Cialis ist bekannt für seine lange Wirkdauer von bis zu 36 Stunden. Dadurch unterscheidet es sich deutlich von Viagra. Viele Schweizer vergleichen daher Preise und schauen nach Angeboten unter dem Begriff cialis generika schweiz, da Generika erschwinglicher sind.
A social protection strategies (adb)
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
Phosphatidylcholine: A Review 
Md. Hassan Kawsar1, Md. Firoz Khan2 and 
Md. Akbar Hossain3 
Abstract: In recent years Phosphatidylcholine has greatly impacted the 
drug delivery technology. The very first and most important advantage of 
phospholipid based vesicular system is the compatibility of 
phospholipids with membrane of human either internal membrane or 
skin (external membrane). For a drug to be absorbed and distributed into 
organs and tissues and eliminated from the body, it must pass through 
one or more biological membrane(s)/ barrier(s) at various locations. Such 
a movement of drug across the membrane is called drug transport. For 
the drugs to be delivered to the body should cross the membranous 
barrier, either it would be from oral route or topical/transdermal route. 
Therefore the phospholipid based carrier systems are of considerable 
interest in this era. A number of drug delivery systems are based entirely 
on Phosphatidylcholine such as Liposomes, Ethosomes, Phytosomes, 
Transferosomes and Nanocochelates. 
Keywords: Phosphatidylcholine, Vesicular systems, Membrane 
Introduction 
Since last decades the popularity of vesicular systems has been 
increased because of a lot of advantages associated with it. 
Vesicular systems are mainly composed of phospholipids. 
Phospholipids are amphipathic (having affinity forboth aqueous 
and polar moieties) molecules as they have a hydrophobic tail and 
a hydrophilic or polar head. 
The hydrophobic tail is composed of two fatty acid chains containing 10-24 carbon atoms and each chain may be saturated or unsaturated (upto 6 double bonds). The polar end of the molecule is mainly phosphoric acid bound to a water-soluble molecule. The hydrophilic and hydrophobic domains/ segments within the molecular geometry of amphiphilic lipids orient and self organize in order supramolecular structure when confronted with solvents1. 
 1 Associate Professor, Department of Pharmacy, State University of Bangladesh 2 Lecturer, Department of Pharmacy, State University of Bangladesh 3 Assistant Professor, Department of Pharmacy, Dhaka International University 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
Some commonly used synthetic phospholipids are dioleoyl-phosphatidyl-choline 
ethanolamine (DOPE), Distearoyl-phosphatidyl-choline (DSPC), Distearoyl-phosphatidyl-ethanolamine (DSPE)2. 
Figure 1: Phophatidylcholine3 
Among all these phospholipids, phosphatidylcholine classes of phospholipids are very important in the drug delivery technology. 
The very first and most important advantage of phospholipid based vesicular systems is the compatibility of phospholipids with membrane of human either internal membrane as well as skin. For a drug to be absorbed and distributed into organs and tissues and eliminated from the body, it must pass through one or more biological membranes/ barriers at various locations. Such a movement of drug across the membrane is called drug transport. The cellular membrane consists of a double layer of amphiphilic phospholipids molecules arranged in such a fashion that their hydrocarbon chains are oriented inwards to form the hydrophobic or lipophilic phase and their polar heads oriented to form the outer and inner hydrophilic boundaries of the cellular membrane that face the surrounding aqueous environment. 
Globular protein molecules are associated on either side of these hydrophilic boundaries and also interspersed within the membrane structure. In short, the membrane is a mayonnaise sandwich where a bimolecular layer of lipids is contained between two parallel monomolecular layers of proteins. The hydrophobic core of the membrane is responsible for the relative impermeability of polar molecules. Aqueous filled pores or perforations of 4 to 10A° in diameter are also present in the membrane structure through which 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
organic ions and small organic water-soluble molecules like urea can pass. In general, the biomembrane acts like a semipermeable barrier permitting rapid and limited passage of some compounds while restricting that of others4. The GI linings constituting the absorption barrier allows most nutrients like glucose, amino acids, fatty acids, vitamins, etc., to pass rapidly through it into the systemic circulation but prevent the entry of certain toxins and medicaments. Thus, for a drug to get absorbed after oral administration, it must first pass through this biological barrier4. 
And for topical/ transdermal delivery of drugs, it has to cross the skin. During the past decades there has been wide interest in exploring new techniques to increase drug absorption through skin5,6,7. Topical delivery of drugs by lipid vesicles has evoked a considerable interest. The skin, the heaviest single organ of the body, combines with the mucosal linings of the respiratory, digestive, and urogenital tracts to form a capsule, which separates the internal body structures from the external environment. The skin has various functions such as protection from external environment, maintenance of body posture, regulation of temperature, etc. Including these various primary functions, it also acts as a site for drug delivery. 
The skin itself has two main layers: the epidermis, which is the outermost layer of the skin, covering the dermis that is the active part of the skin, holding the hair muscles, blood supply, sebaceous glands and nerve receptors. There is a fat layer underneath the dermis. The skin is a very heterogeneous membrane and has a variety of cell types, but the layer that controls the penetration of drugs is called the stratum corneum and despite its thickness of only 15–20 μm, it provides a very effective barrier to penetration. The permeation of the drug through the skin has several routes: transcellular, intercellular, and appendageal (through eccrine glands or hair follicles). Since the appendages occupy a very low surface area, this means of permeation is less significant under normal conditions8. 
Nevertheless, in iontophoretics delivery transdermal route is more significant9. So for the drugs to be delivered to the body should cross the membranous barrier. Either it would be from oral route or 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
topical/transdermal route. Therefore the phospholipid based carrier systems are of considerable interest in this era. 
History: Phosphatidylcholine was first isolated in Odessa, Ukraine 
some 50 years ago. This was followed by further research in 
Germany and Russia. It has been marketed by Sanofi-Aventis for 
over 30 years and, at present; the substance phosphatidylcholine is 
registered in 53 countries. Its main application nowadays lies in the 
intravenous treatment and prevention of fat embolisms in 
polytraumatized patients in the treatment of metabolic disorders 
and as a liver-protecting substance10. 
Mechanism of Vesicle Formation: In aqueous medium the 
molecules in self-assembled structures are oriented in such a way 
that the polar portion of the molecule remains in contact with the 
polar environment and at the same time shields the non-polar part. 
Among the amphiphilic used in the drug delivery, viz soaps, 
detergents, polar lipids, the latter (polar lipids) are often employed 
to form concentric bilayered structures. However, in aqueous 
mixtures these molecules are able to form various phases, some of 
them are stable and others remain in the metastable state11. At high 
concentrations of these polar lipids, liquid-crystalline phases are 
formed that upon dilution with an excess of water can be dispersed 
into relatively stable colloidal particles. The macroscopic 
structures most often formed include lamellar, hexagonal or cubic 
phases dispersed as colloidal nanoconstructs (artificial membranes) 
referred to as liposomes, hexasomes or cubosomes, respectively12. 
The 
Phophatidylcholine (PC). 
Amphipathic molecule in which a glycerol bridge link to a pair of hydrophilic polar head group, phosphatidylcholine. Fatty chains are embedded in the hydrophilic inner region of the membrane surface, the hydrophilic head group, including the phosphate portion, points out towards the hydrophilic aqueous environment. Molecules of PC are not soluble rather dispersible in aqueous environment and they align themselves closely in planer bilayer sheets to minimize the unfavorable interactions between the bulk aqueous phase and long hydrocarbon fatty acyl chain. Such interactions are completely eliminated when the sheets fold over 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
themselves to form closed sealed and concentric vesicles. The large free energy change between an aqueous and hydrophobic environment explains the most favored orientation of lipids to assemble 
confrontation between aqueous and hydrophobic domains. This distinctive behavior derives in the lowest free energy state and hence ensures the maximum stability to self-assembled structures11. The phosphatidylcholine and its synthetic analogues differ markedly from amphiphilic molecules of differ markedly from amphiphilic molecules of other origin (soaps, detergents, lysolecithin) in that they preferably orient to form bilayer sheets rather than micellar structures. 
This presumably attributed to the double fatty acid chain that imparts the molecule an overall tubular shape are more suitable for assemblage in planer sheets. In contrast, the detergent molecule with a polar head and single acyl chain has a conical shape and facilitate the formation of spherical micellar structures. Depending on the hydrophobic environment and aqueous phase, homogenous smectic phases of parallel lipid bilayers (lyotropic phases) or heterogeneous dispersion of multilamellar or single-walled vesicles can be observed. At lower water content and higher temperature, other lyotropic liquid crystalline phases exist, such as the hexagonal, the cubic and the ribbon phases. 
Advantages of Phospholipid Based Carrier Systems in 
Comparison to Other Delivery Systems 
1. These systems show enhanced permeation of drug through skin 
for transdermal and dermal delivery. 
2. These are platform for the delivery of large and diverse group 
of drugs (peptides, protein molecules). 
3. Their composition is safe and the components are approved for 
pharmaceutical and cosmetic use. 
4. Low risk profile- the toxicological profiles of the phospholipids 
are well documented in the scientific literature. 
5. High market attractiveness for products with proprietary 
technology. Relatively simple to manufacture with no complicated technical investments required for production of Ethosomes. 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
6. The vesicular system is passive, non-invasive and is available 
for immediate commercialization. 
Brief Introduction to the Phospholipid Based Carrier Systems 
Liposome: Liposomes are colloidal, vesicular structures composed 
of one or more lipid bilayers surrounding an equal numbers of 
aqueous compartments. Since, 1960's pharmaceutical researchers 
used liposomes as therapeutic tools in medicinal field. A number 
of liposomal formulations of such drugs have available in the 
market such as Doxil® (Doxorubicin), Fungizone® (Amphotericin-
B), Novasome® (Smallpox vaccine) and NyotranTM (Nystatin). 
Liposomes used as potential carriers in field like tumor targeting, 
gene 
immunomodulation and skin care and topical cosmetics products. The present review highlights the composition, method of preparation, characterization, therapeutic applications of liposomes and its marketed products13. 
Ethosome: Ethosomes are soft, malleable vesicles composed 
mainly of phospholipids, ethanol (relatively high concentration) 
and water. These "soft vesicles" represents novel vesicular carrier 
for enhanced delivery to/through skin. The size of Ethosomes 
vesicles can be modulated from tens of nanometers to microns. 
Ethosomes provide a number of important benefits including 
improving the drug's efficacy, enhancing patient compliance and 
comfort and reducing the total cost of treatment. The Ethosomes 
were found to be suitable for various applications within the 
pharmaceutical, 
nutraceutical markets14. 
Phytosome: Phytosome are created when the standardized extract 
and active ingredients of an herb are bound to the phospholipids on 
a molecular level. Phytosome structures contain the active 
ingredients of the herb surrounded by the phospholipids. The 
phospholipid molecular structure includes a water-soluble head 
and two fat-soluble tails, because of this dual solubility, the 
phospholipid acts as an effective emulsifier which is also one of 
the chief components of the membranes in our cells. Phytosomes 
are advanced forms of herbal products that are better absorbed, 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
utilized, and as a result produce better results than conventional herbal extracts15. 
Transferosomes: In functional terms, may be described as lipid 
droplets of such deformability that permits its easy penetration 
through the pores much smaller than the droplet size. 
Transferosomes have been developed in order to take advantage of phospholipids vesicles as transdermal drug carrier. These self optimized aggregates, with ultraflexible membrane, are able to deliver the drug reproducibly either into or through the skin, depending on the choice of administration or application, with high efficiency. Transferosomes overcome the skin penetration difficulty by squeezing themselves along the intracellular sealing lipids of stratum corneum. There is provision for this, because of the high vesicle deformability, which permits the entry due to mechanical stress of surrounding, in a self adapting manner. 
Flexibility of transferosomes membrane is achieved by mixing suitable surface active agents in proper ratios. The resulting flexibility of transferosome membrane minimizes the risk of complete vesicle rupture in the skin and allows transferosomes to follow the natural water gradient across the epidermis, when applied under non occlusive condition. Transferosomes can penetrate the intact stratum corneum spontaneously either through intracellular route or transcellular route16. 
Long circulating liposomes: The major limitation of liposomes is 
their fast elimination from the blood and localization in 
reticuloendothelial system primarily kupfer cells of liver. 
Different methods have been reported to achieve long circulation of liposomes in vivo, including modification with certain lipids such as monosialoganglioside, palmityl-D-Glucoronic acid and PEG-PE. These liposomes show significantly longer circulation in blood than the liposomes without these lipids17, 18, 19, 20, 21. 
Nanocochelates: Nanocochelates consists of a purified soy based 
phospholipid that contains at least about 75% by weight of lipid 
which can be phosphatidyl-serine (PS), dioleoyl-phosphatidyl-
serine (DOPS), phosphatidic acid (PA), phosphatidyl-inositol (PI), 
phosphatidyl glycerol (PG) and /or a mixture of one or more of 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
these lipids with other lipids. Additionally or alternatively, the lipid can include phosphatidylcholine (PC), phosphatidyl-ethanolamine (PE), diphosphotidyl-glycerol (DPG), dioleoyl phosphatidic acid (DOPA), distearoyl phosphatidylserine (DSPS) and 
phosphatidylserine 
phosphatidylgycerol (DPPG)7. 
A multivalent cation, which can be Zn+2 or Ca+2 or Mg+2 or Ba+2 and a drug, which can be protein, peptide, polynucleotide, antiviral agent, anesthetic, anticancer agent, immunosuppressant, steroidal anti inflammatory agent, non steroidal anti inflammatory agents, tranquilizer, nutritional supplement, herbal product, vitamin and/or vasodilatory agent22. 
Table 1: Therapeutic Applications of Liposomes 
Targeted 
Application 
Diseases 
Mycotic infection 
Decrease glucose 
Diabetic mellitus 
enzyme inhibitor 
Phosphodiesterase 
Protein synthesis 
inhibition Inhibition of nerve 
surface with pain 
sensory nerves Inhibit ergosterol 
Candida-albican's 
Rhamnose receptor 
Urtecaria, allergic 
free nerve ending 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
Protein synthesis 
Ocular delivery, 
inflammatory Meningococal, 
Inhibit synthesis of 
bacterial cell wall 
reductase Inhibit DNA/ 
Protein synthesis 
Table 2: List of Marketed Products of Liposome 
Marketed 
Drug used 
Target diseases 
product 
DoxilTM or 
Kaposi's sarcoma 
Kaposi's sarcoma, 
cancer fungal infections, 
fungal infections, 
Prostaglandin-E1 
Dry protein free 
diseases in babies 
Smallpox vaccine 
Avian retrovirus 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
institute, Switzerland 
Refractory ovarian 
cancer Metastatic breast 
Bacterial infection 
NeXstar, USA Aronex Pharm, 
Kaposi's sarcoma 
Shigella Flexneri 
Shigella Flexneri 
Shigella flexneri 
2A Infection Systemic fungal 
Table 3: Therapeutic Applications of Ethosomes 
Comments 
Treatment of Herpetic 
Improved drug delivery 
Treatment of AIDS 
Improved transdermal flux Increased drug entrapment 
efficiency, reduced side 
Trihexypenidyl HCl Parkinsonian syndrome effect & constant systemic 
Efficient healing of S. 
Improved drug penetration 
aureus-induced deep 
and systemic effect 
dermal infections 
Improved therapeutic 
Treatment of Diabetes 
efficacy of drug 
Treatment of male 
Enhance skin permeation 
hypogonodism Prevents inflammation 
Significant accumulation of 
the drug in the skin 
Hair growth promotion 
Higher skin retention 
effect Treatment of dermal 
Reduced drug toxicity 
 
Table 4: Therapeutic Applications of Phytosomes 
Molecule 
Application 
Targeted Diseases 
Enhance bioavailability due to their complex with phospholipids and 
Botanical extracts 
Diabetic mellitus 
delivers faster and improved absorption in intestinal tract. 
To be better absorbed in intestinal 
For treatment of 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
botanical extract 
Infections More skin 
Transdermal immunization 
penetration and have 
junction protein 
a high lipid profile 
Table 5: Therapeutic Applications of Transferosomes 
Application 
Targeted Diseases 
Decreases glucose level 
Diabetic mellitus 
Interferons, for example 
Antiviral, antiproliferive 
For treatment of 
leukocytic derived 
interferone-α (INF-α) 
immunomodulatory effects 
Soluble protein like integral membrane protein, human serum 
Transdermal immunization 
albumin, gap junction protein Corticosteroids 
Treatment of skin diseases 
Skin diseases For the operation 
Topical anesthesia 
Table 6: Therapeutic applications of Nanocochelates Molecule 
Application Targeted Diseases 
Application 
Stabilize and protect an 
Sialic acid and glyco-
extended range of 
micronutrients and the potential to increase the 
nutritional value of processed 
foods To deliver proteins, peptides 
for vaccine and gene 
therapy applications 
In the delivery of 
For reducing the toxicity 
antibacterial agents: 
and improving the 
bactericidal activity 
Conclusion 
A number of drug delivery systems are emerging today. But the 
delivery systems based on Phosphatidylcholine are of much 
importance because of intense advantages associated with them. 
The delivery systems described above have proved their ability and 
efficacy to deliver the active moiety to the desired location of the 
body. But this is not the limit of these Phosphatidylcholine based 
drug delivery systems. In future the Phosphatidylcholine based 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
drug delivery systems can be utilized to the maximum to proof these systems as a revolution in drug delivery technology. This review is only an attempt to attract the attention of researchers to these types of systems. 
References 
1. Lasic, D.D.; 1995; 
Liposome- A Practical Approach; Oxford 
University Press, Oxford; pp. 112-114. 
2. Vyas, S.P. and Khar, R.K.; 2002; 
Liposome, Targeted & Controlled 
Drug Delivery; CBS Publisher & Distributors, New Delhi; p. 174. 
mm.1e0189bdb.html 
4. Brahmankar, D.M. and Jaiswal, S.B.; 2006; 
Biopharmaceutics and 
Pharmacokinetics– A Treatise; Ed. First, Reprint, Vallabh Prakashan, Delhi; pp. 6-7. 
5. Barry, B.W.; 2001; Novel mechanisms and devices to enable 
successful transdermal drug delivery; 
European Journal of 
Pharmaceutical Sciences; 
14:101-114. 
6. Williams, A.; 2003 
Transdermal and topical drug discovery; 1st ed.; 
Pharmaceutical Press, London; pp. 122-132. 
7. Honeywell- Nguyen, P.L. and Bouwstra, J.A.; 2005; Vehicles as a 
tool for transdermal and dermal delivery; 
Drug Discov. Today: 
techno l.; 
2:67-74. 
8. Hadgraft, J.; 2001; 
International Journal of Pharmaceutics; 
184(1):1-6. 
9. Jadoul, A., Doucet, J., Durand, D. and Preat, V.; 1996; 
Journal of 
Control Release; 
42:165. 
10. Hasengschwandtner, F.; Phosphatidyl- choline treatment to induce 
lipolysis; 
Journal of Cosmetic Dermatology; 
4:308–313. 
11. Lasic, D.D.; 1993; 
Liposomes; From biophysics to applications; 
Elsevier, New York; p. 9. 
12. Lasic, D.D.; 1998; 
Trends in Biotechnol.; 
16:307. 
13. Patel, S.S; 2006; Liposome- A versatile platform for targeted 
delivery of drugs; 
Pharmainfo.net; 
4(5):1-10. 
Kawsar, 
et al / Journal of SUB 
4(2): 89-102, 2013 
14. Patel, S.S; 2007; Ethosomes A Promising Tool for Transdermal 
Delivery of Drug; 
Pharmainfo.net; 
5(2):1-10. 
15. Darshan, D.; 2007; Phytosome- A Novel Dosage Structure; 
Pharmainfo.net; 
5(1):1-10. 
16. Jain, S., Sapee, R. and Jain, N.K.; 1998; Proultraflexible lipid 
vesicles for effective transdermal delivery of norgesterol.; 
Proceedings of 25th conference of C.R.S.; U.S.A.; pp. 32-35. 
17. Allen, T.M. and Chonn, A.; 1987; Large unilamellar liposomes with 
low uptake into the reticuloendothelial system; 
FEBS Lett.; 
223:42–
46. 
18. Klibanov, A.L., Maruyama, K., Torchilin, V.P. and Huang, L.; 1990; 
Amphipathic polyethyleneglycols effectively prolong the circulation 
time of liposomes; 
FEBS Lett.; 
268:235–237. 
19. Blume, G. and Cevc, G.; 1990; Liposomes for the sustained drug 
release 
in vivo; 
Biochim. Biophys. Acta; 
1029:91–97. 
20. Papahadjopoulos, D., Allen, T.M., Gabizon, A., Mayhew, E., 
Matthay, K., Huang, S.K., Lee, K.D., Woodle, M.C., Lasic, D.D., 
Redemann, C. and Martin, F.J.; 1991; Sterically stabilized 
liposomes: improvements in pharmacokinetics and antitumor 
therapeutic efficacy; 
Proc. Natl. Acad. Sci.; 
88:11460-11464. 
21. Namba, Y., Sakakibara, T., Masada, M., Ito, F. and Oku, N.; 1989; 
1-O-Palmityl-glucuronate endows liposomes with long half-life 
in vivo; 
Chem. Lett.; pp. 2145–2148. 
22. Tan, F. and Zarif, L.; 2005; Cochleates made with purified soy 
phosphatidylserine; 
European patent; 
1494:690. 
Source: http://sub.edu.bd/sites/default/files/journals_files/9_Hassan_Pharmacy.pdf
   ACUPUNCTURE AND DEPRESSION About depression  Depression is a common mental health problem that affects people of all genders, ages, and backgrounds. About two thirds of adults will at some time experience depression severe enough to interfere with their normal activities (Mintel/YouGov, 2006, Stewart et al, 2004). Women are twice as likely as men to become depressed (Stewart et al, 2004) partly due to hormone changes occurring pre-menstrually, at menopause, during pregnancy or after childbirth. Depression is estimated to cost the UK £7.5 billion a year in medication, benefits and lost working days (McCrone et al, 2008). The World Health Organization predicts that by 2020 depression will be second only to chronic heart disease as an international health burden (WHO, 2008). 
  
   Resident & Student Association rESidENt PrESidENt'S MESSagE 2012 Brings New Projects for aaEM/rSa Teresa M. Ross, MDAAEM/RSA President JM is a 35yo female with a history of recurrent  calcium chloride, etomidate, fentanyl, furosemide, ketorolac,  migraines.  labetalol, ondansetron, phenytoin, prochlorperazine and rabies  immunoglobulin.6 The majority of the medications are for iv use,