Abstract

An acute epileptic seizure is a seizure emergency fatal condition that requires immediate medical attention. IV phenytoin sodium remains the second line therapeutic agent for the immediate treatment of status epilepticus. Phenytoin sodium formulated as nanolipid carriers (NLCs) seems to be promising as an intranasal delivery system for controlling acute seizures. Three different nanosized phenytoin sodium loaded NLCs (<50 nm, 50–100 nm and >100 nm) were prepared by melt emulsification and was further characterised. In vitro drug release studies showed immediate drug release from phenytoin sodium loaded NLCs of <50 nm size, which is highly essential for acute seizure control. The ex vivo permeation study indicated greater permeation from <50 nm sized NLC through the olfactory epithelium compared to thecontrol drug solution. Invivo pharmacokinetic studies revealed higher drug concentration in CSF/brain within 5 min upon intranasal administration of <50 nm sized phenytoin sodium NLCs than the control drug solution and marketed IV phenytoin sodium, indicating direct and rapid nose to brain drug transport through the olfactory epithelium. The study has shown that formulation strategies can enhance olfactory uptake, and phenytoin sodium NLCs of desired particle sizes (<50 nm) offer promising potential for nose to brain direct delivery of phenytoin sodium in treating acute epileptic seizures.

Highlights

  • Accepted: 30 September 2021A seizure emergency condition includes prolonged seizures or frequently visible seizures that require immediate medical attention

  • The results indicated that prepared nanolipid carriers (NLCs) are biocompatible

  • The results revealed that the

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Summary

Introduction

Accepted: 30 September 2021A seizure emergency condition includes prolonged seizures or frequently visible seizures that require immediate medical attention. Seizures extending for more than five minutes are treated analogously to extremely severe and fatal seizures called status epilepticus. The availability of benzodiazepines suitable for administration by alternative routes (other than IV and IM) such as rectal, buccal and intranasal offers additional advantages, facilitating their use immediately and outside of the hospital. These benzodiazepines are shortacting, with an elimination half-life of 1.5 h; a second dose is mostly needed after 5 min or second-line Anti Epileptic Drugs (AED) have to be started immediately. There is an increased risk of fatal respiratory failure or arrest, which increases with frequent repeated doses [1,2,3]

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