained in the curative window for an extended phase of time, thus safeguarding sustained therapeutic action. In certain situations this release pattern isn't always appropriate that insists discharge of a drug after an interval of time. The pulsatile system is in advance quite a few attention, as the drug is launched entirely after described insulates time (Figure 1). PDD is website online and time-specific drug shipping, as a consequence imparting spatial and chronological shipping and accumulative patient fulfillment. This drug transport gives the fast and fleeting delivery of certain amount of selected molecules within a small span of time immediately after a programmed duration, i.e., lag time, and these system have the process of handling the drug substance quickly and completely after an insulated time. Such a release model is called as pulsatile release.1, 2, 3, 4 Human’s body show a particular circadian rhythms that are synchronized by the master circadian clock, the suprachiasmatic center. Chronopharmacotherapy of diseases (myocardial infarction, bronchial asthma, rheumatic disease, angina pectoris, ulcer and hypertension) that explain circadian rhythm in their etiology and management of such diseases entail PDDS, by which drug is released quickly and entirely as a pulse after insulate time.5, 6, 4 There are several other conditions that require release of the drug in pulsatile manner, like many frame capabilities that trace circadian rhythms, consisting of secretion of hormones like luteinizing hormone, follicle stimulating hormone, progesterone and estrogen, acid secretion in the gastric emptying, stomach and GI blood transfusion. There are abundant benefits of the PDDS. These are:

  1. Can be used extensively for day and night time action.

  2. Low cost, side effects are low as dose frequency and dose size is less.

  3. Adapts to body circadian rhythms.

  4. Drug targeting is easy.

  5. Defends the GI mucosa from irritating drugs.

  6. First pass metabolism is lease.

  7. Steady drug level is maintained in the blood plasma.7, 8, 9, 10

Disadvantages

  1. Loading capacity of drug is less.

  2. Release of drug is less.

  3. Formulation steps are complex.

  4. Reproducibility and efficacy is poor.

  5. Skilled/trained persons needed for manufacturing.

Present review focus on advanced methodologies for pulsatile manufacturing and up-gradation in the technologies for manufacturing.

Figure 1

Schematic representation of different drug delivery systems, with (A) sigmoidal release after lag time, (B) delayed release after lag time, (C) sustained release after lag time and (D) extended release without lag time.

[Reproduced from: Jain D., Raturi R., Jain V., Bansal P., Singh R. Recent technologies in pulsatile drug delivery systems. Biomatter. 2011; 1: 57-65.]

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image1.png

Chronopharmacotherapy

The phrase chronopharmaceutics includes two words chronobiology and pharmaceutics. Chronobiology is the area which includes study of biological rhythms and their mechanisms in the body. Chronotherapeutic drug shipping machine is the drug delivery device that's based at the biological rhythms of frame. Chronomodulated machine is also recognized as pulsatile device or sigmoidal release system. There are 4 styles of mechanical rhythms in our body, which manage ordinary and disease associated body structure of the body (Figure 2).They are:

  1. Circadian: The oscillation is completed in 24hrs.

  2. Ultradian: The oscillation completed in shorter duration i.e. less than 24 hrs.

  3. Infradian: The oscillations is longer than 24 hrs.

  4. Seasonal: In the short days of winter, seasonal affected illness reasons melancholy in prone people. Out of four biological rhythms, circadian rhythm is the main rhythms in the body which maintains all the physiological, chemical, biological and behavioral processes.11, 12, 13

Figure 2

Cycle of circadian rhythms [Reproduced from: https://cpapvictoria.com.au/blog.]

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image2.png

Necessitate of pulsatile drug delivery systems

  1. Circadian rhythm follows many body functions which fluctuates according to the time.

  2. Acid secretion, cholesterol synthesis, gastric emptying and GI blood transfusion might change with circadian rhythm.

  3. Chronopharmacotherapy of illnesses which give an explanation for circadian rhythms of their path body structure.

Mechanism of drug release from pdds

The release happens from PDDS in different ways.14

a) Diffusion H2O diffuses to the internal particle as soon as it comes in contact with aqueous fluids.

Erosion With time few particles erode slowly to release the drug.

Osmosis Osmotic pressure develops between the outside aqueous fluid and internal particle which can be one pathway of release of drug.

Classification of PDDS

Pulsatile system are essentially time-controlled drug delivery system in which the system manages the lag time independent of environmental factors like enzyme, pH, GI motility etc. Pulsatile drug delivery systems can be generally categorized into four classes.15

Figure 0
https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image3.png

Time-controlled pulsatile release system

These time-controlled systems can be classified as a single units (e.g., tablet or capsule) or multiple unit systems.

Single unit systems

Capsular systems

Single-unit systems are mostly developed in capsule form. The insulate time is managed by way of a plug, which finds pushed away by erosion or swelling and the drug is launched as a Pulse from the insoluble pill frame. Polymers used for designing of the hydrogel plug are as following: 16

  1. Swellable materials coated with but permeable polymer (polymethacrylates).

  2. Erodible compressed polymer (polyvinyl alcohol, HPMC).

  3. Congealed melted polymer (glyceryl mono oleate).

  4. Enzymatically controlled erodible polymer (pectin).17

Figure 3

Schematic design of pulsincap system.

[Reproduced from: Shidhaye S.S., Lotlikar V.M., Ghule A.M., Phutane P.K., Kadam V.J. Pulsatile delivery systems: An approach for chronotherapeutic diseases. Sys. Rev. Pharm.2010; 1: 55-61.]

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image4.png

Figure 4

Schematic design of osmotic system.

[Reproduced from: Arora S., Ali J., Ahuja A., Baboota S., Qureshi J. Pulsatile drug delivery systems: An approach for controlled drug delivery. Indian J. Pharm. Sci. 2006; 68: 295-300] Pulsatile delivery by solubilisation (or) erosion of membrane

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image5.png

These structures are made in a way that drug reservoir is covered with soluble or erodible layer that dissolves when in contact with fluid and drug is released after an insulated tiem.18 For instance the biological clock of body.19 It includes a strong dosage shape protected with lipid limitations containing surfactants.20 The insulate time and movement of drug is managed by the thickness and grade of viscosity of polymer (Figure 6).

Figure 5

Schematic diagram of delivery system with erodible coating layers [Reproduced from: Kotha R.K., Raghavapally S.G., Adavi S.L., Taranalli S., Pandey D. Current techniques in pulsatile drug delivery: a review.  Int. Res. J. Pharm. 2013; 4:77-84.] Drug delivery system with rupturable layers/ membranes

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image6.png

The system is coated with a rupturable membrane. The outer layer or membrane gets ruptured due to pressure by effervescent agents. In such a system sodium bicarbonate and citric acid are used as effervescent agents.21 Ethyl cellulose coating is done in the core tablet when the system comes in contact with water it releases carbon dioxide which creates pressure and after some time the membrane ruptures due to pressure (Figure 7). The lag time is controlled by way of the composition of the outer polymeric membrane.22, 23, 24, 25

Figure 6

Drug Release Mechanism from System with Rupturable coating Membrane [Reproduced from: Devi R., Kumar S. Pulsatile drug delivery system: new paradigms. Int. J. Innov. Pharm Sci. Res. 2017; 5: 34-49.]

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image7.png

Multiple unit pulsatile systems

Gastric emptying pattern differs for multi-particulate formulations, such system are dispersed freely throughout the GITand is affected by transit time of food26 (Figure 8). These systems are of two types.

Figure 7

Hypothetical designsof multiparticulate pulsatile systems [Reproduced from: Kotha R.K., Raghavapally S.G., Adavi S.L., Taranalli S., Pandey D. Current techniques in pulsatile drug delivery: a review.  Int. Res. J. Pharm. 2013; 4:77-84.] Pulsatile system based on the change in membrane permeability

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image8.png

This system incorporates the interface of some acrylic polymers with quaternary ammonium corporations. The inside core is having drug and succinic acid coated with AMC USP/NF type

The water is responsible for liquefying the succinic acid. This scheme was used to design an acid-containing core and tested in beagle dogs. It shows a good in vitro/in vivo relationship of lag time.27

Stimuli-induced pulsatile release system

This system release the drug in response to stimuli by the external surroundings.28

Thermoresponsive pulsatile release

Hydrogel are the better example for thermo-sensitive drug delivery. The polymer is crosslinked and the transition in temperature is linked in the formation of hydrogel. Temperature-sensitive polymer used are ethyl, methyl, and propyl groups. Poly (N-isopropyl acrylamide) (PINPAm) are extensively used polymers.29

Chemical stimuli-induced pulsatile release

The factor responsible for drug release is biological factors like pH, enzymes or any other chemical stimuli. Example is automatic release of insulin when glucose level rises in blood. Kazunori et. al., reported a gel that showed a remarkable change in swelling caused by glucose using phenylboronic acid.30, 31

Externally regulated pulsatile release system

Electro responsive pulsatile release

Application of electric field as an external stimulator. Electrically response delivery uses polyelectrolytes and are also sensitive to pH change. Poly (2-acrylamide-2-methyl propane sulfonic acid-co butyl methacrylate) hydrogels are example of such delivery system.32, 33

Micro electro-mechanical systems

The device made by this system have the ability to store and release many chemical moiety by moving mechanism. Better control over drug release is possible. Another advancement is microchip, which contains such reservoirs of impermeable substrate through an electrolyte.34 Prototype microchip is made of silicon and contains drug reservoir which is covered at one end by gold that provides the electrochemical reaction and melts on application of electric potential.35, 36

Figure 8

Drug release from magnetically induced pulsatile systems

[Reproduced from: Shanmugan P., Bandameedi R. Chronotherapeutic drug delivery systems. J. Drug Meta. Toxico. 2015; 6: 2-7.]

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/55ae6ce4-c800-4a35-a66e-0975c0e45176image9.png

Table 1

Example of FDA approved pulsatile drug delivery systems in market

Proprietary name

Active pharmaceutical ingredient

Chronopharmaceutical technology

Drug release mechanism

Concerta® tablet

Methylphenidat HCl

Oros

Osmotic regulation

Cardizem LA

Diltiazem Hcl

Ceform microsphere technology

Diffusion/ erosion

UniphyllR

Theophylline

ContinR

Controlled release

InnopranR XL

Propranolol Hcl & Verapamil

Diffucaps

Rapid/sustained release

Covera-HSR

Verapamil

Oros

Osmotic regulation

VerelanR PM

Verapamil

Codas

Delayed release

Pepcid

Famotidine

Physicochemical modification of API

Tablet

LipovasR ,

Simvastatin

Physicochemical modification of API

Tablet

InvegaTM

Paliperidone

OROS

Osmotic regulation

Glucotrol

Glipizide

OROS

Osmotic regulation

Glizid-MR30

Gliclizide

Hydrophilic matrix technology

Swelling/diffusion/erosion

KapidexTM

Dexlansoprazole

DDR Technology

Dual drug release

Coruno®

Molsidomine

Geomatrix technology

Swelling/erosion

Theirform

Diclofenac sodium

3DP

Immediate release/controlled release

PulsincapTM

Dofetilide

PulsincapTM

Rupturable system

Moxatag®: ER tablets

Amoxicillin

Pulsystm

Multiparticulate system

Their form

Diclofenac Na

Three dimensional printing

Externally regulated system

Opana®

Oxymorphone

Timerx®

Erodible/ soluble barrier coating ER Tablets

Cardiazem® LA

Diltiazem HCl,Verapamil HCl

Ceform®

Extended Release tablet

Procardia XL

Nifedipine

Procardia XL®

Sustained release

Hokunalin® tape

Tulobuterol

Transdermal chronodelivery System.

Table 2

Recent patent on pulsatile/controlled drug delivery systems/devices

S. No.

Based on API/Device

Topic

Inventor

Status/Date

Patent No.

1

Device

Multi-dose drug delivery device and method

Robert Farra

Granted/ 2014-03-25

US8679093B2

2

Device

Medical device for controlled drug delivery and cardiac monitoring and/or stimulation

Barry M. Yomtov Stephen J. Herman

Granted/ 2011-03-29

US7917208B2

3

Device

Low-permeability, laser-activated drug delivery device

Jonathan Robert CoppetaKenneth N. HorneJohn T. Santini, Jr.John A. SchollGregory J. R. Spooner Cynthia L. Stevenson Naveed ShamsAndrew Poutiatine

Grant/ 2014-12-16, 2014-01-08

US8911426B2, EP2533737B1

4

Device

Portable drug delivery device including a detachable and replaceable administration or dosing element

Joseph Zhili Huang Guy DiPierro

Grant/2013-02-12,

US8372040B2

5

Device& different APIs

Oral drug delivery system

Su Il YumGrant SchoenhardArthur J. TiptonJohn W. GibsonJohn C. Middleton

Grant/ 2012-03-13, 2015-09-23, 2012-02-01, 2013-06-12, 2013-09-17, 2010-11-11, 2016-01-11, 2011-01-26

US8133507B2, EP2218448B1, JP4865330B2, CN101797221B, CA2810477C, DE60334401D1, DK2218448T3, ES2350689T3

6

Delivery system

Drug delivery system

James M. Olsen

Granted/ 2010-08-03, 2007-11-14, 2008-09-11

US7766885B2, EP1755703B1, DE602005003355T2

7

Device

Cartridge insertion assembly for drug delivery system

Oz Cabiri

Granted/ 2012-04-17, 2014-08-13, 2014-07-02, 2014-05-07

US8157769B2, EP2477679B1, JP5535321B2, CN102639169B

8

Ionizable pharmaceutical agent& lipophilic species

Transmucosal drug delivery system

John A. McCarty

Granted/ 2015-03-31, 2014-04-16, 2013-01-02, 2012-02-07, 2013-07-08, 2013-07-18, 2009-01-10

US8992974B2, JP5475215B2, CN1777411B, CA2516816C, DK1599186T3, ES2414084T3, RU2342953C2

9

Devices

Drug delivery devices, kits and methods there for

Gilbert H. KLIMAN

Granted/ 2013-08-27

US8521273B2

10

Devices

Gastric retention controlled drug delivery system

Kamlesh Mohanlal DudharaNitin Bhalachandra DharmadhikariVaishali Vijay Dhavse

Granted/ 2010-08-17, 2012-12-05, 2012-08-08, 2010-12-01, 2011-06-14, 2010-09-30, 2013-03-15, 2008-05-27

US7776345B2, EP2238975B1, JP4994570B2, CN1520286B, CA2452738C, DE60237372D1, ES2398348T3, RU2325152C2

11

Device

Transmucosal drug delivery device and method including chemical permeation enhancers

Scott UhlandEric PeetersHussain Fatakdawala

Granted/2014-11-11, 2014-11-19, 2015-05-07

US8882748B2, EP2308465B8, JP5715368B2

12

Delivery System

Controlled dose drug delivery system

Amir ShojaeiStephanie ReadRichard A. CouchPaul Hodgkins

Granted/ 2014-09-30

US8846100B2

Pulsatile release systems for vaccine and hormone products

The major mechanism involved in therapeutic benefit from vaccines is development of immunity.37 Vaccine are administered to protect the bosy and hence co-administration is also needed to maintain the immunity. 38 PDDS can be used for delivery of vaccines.38, 39, 40, 41, 42

Marketed Technologies of Pulsatile Drug Delivery

Pharmaceutical companies worldwide are focusing on development of such PDDS which can help to treat major chronic disorders. Recently developed technologies used are listed in Table 1.

Recent Advances in the Pulsatile Drug Delivery System

There are many diseases that require pulsatile release like asthma, cancers, arthritis, ulcers, cardiovascular diseases, allergic problems.27 The recent trend is multi particulate system that offers many advantages. The release pattern of drug is dependent upon pH, internal flora of GI, time release. For increasing therapeutic efficacy of oral delivery various technologies are developed.42

Accubreak Technology

Dose modification becomes easy by this technology. In this small dose of the tablet is taken and a controlled release medication is prepared. When it releases in the body the membrane ruptures and the drug is reduced to half prior to its release.43

TMDS Technology

In single tablet the release rate of multiple ingredients can be optimized.

Geoclock Technology

In this active drug is surrounded by an outer layer which contains a hydrophobic mixture and a brittle material. E.g. LODOTRA – for rheumatoid arthritis.

Duredas Technology (Dual release drug absorption system)

In this there are two layers in which one layer is responsible for immediate release of second layer and sustained action is produced.

Innoherb

In this the herbal compound are converted into beads or pellets and coated within capsule. The coating is done by semi-permeable membrane which is also used to mask the bad tast.44

Orbexa technology

Granulation is done for loading of drugs. Polymers are used for coating and this technology can be imparted in proteins.19

Conclusion

Oral delivery of drugs is the most suitable and cost-effective approach followed. The chrono pharmacology principles can be used and be a fairly promising delivery in many chronic illnesses. The new drug delivery system is need of the hour for better therapeutic efficacy and pulsatile release is one of them. While, controlled release delivery offer the desired therapeutic impact, however, drop brief of diseases following organic rhythms, circadian issues together with peptic ulcer, high blood pressure, osteoarthritis, and asthma which want chrono pharmacotherapy. Circadian rhythm of the body is a widespread concept for knowledge of the most reliable want of drug within the body. Pulsatile drug delivery helps patients to handle the drugs in proper manner in proper time in chronic problems also. Drug transport will help in achi `eving outcomes. We are sure that with an increase in technological development and higher design parameters those obstacles can be overcome inside the close to destiny and wider variety of patients will be significantly benefited from this system.

Source of Funding

None.

Conflict of Interest

None.

References

1 

A Kikuchi T Okano Pulsatile drug release control using hydrogelsAdv Drug Deliv Rev20195415360

2 

JJ Santini AC Richards R Scheidt MJ Cima R Langer Microchips as controlled drug-delivery devicesAngew Chem Int Ed Engl201939142396407

3 

HP James L Sara B Samuel FJ Norman MM John C Jonathan Programmed polypeptide delivery from an implanted, multireservoir microchip deviceNat Biotechnol20062444378

4 

J Santini MJ Cima R Langer A controlled-release microchipNature19992839733543

5 

SS Shidhaye VM Lotlikar AM Ghule PK Phutane VJ Kadam Pulsatile drug delivery systems: an approach for chronotherapeutic diseasesSys Rev Pharma2019115561

6 

C Amy SC Insung MT Betty PW Paul B Henry JC Michael Multi-pulse drug delivery froma resorbable polymeric microchip deviceNat Mater202021176772

7 

WA Ritschel H Forusz Chronopharmacology: a review of drugs studiesMethods Find Exp Clin Pharmacol20181615775

8 

RK Reddy MV Jyothsna TS Mohamed C Chetty Review on: pulsatile drug delivery systemsJ Pharm Sci Res201918510924

9 

SY Yang JA Yang ES Kim G Jeon EJ Oh KY Choi Single-file diffusion of protein drugs through cylindrical nanochannelsACS Nano201947381739

10 

S Rathod Colon targeted pulsatile drug delivery: A reviewPharma Rev202055

11 

J Harkness MB Richter A Panayi K Pette A Unger R Pownall Circadian variation in disease activity in rheumatoid arthritisBr Med J202028463155514

12 

N Jha S Bapat Chronobiology, drug delivery, and chronotherapeuticsKathmandu Univ Med J2020213848

13 

B Botti C Youan Chronopharmaceutics: gimmick or clinically relevant approach to drug deliveryJ Control Release202098333753

14 

SL Patwekar MK Baramade Controlled release approach to novel multiparticulate drug delivery systemInt J Pharm Pharm Sci20194375663

15 

M Bakhshaee JS Binns H Stevens CJ Miller Pulsatile drug delivery to the colon monitored by gamma scintigraphyPharm Res20209230

16 

JM Hebden CG Wilson RC Spiller PJ Gilchrist E Blackshaw M Frier Regional differences in quinine absoption from the undisturbed human colon assessed using a timed release delivery systemPharm Res2020167108792

17 

J Binns H Stevens J Mcewen G Pritchard FM Brewer A Clarke The tolerability of multiple oral doses of pulsincap TM capsules in healthy volunteersJ Control Release2021382-31518

18 

HNE Stevens A Rashid M Bakhshaee US Patent No., US5474784A2021https://www.uspto.gov/patents

19 

S Shidhaye A Dhone T Budhkar C Surve Technologies in pulsatile drug delivery systemInt J Adv Pharm Bio Chem2019143845

20 

JR Crison PR Siersma D Taylor GL Amidon Programmable oral release technology, Port Systems & Mac226: a novel dosage form for time and site specific oral drug deliveryProceed Intern Symp Control Rel Bioact Mater2020222789

21 

AR Gennaro Remington: The Science and Practice of PharmacyWilliams & Wilkins20199035

22 

IR Wildind SS Davis M Bakhshaee HNE Stevens RA Sparrow J Brennan Gastrointestinal transit and systemic absorption of captopril from a pulsed release formulationPharm Res201996547

23 

H Saeger P Virley Pulsincap & Mac226: Pulsed release dosage form. Product information from Scherer DDS. Ltd2018

24 

I Krögel R Bodmeier Floating or pulsatile drug delivery systems based on coated effervescent cores”Int J Pharm2019187217584

25 

GL Amidon GD Leesman US Patent No. 5229131A2018https://patents.google.com/patent/US5229131A/en

26 

H Bechgaard K Ladefoged Distribution of pellets in the gastrointestinal tract. The influence on transit time exerted by the density or diameter of pelletsJ Pharm Pharmacol201730116902

27 

R Yadav S P Tiwari J Galgano Recent challenges in COVID 19 vaccines and its future advancementsIP Int J Comprehensive Adv Pharmacol7117

28 

Y Ueda T Hata H Yamaguchi M Kotani S Ueda Development of a novel drug release system, time-controlled explosion system (TES). Part 1: concept and designJ. Drug Target201823544

29 

J Z Krezanoski Clear, water-miscible, liquid pharmaceutical vehicles and compositions which gel at body temperature for drug delivery to mucous membranesUS 4188373A2018https://patents.google.com/patent/US4188373A/en

30 

K Ishihara M Kobayashi N Ishimura I Shinohara Glucose induced permeation control of insulin through a complex membrane consisting of immobilized glucose oxidase and a poly(amine)Polym J20181662556

31 

S Sershen J West polymeric systems for modulated drug deliveryAdv Drug Deliv Rev201954122560

32 

JS Burns H Stevens J Mcewen G Pritchard FM Brewer A Clarke Pulsatile drug delivery systemJ Control Release2019381515

33 

H Saeger P Virley Pulsincap and Mac226: Pulsed- release dosage form. Scherer DDS, Ltd. 2019

34 

R Yadav M Jha S Prasad D Jat D Jain Mayaro virus (MAYV) Disease: Past, present and futureJ Pharm Biol Sci2022101110

35 

R Yadav A Dubey SP Tiwari P Shrivastava S Mandal Nanotechnology and its Applications: A Scientific Boon for FutureInt J Drug Deliv Technol202212118

36 

JT Santini AC Richards R Schiedt MJ Cima R Langer Microchips as controlled-drug delivery devicesAngew Chem Int Ed20193262396407

37 

G Ada Strategies for exploiting the immune system in the design of vaccinesMol Immunol201928322530

38 

P Kashyap SP Mishra S Dutta R Yadav K Mishra K Sahu Traditional plant and herbs used in rural area for prevention of disease caused by water pollutionIP Int J Comprehensive Adv Pharmacol2021641527

39 

M Rajput R Sharma S Kumar F Jamil N Sissodia Pulsatile drug delivery system: a reviewInt J Res Pharm Biom Sci20193111822

40 

PK Patel CK Patel Pulsatile drug delivery systemAsian J Pharm Clin Res201914451

41 

GA Kumar A Bhat AP Lakshmi K Reddy An Overview of Stimuli-induced pulsatile drug delivery systemInt J Pharm Tech Res20192423753658

42 

R Yadav An review on epidemiology, biochemical characteristics, treatment suggestions, and continued studies on diabetes and cardiovascular diseaseInt J Health Sci20226S35288311

43 

NS Dey S Majumdar M Rao Multiparticulate drug delivery systems for controlled releaseTrop J Pharm Res201873106775

44 

RK Sahu R Yadav P Prasad Adverse drug reactions monitoring: prospects and impending challenges for pharmacovigilanceSpringerPlus20143695



jats-html.xsl


This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.