FIELD OF THE INVENTION

This invention relates to a topical protective formulations for use in the prevention of the spread of sexually transmitted diseases (STDs); and particularly to unique topical formulations including a plurality of film forming excipients which act in concert to provide a barrier to help inhibit the transmission of viral STDs.

BACKGROUND OF THE INVENTION

Sexually transmitted diseases (STDs) are a universal concern, effecting millions of individuals and straining health care systems. More than 20 different sexually transmitted diseases have been identified by the medical community and generally fall into two groups, including bacterial types (e.g., gonorrhea, chlamydia and syphilis) and viral types (human immunodeficiency virus (HIV), human papilloma virus (HPV) and hepatitis). The numerous diseases affect men, women and children of all backgrounds, races and economic classifications. Despite years of research and educational programs, the transmission of STDs remains a global health threat. Although specific methods of transmission may vary depending on the disease-causing organism, STDs are usually transmitted to the uninfected person through injured or exposed skin or mucous membranes during sexual contact.

Treatments may be available for some types of STDs. However, most people who suffer from these types of STDs are unaware that they have the disease and therefore do not get the necessary treatment. Moreover, because of the sociological impact and generally negative stigma associated with these diseases, people are reluctant to seek such treatments. The continued emphasis on educating the population as to the use of â€œmechanical barriersâ€ such as condoms has helped to decrease the morbidity of most STDs but more preventative methods need to be developed to prevent STD transmission.

Chemical actives such as microbicides, antimicrobials, and spermicides, most notably, nonylphenoxypoly(ethyleneoxy)-ethanol (also referred to as nonoxynol-9) have been used in topical formulations to effectively reduce the rate of STD transmission, especially when used in conjunction with prophylactics. However, many of these chemical actives are harsh and have been shown to induce local irritation, inflammation, and ulcerations which might actually favor the transmission of STDs. Thus, a need exists for topical formulations that do not cause irritation and will help inhibit the spread of STDs, especially when used in combination with condoms, and thereby provide an additional degree of protection from contamination, should the condom become damaged.

U.S. Patent Application 2003/0143189 A1 to Askill et al., is directed to a method of treating skin lesions by forming a polymeric film over the lesions to inhibit proliferation of infectious agents in the lesions. These compositions also include one or more chemical agents in combination therewith.

U.S. Pat. No. 6,835,717 to Hildreth is directed to a method of reducing the risk of a sexually transmitted pathogen by contacting a pathogen within the composition which consists of .beta.-cyclodextrin.

U.S. Pat. No. 6,821,958 to Hershline is directed to a method of preventing viral transmission using an alkylsulfate derivative of sulfated dextrin as a topical formulation.

U.S. Pat. No. 6,582,711 to Asmus et al., is directed to an antimicrobial hydroalcoholic composition having a cationic polymeric thickener.

U.S. Pat. No. 6,355,235 to Cone et al., is directed to an antibody capable of trapping sperm and a pharmaceutical carrier.

U.S. Pat. No. 6,328,991 to Myhling is directed to a chemical composition to prevent the transmission of sexually transmitted diseases comprising nonylphenoxpoly-(ethyleneoxy)-ethanol, benzalkonium chloride and povidone iodine.

U.S. Pat. No. 5,439,685 to Augros is directed to a composition of an agent active against microorganisms responsible for sexually transmitted diseases together with a film forming agent such as dimethylpolysiloxane, and benzalkonium chloride as a spermicidal.

U.S. Pat. No. 4,952,411 to Fox, Jr. et al., is directed to a composition of silver sulfadiazine, alone or in combination with chlorhexidine or sodium deoxycholate (antimicrobial and detergent).

U.S. Pat. No. 8,062,631 to Lichtblau is directed to protective formulations in preventing a broad range of STDs. The formulations include bezalkonium chloride, or another quaternary salt compound.

SUMMARY OF THE INVENTION

An object of this invention is to provide non-irritating protective formulations to be used as an adjunct in preventing the spread of viral type STDs. The products of the present invention can be formulated as a topical lotion, cream, solution, emulsion, or the like, and will be hereinafter referred to as creams The use of antimicrobial/antiviral active agents and film-forming excipients in the following formulations have demonstrated unique skin protective barrier properties with enhanced persistence that inhibit â€œskin to skinâ€ and â€œsore to soreâ€ transmission of viral pathogens linked to communicable diseases.

Skin protectant products are regulated under CFR 21 Part 347 â€œSkin Protectant Drug Products for Over the Counter Human Useâ€ . The official description of a skin protectant is â€œa drug product that temporarily protects injured or exposed skin or mucous membrane surfaces from harmful or annoying stimuli, and may help provide relief to such surfaces.â€ These regulations cover applicable ingredients, as well as labeling requirements for over the counter skin protectants. Active ingredients officially classified as skin protectants compositions as well as certain combinations of these compositions are listed in the CFR 21 Sec. 347.10, reproduced in Table 1 below. In accordance with the instant invention, the phrase â€œa skin protectant composition provided in a skin protecting effective concentrationâ€ will be understood to mean any of the following ingredients within their designated range of concentrations:

TABLE 1These include any of the following withinthe Concentration range specified:IngredientConcentrationAllantoin0.5 to 2.0%Aluminum hydroxide0.15 to 5.0%GelCalamine1.0 to 25.0%Cocoa Butter50.0 to 100.0%Cod liver oil5.0 to 13.56% (in accordance with Sec.347.20(a)(1) or (a)(2), provided the productis labeled so that the quantity used in a 24-hrperiod does not exceed 10,000 USP Units vitaminA and 400 USP Units cholecalciferol.Colloidal oatmeal0.007 minimum; 0.003 minimum in combinationwith mineral oil in accordance with Sec.347.20(a)(4).Dimethicone1.0 to 30.0%Glycerin20.0 to 45.0%Hard fat50.0 to 100.0%Kaolin4.0 to 20.0%Lanolin12.5 to 50.0%Mineral oil50.0 to 100.0%; 30.0 to 35.0% in combinationwith colloidal oatmeal in accordance withSec. 347.20(a)(4).Petrolatum30.0 to 100.0%Topical starch10.0 to 98.0%White petrolatum30.0 to 100.0%Zinc acetate0.1 to 2.0%Zinc carbonate0.2 to 2.0%Zinc oxide1.0 to 25.0%

It has been discovered that incorporation of at least one of the aforementioned skin protectants compositions listed in Table 1 in combination with other film forming excipients, in particular, film-forming emollients (e.g., Cetostearyl alcohol, Cetyl alcohol), silicone-containing excipients/skin protectants (e.g., polydimethylsiloxane derivatives of varying viscosities, utilized either singly or in combination, and marketed under names such as Dimethicone 20 and Dimethicone 12500), emulsifying aunts (e.g. selected from Cetearyl alcohol (a mixture of fatty alcohols, predominantly stearyl and cetyl alcohols, polyoxyethylene ethers of a mixture of high molecular mass saturated fatty acids (mainly cetyl alcohol and stearyl alcohol, having a number of ethylene oxide residues in the polyoxyethylene chain, e.g. 20, 12 or the like, and referred to as Ceteareth-20, Ceteareth-12, or the like, and/or mixtures thereof), humectants (e.g. glycerin and anhydrous lanolin) and chelating compounds (e.g. disodium edetate) in a formulation for topical application results in a product that temporarily protects injured or exposed skin or mucous membrane surfaces from harmful or annoying stimuli, thereby preventing cross-contamination of pathogenic microorganisms responsible for sexually transmitted diseases (e.g., Herpes simplex virus type 1 and type 2 (HSV-1, HSV-2), human immunodeficiency virus (HIV), or the like) through skin or mucous membrane surfaces. In addition to the hydrophobic, barrier-forming formulation, active agents that prevent bacterial or viral transmission are also included. The novel formulation products of this invention are persistent in that they form a film or barrier on healthy or even damaged skin.

The hydrophobic portions of the instant formulations utilize a combination of film-forming excipients, including skin protectant(s) listed in Table 1, silicones and silicone derivatives or like equivalents, and film-forming emollients. These ingredients are dispersed by the emulsifiers throughout the continuous aqueous phase. They liquify and spread over the skin as a result of exposure to body heat. This forms a physical hydrophobic layer which resides on the skin surface (including mucosal membranes) and provides a barrier which would inhibit penetration of liquids and pathogens which are primarily hydrophilic in nature. When used in combination with consistent and careful use of condoms, the products of the present invention help inhibit the spread of viral type STDs and protect the skin from contamination should the condom become damaged. The present invention provides a water-in-oil cream for the inhibition of the transmission of viral type sexually transmitted diseases, consisting essentially of, in combination:

- (1) Dimethicone 20, in the range of 10.0 to 20.0% wt/wt;
- (2) Dimethicone 12500, in the range of 3.0-10.0% wt/wt;
- (3) Zinc oxide, in the range of 1.0 to 8.0% wt/wt;
- (4) a mixture of Cetearyl alcohol and Ceteareth-20, in the range of 6.0 to 10.0% wt/wt;
- (5) Glycerin, in the range of 2.0 to 10.0% wt/wt;
- (6) Ceteareth-12, in the range of 0.5 to 3.0% wt/wt;
- (7) Disodium edetate, in the range of 0.01 to 0.1% wt/wt;
- (8) Anhydrous lanolin, in the range of 0.5 to 3.0% wt/wt;
- (9) Cetostearyl alcohol, in the range of 1.0 to 5.0% wt/wt;
- (10) Cetyl alcohol, in the range of 1.0 to 5.0% wt/wt; and
- (11) a sufficient quantity of deionized water to form the cream;
- wherein contact with the skin results in the in situ formation of a skin protective barrier layer.

The present invention provides a water-in-oil cream for the inhibition of the transmission of viral type sexually transmitted diseases, consisting essentially of, in combination:

- (1) Dimethicone 20, at about 15.0% wt/wt;
- (2) Dimethicone 12500, at about 5.0% wt/wt;
- (3) Zinc oxide, at about 2.0% wt/wt;
- (4) a mixture of Cetearyl alcohol and Ceteareth-20, at about 8.0% wt/wt;
- (5) Glycerin, at about 5.0% wt/wt;
- (6) Ceteareth-12, at about 1.0% wt/wt;
- (7) Disodium edetate, at about 0.05% wt/wt;
- (8) Anhydrous lanolin, at about 1.0% wt/wt;
- (9) Cetostearyl alcohol, at about 3.0% wt/wt;
- (10) Cetyl alcohol, at about 2.0% wt/wt; and
- (11) a sufficient quantity of deionized water to form the cream;
- wherein contact with the skin results in the in situ formation of a skin protective barrier layer.

The present invention provides a water-in-oil cream for the inhibition of the transmission of viral type sexually transmitted diseases, consisting essentially of, in combination:

- (1) Dimethicone 20, at about 15.0% wt/wt;
- (2) Dimethicone 12500, at about 5.0% wt/wt;
- (3) Zinc oxide, at about 5.0% wt/wt;
- (4) a mixture of Cetearyl alcohol and Ceteareth-20, at about 7.0% wt/wt;
- (5) Glycerin, at about 8.0% wt/wt;
- (6) Ceteareth-12, at about 1.0% wt/wt;
- (7) Disodium edetate, at about 0.05% wt/wt;
- (8) Anhydrous lanolin, at about 1.0% wt/wt;
- (9) Cetostearyl alcohol, at about 3.0% wt/wt;
- (10) Cetyl alcohol, at about 2.0% wt/wt; and
- (11) a sufficient quantity of deionized water to form the cream;
- wherein contact with the skin results in the in situ formation of a skin protective barrier layer.

The present invention provides a water-in-oil formulation for the inhibition of the transmission of viral type sexually transmitted diseases, consisting essentially of, in combination, the following ingredients in % w/w:

a water phase consisting of(1)Deionized Water (USP) in quantities sufficient todissolve ingredients 2-5;(2)Disodium Edetate0.01-0.1â€‚(3)Zinc Oxide1.0-8.0(4)Glycerin (USP)â€‚2.0-10.0and an oil phase consisting of(5)Dimethicone 2010.0-20.0(6)Dimethicone 12500â€‚3.0-10.0(7)Cetearyl Alcohol and/or Ceteareth-20â€‚6.0-10.0(8)Ceteareth-120.5-3.0(9)Anyhdrous Lanolin0.5-3.0(10)â€‚Cetostearyl Alchohol1.0-5.0(11)â€‚Cetyl Alcohol1.0-5.0

The present invention provides a process for forming an oil-in-water cream consisting essentially of:

a water phase consisting of(a)Deionized Water (USP) in quantities sufficient toincorporate therein ingredients b-e;(b)Disodium Edetate0.01-0.1â€‚(c)Zinc Oxide1.0-8.0(d)Glycerin (USP)â€‚2.0-10.0and an oil phase consisting of (in % w/w)(e)Dimethicone 2010.0-20.0(f)Dimethicone 12500â€‚3.0-10.0(g)Cetearyl Alcohol and/or Ceteareth-20â€‚6.0-10.0(h)Ceteareth-120.5-3.0(i)Anyhdrous Lanolin0.5-3.0(j)Cetostearyl Alchohol1.0-5.0(k)Cetyl Alcohol1.0-5.0

- wherein said water-in-oil cream is produced in accordance with the following steps:
  - 1. heating to 75Â° C. Dimethicone 20, Dimethicone 12500, Cetearyl Alcohol, Ceteareth-20, Ceteareth-12, Anhydrous Lanolin, Cetostearyl Alcohol and Cetyl Alcohol to allow the materials to melt;
  - 2. dissolving Disodium Edetate in the deionized water;
  - 3. Heating Step #2 to 75-78Â° C.;
  - 4. Dispersing the Zinc Oxide in the Glycerin to form a homogeneous dispersion;
  - 5. With high speed mixing, slowly adding the materials from Step #3 (Water phase) to the materials from Step #1 (Oil phase) and initiating cooling;
  - 6. When at 60Â° C.; adding the dispersion from Step #4 to the materials from Step #5;
  - 7. When at 50Â° C., reduce mixing speed;
  - 8. When at 40Â° C., further reduce the mixing speed;
  - 9. When at 25Â° C. stop mixing.

The invention provides a water-in-oil formulation for the inhibition of the transmission of viral type sexually transmitted diseases, consisting essentially of, in combination, the following ingredients in about the following %:

INGREDIENTSWT/WT %Dimethicone 20 (Dow Corning Q7-9120 Silicone Fluid 2015.03cSt).Dimethicone 12500 (Dow Corning Q7-9120 Silicone Fluid5.0112500 cSt).Zinc Oxide, USP2.00Cetearyl Alcohol & Ceteareth-20 (Emulgade 1000 NI,8.02Cognis)Glycerin, USP5.01Ceteareth-12 (Eumulgin B1, Cognis)1.00Edetate Disodium, USP0.05Anhydrous Lanolin, USP1.00Cetostearyl Alcohol, NF3.01Cetyl Alcohol, NF2.00Purified Water USP57.87

The cream or formulation may be packaged in single-use doses. The cream or formulation may be gamma sterilized. The cream may consist only of the listed ingredients.

Accordingly, it is an objective of the instant invention to provide various topical protective formulations to be used in preventing the spread of viral type STDs.

Another objective of the present invention is to provide formulations which are condom compatible, meaning that they are latex friendly and provide effective lubricity.

It is yet another objective of the instant invention to provide skin protective formulations wherein contact with the skin results in the formation of a hydrophobic skin protective surface layer.

It is yet another objective of the instant invention to provide skin protective formulations wherein contact with the skin results in the formation of a mechanical barrier skin protective surface layer.

It is yet another objective of the instant invention to provide skin protective formulations wherein contact with the skin results in the formation of a hydrophobic skin protective surface layer containing antiviral agents.

Yet another objective of the invention is to provide products formulated as a lotion, cream, solution, emulsion, or other topically applied product.

Other objects and advantages of this invention will become apparent from the following description, wherein are set forth, by way of illustration and example, certain embodiments of this invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Detailed embodiments of the instant invention are disclosed herein, however, it is to be understood that the disclosed embodiments are merely exemplary of the invention, which may be embodied in various forms. Therefore, specific functional and structural details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representation basis for teaching one skilled in the art to variously employ the present invention in virtually any appropriately detailed structure.

An embodiment of the present invention comprises a water phase and an oil phase.

The water phase may comprise deionized water, edetate disodium, zinc oxide and glycerin.

Zinc oxide is an inert, nontoxic chemical compound with the chemical formula of ZnO. Zinc Oxide can be used as a skin barrier. When applied to skin, Zinc Oxide acts as a mechanical barrier that physically excludes isolates and prevents the skin from any contact with harmful stimuli. Zinc Oxide is often used in creams or lotions and provides a continuous barrier which also helps prevent the loss of active ingredients due to friction and rubbing. Because of its inert, non-toxic characteristics and general non-solubility in water, it can be applied to skin as many times as may be needed. While zinc oxide is the preferred skin protectant composition of the present invention, other suitable skin protectant compositions and their amounts effective to provide skin protection as listed in Table 1 above could be used herein (e.g., Dimethicone).

Glycerin (INCI name: Glycerin) is a non-irritating humectant and film former. It is also water soluble. Moreover, glycerin is compatible with latex products and provides extended lubricity, which makes it a common base for many products designed for genital use.

The ingredients of the oil phase of a preferred embodiment will now be discussed.

Lanolin is a humectant isolated from wool-bearing animals such as sheep. It is a product of the sebaceous gland and consists mostly of a mixture of cholesterol and the esters of several fatty acids. It has many commercial uses, including within the medical and cosmetic industries.

The phase â€œfilm-forming emollientâ€ refers to any excipient suitable for cosmetic and pharmaceutical applications which forms a water-repelling film. According to a preferred, albeit non-limiting embodiment, the film-forming emollients are cetyl alcohol and cetostearyl alcohol. Cetyl alcohol (IUPAC name of 1-hexadecanol) is a member of the alcohol class of compounds. It is a solid organic compound and belongs to a group of fatty alcohols. In addition to its use as an emollient, it is often used in the cosmetic industry as a surfactant in shampoos, emulsifiers or thickening agents in the manufacture of skin creams and lotions. Cetostearyl alcohol is a blend of cetyl alcohol and stearyl alcohol, two fatty alcohols derived from vegetable sources.

The phase â€œsilicone-containing excipientâ€ refers to any silicone or silicone derivatives, including silicone-based skin protectants, suitable for cosmetic and pharmaceutical applications which acts as an emollient and forms a water-repelling film, including silicone oils. In addition to skin barriers, silicone and silicone oils are highly substantive on the skin. As a result of this property, silicon and silicone oils are often used in topical formulations, such as creams and lotions, to improve the substantivity of active ingredients on the skin.

After applying the topical formulations to the skin and removing volatile substances, the film formed as a result of using a silicone-containing excipient helps to maintain the active ingredient in close contact with the skin and prevents the loss of the active ingredient by abrasion. The ability to form hydrophobic films which can easily be applied and spread over skin accounts for high resistance to wash-off and rub-off. Use of silicones in topical formulations over petroleum-based products is more desirable because silicones do not exhibit the negative aesthetics of petroleum and, unlike petroleum, are known to be compatible with the materials used to manufacture condoms. According to one non-limiting embodiment, Dimethicone (preferably Dimethicone 20 cSt and Dimethicone 12500 cSt) is preferred. Dimethicone is a highly pure, non-volatile silicone fluid which is colorless and odorless. It can be used as a lubricant and emollient skin protectant.

Ceteareth-12 is part of a family with the INCI name of Ceteareth-n and refers to polyoxyethylene ethers of a mixture of high molecular mass saturated fatty alcohols. The â€œnâ€ indicates the average number of ethylene oxide residues in the polyoxyethylene chain. Ceteareth-12 is a non-toxic surfactant which is frequently used as an emulsifier in the cosmetic industry. The mixture of Cetearyl alcohol and Ceteareth-20 (EMULGADE 1000NI, Cognis Corporation) is a non-ionic, self-emulsifying base commonly used in the production of oil/water creams and lotions.

Disodium Edetate, having the chemical name of disodium (ethylene-dinitrilo) tetra-acetate dihydrate, is also commonly known as the disodium salt of EDTA. The chemical acts as a chelating compound by preventing ingredients from binding to trace elements that may be present.

Excipients and antimicrobial/antiviral ingredients useful in forming the skin protective creams, according to the present invention are described in the following non-limiting example.

EXAMPLE 1

In formulating a batch of a skin protective cream according to the invention, active ingredients and excipients useful in the manufacture of this product, a particularly effective product resulted when ingredients were utilized within the following approximate ranges:

ACTIVE INGREDIENTS/EXCIPIENTWT/WT % RANGESWater phase(1)Deionized WaterQ.S.(2)Edetate Disodium0.01-0.1â€‚(3)Zinc Oxide1.0-8.0(4)Glycerin (USP)â€‚2.0-10.0Oil phase(5)Dimethicone 2010.0-20.0(6)Dimethicone 12500â€‚3.0-10.0(7)Cetearyl Alcohol and/or Ceteareth-20â€‚6.0-10.0(8)Ceteareth-120.5-3.0(9)Anyhdrous Lanolin0.5-3.0(10)â€‚Cetostearyl Alchohol1.0-5.0(11)â€‚Cetyl Alcohol1.0-5.0

A preferred, albeit non-limiting procedure for manufacture of the formulation comprises the steps of:

Procedure:

1. Heat to 75Â° C.-Dimethicone 20.sup.-, Dimethicone 12500, Cetearyl Alcohol and Ceteareth-20 (available as EMULGADE 1000 NI from Cognis), Ceteareth-12 (available as (EUMULGIN B1 from Cognis), Anhydrous Lanolin, Cetostearyl alcohol and Cetyl alcohol. Allow the materials to melt.

2. Dissolve Disodium Edetate in the deionized water (USP).

3. Heat Step #2 to 75-78Â° C.

4. Disperse the Zinc Oxide in the Glycerin to form a homogeneous dispersion.

5. With high speed mixing, slowly add the materials from Step #3 (Water phase) to the materials from Step #1 (Oil phase). Initiate cooling.

6. When at 60Â° C.; add the dispersion from Step#4 to the materials from Step #5 (Emulsion).

7. When at 50Â° C., reduce mixing speed.

8. When at 40Â° C., further reduce the mixing speed.

9. When at 25Â° C. stop mixing.

While not wishing to be bound to any particular theory, it is believed that these film forming excipients and active ingredient form a neutral and hydrophobic layer barrier which is also believed to interact with the skin thereby having a stabilizing effect upon the hydrophobic layer, which results in the enhanced persistence of the product. The use of a silicone-containing skin protectant, e.g. Dimethicone 20 and Dimethicone 12500, or a like equivalent, acts in coordination with at least one of the skin protectants compositions as defined in CFR 21 Sec. 347.10, e.g. Zinc Oxide, or others from Table 1, excipients and the film-forming emollients, and melts when contacted with the heat of the body. This in turn forms a physical hydrophobic layer that provides a barrier which appears to inhibit penetration of liquids and sexually transmitted pathogens (viral, bacterial) which are primarily hydrophilic in nature. This property helps protect the user from contamination due to sexual contact with infected individuals.

EXAMPLE 2

A formulation was prepared with the following ingredients and wt/wt %:

INGREDIENTSWT/WT %Dimethicone 20 (Dow Corning Q7-9120 Silicone Fluid15.03006012020 cSt).Dimethicone 12500 (Dow Corning Q7-9120 Silicone5.010020040Fluid 12500 cSt).Zinc Oxide, USP2.004008016Cetearyl Alcohol & Ceteareth-20 (Emulgade 1000 NI,8.016032064Cognis)Glycerin, USP5.010020040Ceteareth-12 (Eumulgin B1, Cognis)1.002004008Edetate Disodium, USP0.050100200Anhydrous Lanolin, USP1.002004008Cetostearyl Alcohol, NF3.006012024Cetyl Alcohol, NF2.004008016Purified Water USP57.865731460

This formulation was evaluated for a barrier function against fluid and herpes simplex virus type 2 at a contact time of 30 minutes. Samples were taken and titrated by 50% tissue culture infectious close (TCIDSO) endpoint assay using Vero cells. The formulation was found to be an effective barrier.

The formulation may be packaged in individual dosages of up to 6.0 grams into foil squared pillow pack containers. The formulations, before or after packaging, may be gamma sterilized (mixture or individual packs) at radiation levels of 15.0 kGy to 30 kGy.

The embodiments of the present invention exclude and avoid the use of benzalkonium chloride or any other quaternary salt compound, which is used in the formulations in U.S. Pat. No. 8,062,631, and is effective in providing a barrier function and anti-viral activity.

It is to be understood that while a certain form of the invention is illustrated, it is not to be limited to the specific form or arrangement herein described and shown. It will be apparent to those skilled in the art that various changes may be made without departing from the scope of the invention and the invention is not to be considered limited to what is shown and described in the specification and drawings/figures.

All patents and publications mentioned in this specification are indicative of the levels of those skilled in the art to which the invention pertains. All patents and publications are herein incorporated by reference to the same extent as if each individual publication was specifically and individually indicated to be incorporated by reference. It is to be understood that while a certain form of the invention is illustrated, it is not to be limited to the specific form or arrangement herein described and shown. It will be apparent to those skilled in the art that various changes may be made without departing from the scope of the invention and the invention is not to be considered limited to what is shown and described in the specification. One skilled in the art will readily appreciate that the present invention is well adapted to carry out the objectives and obtain the ends and advantages mentioned, as well as those inherent therein. The excipients and related compounds described herein are presently representative of the preferred embodiments, are intended to be exemplary and are not intended as limitations on the scope. Changes therein and other uses will occur to those skilled in the art which are encompassed within the spirit of the invention and are defined by the scope of the appended claims Although the invention has been described in connection with specific preferred embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the invention which are obvious to those skilled in the art are intended to be within the scope of the following claims.