Spinal Drug DeliveryEdited by
- T. L. Yaksh, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
This book provides a unified and comprehensive compendium of issues related to the spinal delivery of drugs. The text, consisting of 34 chapters, begins with an extensive review of the early history, reflecting the development of the spinal cord as a route of spinal drug delivery. It then presents 4 principal divisions. In the first, the embryology, anatomy of the spinal canal, the spinal canal meninges and vasculature are reviewed in humans and non-human species. The second division considers the factors that define the redistribution of spinally delivered drugs and the movements of such drugs into the spinal parenchyma are considered in detail. The third section considers issues that relate to the preclinical development of drugs for spinal delivery. This division includes issues that pertain to preclinical models for drug safety evaluation, the nature of vehicles for spinal drugs and properties of materials for chronic spinal implantation. In addition, the nature of the inflammatory reactions that are observed with foreign bodies and toxicity are presented. The fourth division considers the several therapeutic targets towards which spinally delivered drugs are aimed. These include analgesics, anesthetics, antispasticity, antimetastatic and growth factors. In each case, the site and mechanisms of action and the several drug classes that are relevant are presented. The book seeks to address the broad categories of interest that are represented by the scientists who focus on the biology of spinal cord function, the toxicologist and chemist who develop and formulate drugs for human spinal therapeutic use and the clinicians who seek an in-depth review of spinal drug delivery.
Published: May 1999
(...)this is a well integrated collection of freestanding review-style manuscripts that are extremely well referenced and current. This book would serve as essential reading and reference material for any basic science researcher or aspiring clinician-researcher working in areas pertaining to spinal drug delivery.
(...)this highly scientific and intellectually stimulating monograph is testimony to the recent explosion of knowledge and interest in this area. The editor and all contributing authors should be commended not only for their contributions to this text, but moreover, for their tiresome dedication to performing basic science research that has led to novel clinical developments in spinal drug delivery that have and will continue to truly benefit all of mankind.
(J.A. Grass, Department of Anesthesiology, Western Pennsylvania Hospital, USA), Anesthesia and Analgesia, March 2000
Translated from Dutch: "The authors have succeeded in presenting a complete picture of current knowledge in the area of spinal drug delivery in a very easy to read format. The good structure of the chapters allows easy access to desired information and the text is appropriately illustrated. An important reference work for doctors and researchers dealing with the administration of spinal drug medicine."
(E.N. van Roon), Pharmaceutisch Weekblad, June 2000
- List of contributors. Acknowledgements. Dedication. Introduction. 1. The history of spinal drug delivery: the evolution of lumbar puncture and spinal narcosis (D.C. Mackey). 2. Comparative spinal anatomy of vertebrates (R. Nieuwenhuys). 3. Spinal anatomy of experimental animals (T.F. Fletcher, S.A. Malkmus). 4. Gross anatomy of the human vertebral column (Q. Hogan). 5. Anatomy of DRG, intrathecal nerve roots, and epidural nerves with emphasis on mechanisms of neurotoxic injury (R.R. Myers, K. Olmarker). 6. The spinal meninges and their role in spinal drug movement (C.M. Bernards). 7. Anatomy and physiology of the spinal vasculature (M. Marsala). 8. Spinal cerebrospinal fluid chemistry and physiology (A.A. Artru). 9. Epidural and intrathecal drug movement (C.M. Bernards). 10. Structure of extracellular space and physiochemical properties of molecules governing drug movement in brain and spinal cord (C. Nicholson). 11. Spinal pharmacokinetics (S.L. Shafer, A. Shafer). 12. Reaction of intrathecal and epidural spaces to infection and inflammation (R.O. Weller). 13. Animal models of intrathecal and epidural drug delivery (T.L. Yaksh, S.A. Malkmus). 14. Human spinal drug delivery: methods and technology (M.S. Wallace). 15. General considerations in the formulation of drugs for spinal delivery (R.J.E. Grouls, E.H.M. Korsten, T.L. Yaksh). 16. Material properties and bioreactivity (D.E. Albert, M.A. Hintz). 17. General considerations in the characterization of drug action after spinal delivery (T.L. Yaksh). 18. Preclinical safety evaluation for spinal drugs (T.L. Yaksh, M.L. Rathbun, J.C. Provencher). 19. Clinical implementation of agents for spinal delivery (J.C. Eisenach). 20. Spinally delivered analgesic drugs (S.E. Abram). 21. Local anesthetics acting on the spinal cord (A. Gokin, G. Strichartz). 22. Intrathecal chemotherapy (L. Bomgaars, S.M. Blaney, D.G. Poplack). 23. Intrathecally delivered medications for spasticity and dystonia (J.M. Meythaler). 24. Spinal drug delivery: contrast media (V.M. Haughton). 25. Spinal delivery of neurotrophins and related molecules (C.P. LeBel). 26. Spinal drug delivery: cellular implants (J. Sagen). Subject index.