©Quarterly Homœopathic Digest, Vol.XXX,1 - 2/2013. Private circulation only. 27
Our law is so weak that brands do not even say on
the package labels, how much Sodium the food
contains. For now, the real option is to say ‘no’ to salt.
VI. On Inhaling drugs that heal, not harm.
How many different ways can we administer a
medication or a drug? Depending on its physical
properties, it can be rubbed on the skin like most
lotions. It can be instilled in the form of drops,
swallowed in the form of tablets, emulsions or potions.
It is injected directly into bloodstream.
Of all these, the mode of injection using a syringe
and needle is perhaps the latest, or most modern
method. It requires technology of the kind that was not
available a century ago – making metal needles that are
hollow and with sharp tips, and syringes to suck up the
solution and deliver known amounts through the needle
attached at the delivery end. But then, native medicine
men in Central America, the orient and perhaps even in
India, seem to have used ants, wasps and bees to sting
their venom into the bodies of patients suffering from
nervous disabilities. Such attempts were made
presumably to “awaken” the sleeping sensations” of the
patient, as a form of shock therapy.
There is another form of taking in drugs and
chemicals, and that is inhalation through the lungs. This
can be done as a spray through the nose, or as fine
particles through the nostrils. This mode of drug
delivery has been known for at least half a century – and
known to have been practiced by the Indian tribes of the
American continent. Indeed the current fad called
aromatherapy owes its origin to these tribes.
These Indian tribes took drugs and medication not
only for illnesses, but also as a pleasurable addiction.
The practice of sniffing snuff, originated in this manner.
The Indians dried the tobacco leaves and chewed on
them. They rolled the dry leaves, lit them and inhaled
or smoked them – calling this practice “Sik-ar” (hence
cigar/cigarette). Happily enough, the practice of
sniffing tobacco as snuff is not as wide-spread or
popular today as it used to be even 50 years ago.
(Sadly, however, sniffing other drugs such as cocaine,
Marijuana, Amphetamines and other mood-enhancing
but deadly addictives are practiced among the so-called
“with it” crowd. Thankfully though, this practice is on
the decline because of the enormity of the cost, medical
warnings and governmental action.)
Now comes an interesting and welcome turn to this
sniff mode of intake of substances. If we can take in
mood-altering substances why not Insulin, why not
Immunologicals, Hormones? The idea of inhalation
delivery through the airsac or the lungs has been around
for a couple of decades already, as people suffering
from Asthma are only too aware. Antihistamines,
which counteract allergy and associated discomfort,
have been packaged in the form of aerosols or “clouds”,
and delivered through the open mouth into the lungs
using nebulizers and they provide fast relief by opening
up the breathing passage.
There are several plus points for the through – the –
lung delivery of medication. The lungs have a large
surface area, so that absorption is fast and ample. Lungs
are quite tolerant to foreign substances, they are much
more permeable than skin, nasal mucosa or the gastro-
intestinal tract. And lungs have substances that inhibit
the enzymatic breakdown of proteins, so that the
through-lung delivery of proteins is more attractive than
through the stomach. This has led to much research into
the pulmonary delivery of protein drugs.
When we attempt to deliver material through
inhalation into the lungs, we need to “fool” the lung so
that it does not expel it through sneezing or through the
mouth. These occur through the “hairs” and the “muco-
ciliatary escalator” of the upper lungs. If we bypass this
through some clever means, the lungs will still put up
resistance. An army of cells there, the macrophages,
close in on the inhaled particles and digest them into
bits and clear them off. The pharmacologist who wishes
to deliver drugs through the pulmonary mode needs to
overcome both these protection mechanisms.
There are some issues that need to be addressed
when delivering medication as solids and dry powders.
They tend to clump and thus are hard to aerosolize or
puff through. On the manufacturing side, they pose
problems of preparation and packaging. The alternative
of spraying aqueous solutions, while quantitative and
reproducible in measured doses, has difficulties of
microbial contamination, low drug loading and stable
formulations.
KLIBANOV was one of the first people to show
that many proteins are actually quite stable and
biologically active even when they are suspended as
insoluble powders in organic solvents like ethanol.
When he presented his initial results almost two decades
ago, they were received with skepticism.
He summarizes that many Proteins and Enzymes
are actually active and stable when dispersed as
suspensions in organic solvents like ethanol; some even
perform better than in water.
Once having gotten this idea, the group decided to
suspend the drug insulin in ethanol, sonicate it and spray
it as an aerosol into rats, using a commercial nebulizer.
The results were excellent, nebulization delivered the
protein into the animal and the protein was active. The
particle size of the ethanol spray was good enough to
escape the macrophage clearance route, and light
enough to be sprayed deep into the lungs. And ethanol
is an excellent vehicle of delivery.
Ayurveda, the hoary Indian medical practice of
yore, has used nasal therapy or nasya. Since we are not
sure of the dates of origin of Ayurvedic practices, I