ABSTRACT
Kratom is an herbal supplement that has gained popularity for recreational use within the United States. Kratom exerts opioid-like effects and, although not US FDA approved, is commonly used for self-treatment of pain, withdrawal management from opioids, and euphoria. Drug-related hepatic injury has been associated with kratom use. All of this raises concern for patient safety and monitoring. The potential for additive liver toxicity must be considered when kratom is used concurrently with hepatotoxic, over-the-counter, herbal, and prescription medications. This case report describes a case of kratom-induced liver inflammation complicated by opioid withdrawal that was precipitated by initiation of IM naltrexone. To our knowledge, there are no published case reports related to opioid withdrawal following naltrexone administration in patients using kratom (without other opioids). The purpose of this case report is to demonstrate potential complications that may arise with kratom use and considerations that should be taken prior to initiation of naltrexone in kratom users.
ABSTRACT
Drug delivery to the eye is challenging for formulation scientists due to physiological barriers that separate the eye from the rest of the body. A variety of ocular disorders demand the development of optimal drug delivery systems for the administration of drugs and therapeutic agents that can overcome barriers that restrict drug bioavailability. SiRNA inhibits the expression of target genes and has immense potential as a biological tool for the therapeutic inhibition of disease causing genes; however, delivery of siRNA to ocular tissue is a challenge. Recent literature suggests that nanoplatforms show great promise in enhancing ophthalmic drug delivery. A drug delivery system involving nanoparticles and siRNA could surpass problems faced in ocular delivery with improved biodistribution and lower toxicity. This review covers recent research in the area of nanocarrier siRNA drug delivery for various ocular disorders.
