Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics

Manrique, Yady J., Sparkes, Arron M., Cichero, Julie A.Y., Stokes, Jason R., Nissen, Lisa M. and Steadman, Kathryn J. (2016) Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics. Drug Development and Industrial Pharmacy, 42 9: 1537-1544. doi:10.3109/03639045.2016.1151033


Author Manrique, Yady J.
Sparkes, Arron M.
Cichero, Julie A.Y.
Stokes, Jason R.
Nissen, Lisa M.
Steadman, Kathryn J.
Title Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics
Journal name Drug Development and Industrial Pharmacy   Check publisher's open access policy
ISSN 1520-5762
0363-9045
Publication date 2016
Sub-type Article (original research)
DOI 10.3109/03639045.2016.1151033
Volume 42
Issue 9
Start page 1537
End page 1544
Total pages 8
Place of publication Philadelphia, United States
Publisher Taylor and Francis
Collection year 2017
Language eng
Formatted abstract
Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12–50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.
Keyword Rheology
Acetaminophen
Dissolution
Dysphagia
Viscosity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Chemical Engineering Publications
HERDC Pre-Audit
School of Pharmacy Publications
 
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