Clinical polymers

Water content indirectly affects other lens characteristics. Water evaporation from the lens can result in a dry eye sensation and subsequent desiccative erosion of the cornea. Clinical studies have shown the incidence of corneal erosion as a result of lens desiccation to be a material-dependent and water-content-dependent phenomenon (25,26). The nature of water and sodium ions in hydrogels has been studied primarily by nmr and thermal techniques (27,28). An empirical relationship between water mobility in contact lens polymers and desiccative staining has been proposed (29). 

Since the pioneer work by Merigan in 1967 [1], many kinds of synthetic or natural polyanionic polymers have been examined for their biological activities [2-8], such as cytotoxicity, antiviral activity, antitumor activity, and immunomodulating activity. Although the biological results were interesting, the extent of activity for clinical application was still low. 

Anion exchange resins are basic polymers with a high affinity for anions. Because different anions compete for binding to them, they can be used to sequester anions. Clinically used anion exchange resins such as cholestyramine are used to sequester bile acids in the intestine, thereby preventing their reabsorption. As a consequence, the absorption of exogenous cholesterol is decreased. The accompanying increase in low density lipoprotein (LDL)-receptors leads to the removal of LDL from the blood and, thereby, to a reduction of LDL cholesterol. This effect underlies the use of cholestyramine in the treatment of hyperlipidaemia. 

Chitosan has been associated with other biopolymers and with synthetic polymer dispersions to produce wound dressings. Biosynthetic wound dressings composed of a spongy sheet of chitosan and collagen, laminated with a gentamicyn sulphate-impregnated polyurethane membrane, have been produced and clinically tested with good results. 

Developers of controlled release formulations have employed polymers produced from both L-lactide and Dl -lactide. In terms of clinical studies, however, it appears that perhaps the DL-lactide formulations have been somewhat more successful. It is unclear if this is due to the DL-lactide materials being less crystalline and more permeable to most drugs or perhaps more sophisticated techniques and... 

The effects of microsphere size distribution, drug/polymer ratio, and microsphere quality can be easily demonstrated in this laboratory model. Furthermore, as animal data and human clinical trial results are available the model becomes quite useful as a quality control method (46). 

Recently, Tsakala et al. (90) formulated pyrimethamine systems based on several lactide/glycolide polymers. These studies were conducted with both microspheres (solvent evaporation process) and implants (melt extrusion process). In vitro studies indicated that pyrimethamine-loaded implants exhibited apparent zero-order release kinetics in aqueous buffer whereas the microspheres showed an initial high burst and considerably more rapid drug release. In vivo studies in berghi infected mice confirmed that the microspheres did not have adequate duration of release for practical application. However, the implants offer promise for future clinical work as more than 3 months protection was observed in animals. 

A summary of the properties of the different types of dextrans available is presented in Table 25.1. Dextrans for clinical use as plasma expanders must have moleeular weights between 40000 (= 220 glucose units) and 300000. Polymers below the minimum are excreted too rapidly fiom the kidneys, whilst those above the maximum are potentially dangerous because of retention in the body. In practice, infusions containing dextrans of average molecular weights of40000,70000 and 110000 are commonly encountered. 

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