Non-invasive Route Of Administration Research Articles

Intranasal Drug Delivery into Mouse Nasal Mucosa and Brain Utilizing Arginine-Rich Cell-Penetrating Peptide-Mediated Protein Transduction

The nasal pathway represents a non-invasive administration route of pharmaceutical agents with local, systemic, and central nervous system action. Intranasal application has a relatively short time to onset of effect and high bioavailability because it avoids hepatic first-pass metabolism. However, sustained delivery is important because drugs can be rapidly eliminated via mucociliary clearance. Protein transduction using arginine-rich cell-penetrating peptides (poly-arginine) shows high delivery efficiency, no cell specificity, and minimal cytotoxicity. We investigated the effect of poly-arginine on protein delivery into the nasal mucosa and brain of mice, and its ability to prolong contact between the delivered molecule and nasal mucosa by preventing mucociliary clearance. Enhanced green fluorescent protein (EGFP) fused to a nine-arginine peptide (EGFP-9R group) or EGFP (EGFP group) was administered once to the bilateral nasal cavities of mice. Histopathological evaluation was conducted for 3–120 h to evaluate side effects, and the number of sneezes was recorded before and after administration. EGFP was detected in cells lining the nasal cavity and their vicinity for 3–96 and 3–24 h in the EGFP-9R and EGFP groups, respectively. EGFP was detected in the brain at 3–96 h in the EGFP-9R group but not in the EGFP group. Nasal symptoms and histopathological assessment revealed no deterioration in either group. These results suggest that protein transduction using poly-arginine can deliver therapeutically relevant molecules for allergic rhinitis, and can be applied for olfactory disturbance and other central nervous system diseases. Further research is necessary to establish therapy protocols using this technique.

Pharmacokinetics of Intranasally Administered Dexmedetomidine in Chinese Children.

Background: Intranasal application is a comfortable, effective, nearly non-invasive, and easy route of administration in children. To date, there is, however, only one pharmacokinetic study on intranasal dexmedetomidine in pediatric populations and none in Chinese children available. Therefore, this study aimed to characterize the pharmacokinetics of intranasally administered dexmedetomidine in Chinese children. Methods: Thirteen children aged 4 to 10 years undergoing surgery received 1 µg/kg dexmedetomidine intranasally. Arterial blood samples were drawn at various time points until 180 min after dose. Dexmedetomidine plasma concentrations were measured with high performance liquid chromatography (HPLC) and mass spectrometry. Pharmacokinetic modeling was performed by population analysis using linear compartment models with first-order absorption. Results: An average peak plasma concentration of 748 ± 30 pg/ml was achieved after 49.6 ± 7.2 min. The pharmacokinetics of dexmedetomidine was best described by a two-compartment model with first-order absorption and an allometric scaling with estimates standardized to 70-kg body weight. The population estimates (SE) per 70 kg bodyweight of the apparent pharmacokinetic parameters were clearance CL/F = 0.32 (0.02) L/min, central volume of distribution V1/F = 34.2 (4.9) L, intercompartmental clearance Q2/F = 10.0 (2.2) L/min, and peripheral volume of distribution V2/F = 34.9 (2.3) L. The estimated absorption rate constant was Ka = 0.038 (0.004) min−1. Conclusions: When compared with studies in Caucasians, Chinese children showed a similar time to peak plasma concentration after intranasal administration, but the achieved plasma concentrations were about three times higher. Possible reasons are differences in age, ethnicity, and mode of administration.

Cytotoxicity screening of emulsifiers for pulmonary application of lipid nanoparticles

IntroductionThe pulmonary route is a non-invasive administration route that receives growing attention. The challenge for formulation development of orally inhaled formulations is, however, the limited number of approved excipients. Lipid nanoparticles are desired drug delivery systems for inhalation because lipids are biocompatible. However, addition of emulsifiers to stabilize the formulation may cause toxic effects. Alveolar epithelial cells and alveolar macrophages are the main cell types that get in contact with inhaled formulations in the deep lung. The different cell types are supposed to differ in the extent of particle uptake. Kolliphor RH40, Poloxamer 188, and Tween 80 are approved for use in oral formulations and widely used in the academic field for manufacturing of lipid nanoparticles. However, little is known about their pulmonary toxicity. MethodsCytotoxicity of Kolliphor RH40, Poloxamer 188, and Tween 80 was studied by integration into solid lipid nanoparticles loaded with itraconazole as model drug. Cytotoxicity of the formulations was assessed in human alveolar epithelial cells and human and murine macrophages and correlated to cell uptake. ResultsThe tested emulsifiers showed overall low cytotoxicity with less pronounced adverse effects in human cells than in murine macrophages. Cellular uptake of Poloxamer 188 containing lipid nanoparticles was decreased in macrophages, while uptake of lipid nanoparticles with the other emulsifiers was similar in epithelial cells and phagocytes. ConclusionThe tested emulsifiers appear suitable for use in pulmonary applications. Due to larger cell size and lower proliferation rate human cells showed lower cytotoxicity than the murine cells. Being human cells, they appear more suitable for the screening of adverse effects in human lungs.

Vía intranasal: una alternativa para la administración de fármacos de acción central en equinos

La vía intranasal es reconocida en medicina humana como una vía muy promisoria para la administración sistémica y cerebral de fármacos. Es una vía de administración indolora, incruenta, económica y práctica. Por sus características, es muy útil para la aplicación de fármacos en pacientes con alteraciones orales, con diarrea o que no cooperen. Además, es una potencial vía directa al sistema nervioso central (SNC). Su uso en medicina veterinaria es muy raro, salvo para la administración de tratamientos locales. En la especie equina, aun cuando no hay estudios completos y profundos sobre las características anatomofisiológicas de la cavidad nasal, su gran superficie e irrigación (área potencial de absorción) permiten inferir su viabilidad para la administración sistémica de fármacos. En el presente artículo se discuten las características de la cavidad nasal de los equinos en relación a las diversas vías de absorción sistémica y del transporte nariz-cerebrode fármacos, así como las potenciales aplicaciones de esta vía de administración.

Nose-to-brain delivery of levetiracetam after intranasal administration to mice

Despite being one of the most commonly prescribed antiepileptic drugs, levetiracetam is marketed in oral and intravenous dosage forms, which are associated to drug-drug interactions and drug-resistant epilepsy (DRE). The purpose of the present study was to assess the potential of the intranasal route to deliver levetiracetam into the brain, due to the particular anatomical features of the nasal cavity. After development and characterization of the drug formulation, a thermoreversible gel loaded with levetiracetam was administered to CD-1 male mice by intranasal route and its pharmacokinetics compared to those observed after intravenous administration. Similar plasma pharmacokinetic profiles were obtained and the intranasal absolute bioavailability was 107.44%, underscoring that a high drug fraction was systemically absorbed. In brain tissue, maximum drug concentrations were 4.48 and 4.02 μg/g (intranasal vs intravenous) and the mean cerebral concentrations were significantly higher after intranasal administration. The percentage of drug targeting efficiency was 182.35% while direct transport percentage was 46.38%, suggesting that almost 50% of levetiracetam undergoes direct nose-to-brain delivery. Complementarily, an in vivo intranasal repeated dose toxicity study was performed and no relevant histopathological alterations were observed. The herein proposed non-invasive and safe intranasal administration route allowed a direct nose-to-brain delivery of levetiracetam and is a promising strategy for the treatment of DRE.

Essential Oils and Isolated Terpenes in Nanosystems Designed for Topical Administration: A Review.

Essential oils are natural products with a complex composition. Terpenes are the most common class of chemical compounds present in essential oils. Terpenes and the essential oils containing them are widely used and investigated by their pharmacological properties and permeation-enhancing ability. However, many terpenes and essential oils are sensitive to environmental conditions, undergoing volatilization and chemical degradation. In order to overcome the chemical instability of some isolated terpenes and essential oils, the encapsulation of these compounds in nanostructured systems (polymeric, lipidic, or molecular complexes) has been employed. In addition, nanoencapsulation can be of interest for pharmaceutical applications due to its capacity to improve the bioavailability and allow the controlled release of drugs. Topical drug administration is a convenient and non-invasive administration route for both local and systemic drug delivery. The present review focuses on describing the current status of research concerning nanostructured delivery systems containing isolated terpenes and/or essential oils designed for topical administration and on discussing the use of terpenes and essential oils either for their biological activities or as permeation enhancers in pharmaceutic formulations.

Epilepsy Disease and Nose-to-Brain Delivery of Polymeric Nanoparticles: An Overview.

Epilepsy is the fourth most common global neurological problem, which can be considered a spectrum disorder because of its various causes, seizure types, its ability to vary in severity and the impact from person to person, as well as its range of co-existing conditions. The approaches to drug therapy of epilepsy are directed at the control of symptoms by chronic administration of antiepileptic drugs (AEDs). These AEDs are administered orally or intravenously but alternative routes of administration are needed to overcome some important limits. Intranasal (IN) administration represents an attractive route because it is possible to reach the brain bypassing the blood brain barrier while the drug avoids first-pass metabolism. It is possible to obtain an increase in patient compliance for the easy and non-invasive route of administration. This route, however, has some drawbacks such as mucociliary clearance and the small volume that can be administered, in fact, only drugs that are efficacious at low doses can be considered. The drug also needs excellent aqueous solubility or must be able to be formulated using solubilizing agents. The use of nanomedicine formulations able to encapsulate active molecules represents a good strategy to overcome several limitations of this route and of conventional drugs. The aim of this review is to discuss the innovative application of nanomedicine for epilepsy treatment using nose-to-brain delivery with particular attention focused on polymeric nanoparticles to load drugs.

Promising Chitosan-Coated Alginate-Tween 80 Nanoparticles as Rifampicin Coadministered Ascorbic Acid Delivery Carrier Against Mycobacterium tuberculosis.

The aim of this study was to design a nanocarrier system for inhalation delivery of rifampicin (RIF) in combination with ascorbic acid (ASC), namely constituted of sodium alginate coated with chitosan and Tween 80 (RIF/ASC NPs) as a platform for the treatment of pulmonary tuberculosis infection. A Box-Behnken experimental design and response surface methodology (RSM) were applied to elucidate and evaluate the effects of several factors on the nanoparticle properties. On the other hand, it was found that RIF/ASC NPs were less cytotoxic than the free RIF, showing a significantly improved activity against nine clinical strains of Mycobacterium tuberculosis (M. tb) in comparison with the free drug. RIF/ASC NPs had an average particle size of 324.0 ± 40.7nm, a polydispersity index of 0.226 ± 0.030, and a zeta potential of - 28.52 ± 0.47mV and the surface was hydrophilic. The addition of sucrose (1% w/v) to the nanosuspension resulted in the formation of a solid pellet easily redispersible after lyophilization. RIF/ASC NPs were found to be stable at different physiological pH values. In summary, findings of this work highlight the potential of the RIF/ASC NP-based formulation development herein to deliver RIF in combination with ASC through pulmonary route by exploring a non-invasive route of administration of this antibiotic, increasing the local drug concentrations in lung tissues, the primary infection site, as well as reducing the risk of systemic toxicity and hence improving the patient compliance.

DIFFERENTIATED APPROACH TO THE PROBLEM OF REHABILITATION OF BABIES WITH SEPSIS

A comparative study in two groups of children received a complex of restorative therapy during the rehabilitation period, with measures for correction of intestinal biocenosis, neurometabolic therapy, and immunotherapy with Viferon and children receiving the immunomodulator T-activin only showed the significant efficacy of the integrated approach in rehabilitation. In addition, a relatively fast positive immunological effect is achieved, a good tolerance of the drug Viferon, a non-invasive route of administration and the absence of adverse responses with the immunorehabilitation method described allow us recommending this drug in the complex of immunoresponsive measures in infants who have had suffered from sepsis.

Intranasal ketorolac and opioid in treatment of acute renal colic

The usual treatment of pain in acute renal colic is analgesic in intravenous (IV) route. We tried a rapid, non-painful, non-invasive route of administration using intranasal ketorolac plus fentanyl versus IV standard treatment with non steroidal anti-inflammatory drug plus opioid for the relief of pain in renal colic presenting patients to an Emergency Department (ED). We conducted a prospective nonblinded clinical trial. A sample of 82 adult patients with clinical diagnosis of acute renal colic was included to receive either intravenous ketorolac plus fentanyl or intranasal ketorolac plus fentanyl. Pain score was rated by using a 10 cm visual analogue scale at 0, 30 and 60 minutes after the treatment. Primary outcome was pain reduction. Secondary outcomes were adverse events and rescue treatment. Eighty-two patients were enrolled. The first forty-one patients received intranasal ketorolac plus fentanyl and the second forty-one received intravenous ketorolac plus fentanyl. There were not statistically significant differences in reduction of pain between the two groups at 30 and 60 minutes (P-value at 30=0,225; P-value at 60=0,312) although the trend was in favour of IV group. There were no significant differences between the groups with regard to secondary outcomes (adverse events and rescue treatment). Intranasal ketorolac and fentanyl are equivalent in analgesic effect to intravenous ketorolac and fentanyl treatment for ED patients with acute renal colic and the intranasal treatment can be considered a valid alternative to the standard intravenous treatment.

Comparison of sedation scores after nebulized and intravenous Midazolam in children

Background: An efficacious, reliable, and non-invasive route of administration for midazolam, a drug used for sedation and pre-anesthetic medication, would have obvious advantages. This study compares the sedation achieved by nebulized route and intravenous route as procedural sedation.Methods: A randomized double-blinded interventional study was designed to compare the effect of nebulized midazolam with intravenous midazolam as a sedative medication in 86 children undergoing imaging procedures like CT scan, MRI scan, EEG. Ramsay sedation scores and parameters of cardiovascular and respiratory function were measured over 20 min and summarized Results: The mean sedation score in both groups was comparable at baseline, 10 minutes and 20 minutes with p values of 0.1, 0.1, 0.09 respectively. Parameters of cardiovascular and respiratory function were comparable in both the groups. Conclusion: Present study showed that nebulized midazolam when given at a higher dose of 1 mg/kg was found to be as potent as intravenous midazolam, opening up a door for a sedative which is easier to administer, has better acceptance with lesser complication.

Chitosan Based Self-Assembled Nanoparticles in Drug Delivery.

Chitosan is a cationic polysaccharide that is usually obtained by alkaline deacetylation of chitin poly(N-acetylglucosamine). It is biocompatible, biodegradable, mucoadhesive, and non-toxic. These excellent biological properties make chitosan a good candidate for a platform in developing drug delivery systems having improved biodistribution, increased specificity and sensitivity, and reduced pharmacological toxicity. In particular, chitosan nanoparticles are found to be appropriate for non-invasive routes of drug administration: oral, nasal, pulmonary and ocular routes. These applications are facilitated by the absorption-enhancing effect of chitosan. Many procedures for obtaining chitosan nanoparticles have been proposed. Particularly, the introduction of hydrophobic moieties into chitosan molecules by grafting to generate a hydrophobic-hydrophilic balance promoting self-assembly is a current and appealing approach. The grafting agent can be a hydrophobic moiety forming micelles that can entrap lipophilic drugs or it can be the drug itself. Another suitable way to generate self-assembled chitosan nanoparticles is through the formation of polyelectrolyte complexes with polyanions. This paper reviews the main approaches for preparing chitosan nanoparticles by self-assembly through both procedures, and illustrates the state of the art of their application in drug delivery.

Application of Chitosan and its Derivatives in Nanocarrier Based Pulmonary Drug Delivery Systems.

The respiratory tract as a non-invasive route of drug administration is gaining increasing attention in the present time on achieving both local and the systemic therapeutic effects. Success in achieving pulmonary delivery, requires overcoming barriers including mucociliary clearance and uptake by macrophages. An effective drug delivery system delivers the therapeutically active moieties at the right time and rate to target sites. A major limitation associated with most of the currently available conventional and controlled release drug delivery devices is that not all the drug candidates are well absorbed uniformly locally or systemically. We searched and reviewed the literature focusing on chitosan and chitosan derivative based nanocarrier systems used in pulmonary drug delivery. We focused on the applications of chitosan in the development of nanoparticles for this purpose. Chitosan, a natural linear bio-polyaminosaccharide is central in the development of novel drug delivery systems (NDDS) including nanoparticles for use in the treatment of various respiratory diseases. It achieves this through its unique properties of biodegradability, biocompatibility, mucoadhesivity and its ability to enhance macromolecule permeation across membranes. It also achieves sustained and targeted effects, primary requirements for an effective pulmonary drug delivery system. This review highlights the applications and importance of chitosan with special emphasis on nanotechnology, employed in the management of respiratory diseases such as asthma, Chronic Obstructive Pulmonary Disease (COPD), lung cancer and pulmonary fibrosis. This review will be of interest to both the biological and formulation scientists as it provides a summary on the utility of chitosan in pulmonary drug delivery systems. At present, there are no patented chitosan based controlled release products available for pulmonary drug delivery and so this area has enormous potential in the field of respiratory science.

The Pharmacokinetics and Local Tolerability of a Novel Sublingual Formulation of Buprenorphine.

The principal study objective was to investigate the pharmacokinetic characteristics and determine the absolute bioavailability and tolerability of a new sublingual (SL) buprenorphine wafer. The study was of open label, two-way randomized crossover design in 14 fasted healthy male and female volunteers. Each participant, under naltrexone block, received either a single intravenous dose of 300 mcg of buprenorphine as a constant infusion over five minutes or a sublingual dose of 800 mcg of buprenorphine in two treatment periods separated by a seven-day washout period. Blood sampling for plasma drug assay was taken on 16 occasions throughout a 48-hour period (predose and at 10, 20, 30, and 45 minutes, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 24 and 48 hours postdose). The pharmacokinetic parameters were determined by noncompartmental analyses of the buprenorphine plasma concentration-time profiles. Local tolerability was assessed using modified Likert scales. The absolute bioavailability of SL buprenorphine was 45.4% (95% confidence interval = 37.8-54.3%). The median times to peak plasma concentration were 10 minutes and 60 minutes after IV and SL administration, respectively. The peak plasma concentration was 2.65 ng/mL and 0.74 ng/mL after IV and SL administration, respectively. The half-lives were 9.1 hours and 11.2 hours after IV and SL administration, respectively. The wafer had very good local tolerability. This novel sublingual buprenorphine wafer has high bioavailability and reduced Tmax compared with other SL tablet formulations of buprenorphine. The wafer displayed very good local tolerability. The results suggest that this novel buprenorphine wafer may provide enhanced clinical utility in the management of both acute and chronic pain. Buprenorphine is approved for use in pain management and opioid addiction. Sublingual administration of buprenorphine is a simple and noninvasive route of administration and has been available for many years. Improved sublingual formulations may lead to increased utilization of this useful drug for acute and chronic pain management.

Methoxyflurane inhalation vapour in trauma pain: a profile of its use in the EU

Methoxyflurane (Penthrox®) administered as an inhalation vapour via a hand-held inhaler is approved in Europe for the emergency relief of moderate to severe pain in conscious adults with trauma-associated pain. The time to the onset of meaningful pain relief is 3–4 min. Methoxyflurane provided effective levels of analgesia in patients presenting to the emergency department pain associated with minor trauma, was more effective than intramuscular tramadol when administered by paramedics for acute musculoskeletal pain, and had a more rapid onset of action than tramadol in patients presenting to the emergency department with ankle injuries. When used to relieve trauma pain in the emergency setting, methoxyflurane is generally well tolerated and, unlike when it was used at higher doses as an inhalational anaesthetic, is not associated with a risk of nephrotoxicity. With its non-invasive route of administration, ease of use and/or rapid onset of action, patient-administered inhaled methoxyflurane is a useful option for the management of trauma pain in the pre-hospital or emergency department setting.

Evaluation of value in non-inferiority trials by ASCO’s conceptual framework.

e18304 Background: ASCO released a conceptual framework assessing the value of cancer treatment options in 2015 and its updated version in 2016 as a tool to evaluate clinical benefit and toxicity in clinical trials. This framework was developed as a facilitator of discussions on the individual treatment between physicians and their patients. This tool consists of the elements of clinical benefit, toxicity, and symptom palliation, and these elements are combined into a score termed the net health benefit (NHB). However, in the clinical setting, not only these elements but also various factors benefit patients such as more convenient treatment schedule, shorter administration time, or non-invasive route of administration. Especially, test treatment in non-inferiority trials is likely to have these merits in addition to the benefit in toxicity. Therefore, we investigated whether the ASCO framework can identify reasonable NHB in test treatment regimens of non-inferiority trials. Methods: A systematic literature search of randomized non-inferiority trials for cancer reported from 2009 to 2015 was performed using PubMed. Inclusion criteria were English, a full-length article, available toxicity data, non-inferiority trial with a positive result, and chemotherapy. We calculated clinical benefit, toxicity score, bonus points, and NHB according to the ASCO framework. Results: We found 20 non-inferiority trials. Median sample size was 419. The common cancer types were colorectal (7 trials), lung (5), hematologic (2), and breast (2). Of 20 trials, 8 were conducted internationally, 4 in Japan, and 3 in Germany. In the ASCO framework, median NHB was 4.5 points, and 7 of 20 trials (35%) showed negative impact of test treatment, which means that NHB was minus points (-0.6 to -24.53). In 6 of these 7 trials, test treatment was in more convenient schedule or administered by non-invasive route compared with standard treatment. Conclusions: In the ASCO framework, merits in treatment schedule or route of administration may not be fully captured, and the test treatments in some non-inferiority trials showed negative NHB. It is desirable to assess not only NHB but also such merits in considering the risk-benefit balance in non-inferiority trials.

Recent Advances in Non-Invasive Delivery of Macromolecules using Nanoparticulate Carriers System.

The drug delivery of macromolecules such as proteins and peptides has become an important area of research and represents the fastest expanding share of the market for human medicines. The most common method for delivering macromolecules is parenterally. However parenteral administration of some therapeutic macromolecules has not been effective because of their rapid clearance from the body. As a result, most macromolecules are only therapeutically useful after multiple injections, which causes poor compliance and systemic side effects. Therefore, there is a need to improve delivery of therapeutic macromolecules to enable non-invasive delivery routes, less frequent dosing through controlled-release drug delivery, and improved drug targeting to increase efficacy and reduce side effects. Non-invasive administration routes such as intranasal, pulmonary, transdermal, ocular and oral delivery have been attempted intensively by formulating macromolecules into nanoparticulate carriers system such as polymeric and lipidic nanoparticles. This review discusses barriers to drug delivery and current formulation technologies to overcome the unfavorable properties of macromolecules via non-invasive delivery (mainly intranasal, pulmonary, transdermal oral and ocular) with a focus on nanoparticulate carrier systems. This review also provided a summary and discussion of recent data on non-invasive delivery of macromolecules using nanoparticulate formulations.

Carrier Mediated Systemic Delivery of Protein and Peptide Therapeutics.

Over the last few decades proteins and peptide therapeutics have occupied an enormous fraction of pharmaceutical industry. Despite their high potential as therapeutics, the big challenge often encountered is the effective administration and bioavailability of protein therapeutics in vivo system. Peptide molecules are well known for their in vivo short half-lives. In addition, due to high molecular weight and susceptibility to enzymatic degradation, often it is not easy to administer peptides and proteins orally or through any other noninvasive routes. Conventional drug management system often demands for frequent and regular interval intravenous/subcutaneous administration, which decreases overall patient compliance and increases chances of side-effects related to dose-fluctuation in systemic circulation. A controlled mode of delivery system could address all these short-comings at a time. Therefore, long-acting sustained release formulations for both invasive and noninvasive routes are under rigorous study currently. Long-acting formulations through invasive routes can address patient compliance and dose-fluctuation issues by less frequent administration. Also, any new route of administration other than invasive routes will address cost-effectiveness of the therapeutic by lessening the need to deal with health professional and health care facility. Although a vast number of studies are dealing with novel drug delivery systems, till now only a handful of controlled release formulations for proteins and peptides have been approved by FDA. This study therefore focuses on current and perspective controlled release formulations of existing and novel protein/peptide therapeutics via conventional invasive routes as well as potential novel non-invasive routes of administration, e.g., oral, buccal, sublingual, nasal, ocular, rectal, vaginal and pulmonary.

Spleen et idéal

Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive routes of administration, pharmacology, and adverse effects.

Management of pain using transdermal patches

Transdermal delivery is a non-invasive route of drug administration through the skin surface that can deliver the drug at a predetermined rate across the dermis to achieve a local or systemic effect. It is potentially used as an alternative to oral route of drugs and hypodermic injections. Analgesics are mostly used for various diseases as most of them are associated with severe or mild pain .The use of analgesics as a pain relief patch is now being used commonly. A transdermal analgesic or pain relief patch is a medicated adhesive patch used to relieve minor to severe pain. Currently, the patches are available for many Opioids , Non opioids analgesics. Local anesthetics and antianginal drugs. The drugs include Fentanyl, Buprenorphine ketoprofen, diclofenacepolamine , piroxicam , Capsaicin ,Nitroglycerine and Lignocaine . They are available as both matrix and reservoir patches. This review explores the various drugs used to manage pain and their route of administration in terms of frequency, complications and effects