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With operations across Alginates (1170) Alginic Acid (1172) Cellulose Ethers (2150) Cellulose, Powdered (2158) Guar Gum (3466) Sodium Alginate (5530) Sodium CMC (5568) Starch (5724)Tableting Agents (5854) Thickening Agents (5934) Xanthan Gum (6282), Excipients for manufacturing Pharmaceutical and Personal Care formualtions. They count on honest reviews like yours. A list of sweeteners and the number of medicines containing each sweetener is shown in Table 1. Finestone HM, Foley NC, Woodbury GM, Greene-Finestone L: Quantifying fluid intake in dysphagic stroke patients: a preliminary comparison of oral and nonoral strategies. Yoon S-J, Chu D-C, Juneja LR: Physiological functions of partially hydrolysed guar gum. Thickener excipients are mainly used to improve and increase the viscosity of the drug mixture without affecting other characteristics, giving the drug a suitable mouthfeel and taste. Nutr Bull. J Texture Stud.
1997, 11: 139-148. (2004) suggests that signals from the small intestines may well have a role with thickened liquids, as satiety signals continue despite gastric emptying [39]. Water is a necessity for biochemical actions within and outside of cells. or continue reading here: by Eccles, R. What is the Role of Over 100 Excipients in Over the Counter (OTC) Cough Medicines?. Marciani L, Gowland PA, Spiller RC, Manoj P, Moore RJ, Young P, Fillery-Travis AJ: Effect of meal viscosity and nutrients on satiety, intragastric dilution, and emptying assessed by MRI. Jukes S, Cichero JAY, Haines T, Wilson C, Paul K, ORourke M: Evaluation of the uptake of the Australian standardized terminology and definitions for texture modified foods and fluids. hbbd``b`5@I The searchterm cough was used on the database in June 2020 and this generated data on 105 medicines used to treat cough. could be delivered to the patient as tablets or capsules without any loss of pharmacological activity, but because of the history of cough medicines being formulated from food substances such as honey, a sweet viscous syrup formulation is expected by the patient consumer [2]. The fibre content of thickeners may impact on feelings of satiety. If you have any requirements for excipients, please contact us by phone or email, and our colleagues will reply to you within 2-4 working days. 2012, 32: 150-152. 2005, 22 (1): 11-23. The sweetness is slow in onset and tends to linger.
2012, 11 (2): 513-521. In aged care skilled nursing facilities and hospitals where thickened liquids are made in bulk, large-scale industrial mixers are often used. Zijlstra N, Mars M, de Wijk RA, Westerterp-Plantenga MS, de Graaf C: The effect of viscosity on ad libitum food intake.
2006, 106 (7): 1049-1054. Dysphagia. Founded in 1971, Spectrum Chemicals & Laboratory Products, a division of Spectrum Chemical Mfg. World Population Ageing: 19502050. Thickened liquids are not a diet of choice, but one of safety, and have been used therapeutically to manage dysphagia for about 19years [10]. 10.1007/BF00630301. Polypeptide thickeners mainly include gelatin, sodium caseinate and cheese pastry, etc. 10.1093/ageing/afp100. 1984, 26: 279-281. Data pertaining to world population aging suggest that by the year 2050 one fifth of the population of the developed world will be over the age of 60yrs and that for the first time in history there will be more elders than young people [54]. This paper will review the literature for the impact of thickened liquids on hydration, medication bioavailability and physiologic feelings of satiety. Google Scholar. CAS Huupponen R, Seppala P, Iisalo E: Effect of guar, a fibre preparation on digoxin and penicillin absorption in man. They count on honest reviews like yours. Finestone HM, Greene-Finestone LS: Rehabilitation Medicine: 2. 10.1590/S1984-82502011000200011. This review searched the United Kingdom electronic medicines compendium (emc) and found over 100 excipients in 60 different liquid formulations of over the counter cough medicines. Two elements confound these results, however. Handbook of Pharmaceutical Excipients 9th Edition, https://doi.org/10.1007/s00408-020-00390-x, Pharmaceutical Excipients Some Definition, Inactive ingredient search for approved drug products in the USA, Partial Inverted Syrup (sucrose, fructose, and glucose). Glycerol was also listed as an active ingredient in 17 cough medicines and the SmPC often stated that Glycerol has demulcent properties and may possibly block sensory cough receptors in the respiratory tract. No evidence has been found in the literature to support glycerol acting on sensory cough receptors. 10.1208/s12249-009-9207-4. Oral ingestion is seen to be: more convenient, have high compliance, safety, efficiency, ease of accessibility and low production costs [30]. ExciPerience The great excipient event! 10.1001/archoto.2010.129. 2008, 31: 44-56. Pharmaceutical Manufacturing Resource Directory, Rate and Review Universal Preserv-A-Chem Inc, Rate and Review Spectrum Chemicals & Laboratory Products. Rolls BJ, Bell EA, Waugh BA: Increasing the volume of a food by incorporating air affects satiety in man. In Australia, people over 70years are expected to make up 20% of the population by 2051[2]. 10.1016/j.jada.2006.04.022. We can custom thickener excipients for customers, and we can also provide customers provide solutions for drug development research. 2022 - Pharma Excipients. Typically the least viscous liquid (akin to the thickness of nectar) is used for mild dysphagia, whilst increasingly thicker liquids are used to manage more severe forms of the condition. Starches such as modified corn starch swell, whilst gums cause meshes of entanglement that water molecules become lodged in [14]. Thickeners such as glycerol also provide a sweet taste, and others such as carrageenan can support antiviral and antibacterial claims. Springer Nature. When the added amount, working environment, compound combination, processing technology and other factors change, they also act as gelling agents, emulsifiers and film-forming agents. We'll email you as soon as it's published, (typically within 48 hours). We'll email you as soon as it's published, (typically within 48 hours). Lung (2020). Swallowing difficulty (dysphagia) has a prevalence of 13% in community dwelling elders, approximately 25% of hospitalized individuals and rises to 60% or more of elderly residents living in skilled nursing facilities [37]. Dehydration is a common concern for people with dysphagia [18, 19]. The food literature clearly demonstrates that increasing nutrient and caloric load slows gastric emptying [39, 40]. This effect holds true even for extremely thick fluids. 10.5172/conu.673.31.1.44. Corp., is a manufacturer and distributor of fine chemicals and laboratory products with quality and delivery you can count on every time.
0 However, this treatment modality is not without complications. 2011, 47 (2): 299-311. CAS This paper has demonstrated that although water is made bioavailable from all thickeners to even extreme levels of thickness, that individuals with dysphagia are frequently dehydrated. The prevalence of the use of thickened fluids has only been studied comprehensively for the aged care demographic. Download the full publication here: What is the Role of Over 100 Excipients in Over the Counter (OTC) Cough Medicines? As noted above, guar gum and xanthan gum tend to be broken down by the bacterial microflora of the colon. 2009, 90: 269-275. Dysphagia. However, absorption of penicillin (Class III) was found to be significantly reduced when mixed with guar gum at a concentration of 5gr to 200ml water [34]. In vivo studies of individuals with dysphagia are required to demonstrate the true effects of thickened liquids on medication bioavailability and satiety. spoon-thick or Extremely thick fluids Level 900) will struggle to meet hydration needs orally. PubMed found that partially hydrolysed guar gum did not affect mouthfeel, texture or satiety [45]. The studies used blood and saliva sampling. You can use your LinkedIn account to login to the Pharmaceutical Manufacturing Resource Directory. AAPS PharmSciTech. The physiological response to mouthful size and oral processing time inherently places individuals with dysphagia who require very thick liquids, at risk of dehydration. The stomach has a large epithelial surface, however, contents stay in the stomach for a relatively short period of time giving a short window for absorption. Cichero, J.A. Satiety relates to the state of being fed or gratified to, or beyond capacity. Thanks for submitting your review of FMC BioPolymer .
Dysphagia results from many conditions such as: stroke, Motor Neurone disease, Parkinsons disease, dementia, head and neck cancer, head injury and others. Garon BR, Engle M, Ormiston C: A randomised control study to determine the effects of unlimited oral intake of water in patients with identified aspiration. Active Pharmaceutical Ingredient Excipients, Solubility Improvement and Bioavailability Enhancement Services, Drug Formulation and Packaging Compatibility, Determination of Contact Angle of Pharmaceutical Excipients, Pharmaceutical Formulation Characterization Testing, Heavy Metal Testing Services in Pharmaceuticals, Cyclodextrin (-CD) Inclusion Complex Services, Self-emulsifying Drug Delivery System Services, Sealing Test of Pharmaceutical Packaging Materials, Detection of Fluorescent Whitening Agents in Pharmaceutical Packaging Materials, Packaging Design Services for Pharmaceuticals, Determination of Water Vapor Transmission Capacity of Pharmaceutical Packaging Materials, Headspace Gas Analysis for Pharmaceutical Packaging, Physical and Mechanical Properties Testing, Thermal Shrinkage Test of Pharmaceutical Packaging Materials. Propylene glycol was the second most commonly used thickening agent found in 20 of the cough medicines. Daily hydration target (1.7-2.0 litres) [17 ]and comparison volume of thin or thickened liquids consumed by individuals with dysphagia. Castellanos VH, Butler E, Gluch L, Burke B: Use of thickened liquids in skilled nursing facilities. We'll email you as soon as it's published, (typically within 48 hours). Arch Phys Med Rehabil. 2004, 104: 1222-1226. Stabilization refers to the thickener added to the drug mixture, which can make the mixture stable, not easy to change, and not easy to change the quality. A combination of poor flavour plus poor thirst quenching ability may begin to explain why patients consume less thickened liquids than un-thickened liquids. PubMed Clinicians should strive to prescribe only the least thickened liquid required for swallowing safety and aggressively pursue treatments to improve functional return to normal, un-thickened liquids. Given the aged population forecasts for the year 2050, improved dysphagia management should be a high priority. Has a masking effect on bad odors. Thanks for submitting your review of Vanderbilt Minerals, LLC. Glycerol and propylene glycol are unusual as a thickening agent as most thickening agents are synthetic long-chain polymer molecules such as hydroxyethylcellulose (Hyetellose, Natrosol), polyvinylpyrrolidone (Povidone), carboxymethylcellulose (Carmellose), and maltodextrin. 10.1007/s00455-009-9221-4. Article Age Ageing. Compared with the control condition, all aerated samples reduced the amount of food consumed immediately following by 12%. Although it is stated in the SmPC of 10 medicines that natural sugars can possibly block sensory cough receptors within the respiratory tract, no evidence has been found in the literature to support this mode of action. 10.1046/j.1365-277X.1997.00061.x. Neuromuscular impairment that results in delayed oral transit further compounds the effect of reduced intake. 
It has been hypothesised that textural qualities such as thickness provide cues as to the energy load within the drink. 2012, 1: 20-30. 1994, 9: 101-6. Am J Physiol- Gastr L. 2001, 280: G1227-1233. Thanks for submitting your review of BASF Catalysts LLC. In most medicines, the excipients play a supportive role in delivering the medicine, but in the case of cough medicines, excipients have more important and complex roles and they can also be the main active ingredient of the cough medicine. Thanks for submitting your review of BASF Corporation. Flavour suppression and off flavours of thickened liquids have been reported by Matta et al. The stomach selectively empties more dilute material whilst continuing to work on the more solid-like material. There appear to be only two studies that have specifically investigated the bioavailability of water when mixed with thickening agents, used for dysphagia treatment. 1998, 22: 906-909. J Pharm Sci. Although viscosity impedes drug dissolution and disintegration, a further complication presents in the form of electrical charge associated with the thickener and the way it interacts with the solution. 10.1007/s11095-004-9004-4. According to the ionic properties of thickeners, they can also be divided into two categories, namely ionic thickeners, such as alginic acid, sodium carboxymethyl cellulose and starch, etc. Cookies policy. Consequently, concern has been raised about the waterbinding capacity of gums, and their potential contribution to inadequacies of hydration in individuals with dysphagia.
Reach this audience by promoting your company in this directory. Pretorius E, Bouic PJD: Permeation of four oral drugs through human intestinal mucosa. The list of excipients in the summary of product characteristics (SmPC) for each of the 60 cough medicines was searched and a list of all excipients and their frequency of occurrence was made. Thanks for submitting your review of BASF Catalysts LLC. demonstrated that water bioavailability was unaffected by water thickened with xanthan gum to pudding-thick level (mean 0.970.06 standard error) [23]. The thickener molecules contain many hydrophilic groups, such as hydroxyl, carboxyl, amino and carboxylate, which can hydrate with water molecules. hypothesised that one of the reasons why insufficient thick liquids are consumed is due to thickened liquids triggering gastric stretch receptors to satiety more so than thin liquids [14]. We'll email you as soon as it's published, (typically within 48 hours). High-resolution colour-coded images acquired through echoplanar magnetic resonance imaging shows that the same process occurs with locust bean gum and alginate thickened substances [39, 40]. Thanks for submitting your review of Vanderbilt Minerals, LLC. We will email you information to reset your password. Google Scholar. 2001, 82: 1744-1746.
JC has been an educational speaker for the Nestl Nutrition Institute and Wyeth. Whelan K: Inadequate fluid intakes in dysphagic acute stroke. Most medicines are white bitter powders that are formulated as tablets and capsules but cough medicines are an exception where the taste and appearance of the medicine are more important to the patient than the pharmacology of the active ingredient. National Research Council of the National Academies: Ageing and the Macroeconomy: Long-term implications of an older population. Sharpe et al. 1998, Texas: Pro-ed, Inc., 2. The active ingredients such as the antitussive dextromethorphan or expectorant guaifenesin, etc. 2005, 13 (3): 537-544. study suggests that aeration must be kept to minimum to reduce feelings of satiety in individuals with dysphagia [42]. The small intestines provide for fast absorption and a large surface area. Clinical recommendations to take small amounts of thickened fluids may result in less being consumed. Contemp Nurse. 10.1053/apmr.2001.27379. Kayser-Jones K, Pengilly K: Dysphagia among nursing home residents. However, liquids thickened with guar gum did not show phase separation, resulting in a homogenous gastric mass [39]. Malitol can be used as a low calorie sweetener and it has the advantage that it does not crystallize easily and therefore is less likely than natural sugars to cause bottle tops to stick. Privacy The time taken for medication to transit the small intestines will affect absorption rate and hence bioavailability of the drug. During oral manipulation and swallowing, liquid flow is turbulent, resulting in eddies and vortices [8]. Rolls ET, Verhagen JV, Kadohisa M: Representations of the texture of food in the primate orbitofrontal cortex: Neurons responding to viscosity, grittiness and capsaicin. J Nutr. Their role in most medicines is to act as a stable vehicle for the delivery of the active ingredient in the form of a tablet, capsule, cream, or liquid. Dysphagia. 75% of individuals in long-term care have been reported to be dehydrated when relying on thickened liquids for oral hydration [20]. inulin) did not have a satiating effect, even at high doses [46]. McGrail A, Kelchner LN: Adequate oral fluid intake in hospitalised stroke patients: Does viscosity matter?. Medications have preferred absorptive sites to maximise their effect. Robertson HM, Patillo MS: A strategy for providing food to the patient with neurologically based dysphagia. PubMed Liquid-access issues will contribute to reduce daily intake and, are largely remediable. Clin Nutr. 10.1038/jp.2011.105. Thickened liquids are used as one form of management for dysphagia.
Incorporated air has also been used to increase volume whilst keeping energy density, taste, and macronutrient contents the same [42]. Google Scholar. The information on cough medicines has been taken from the electronic medicines compendium (emc) [3] which contains freely available information about medicines licensed for use in the United Kingdom and lists over 14,000 documents. There is a great advantage in using food and beverage additives as excipients in cough medicines as they are generally recognized as safe (GRAS) by regulatory authorities and this makes the registration of new formulations of cough medicines much easier for companies marketing cough medicines.
Administration of medication with thickened liquids needs careful consideration and consultation with a pharmacist. Hill et al. JLiF ` H: Thickened liquids are often used in the management of dysphagia to improve bolus control and to help prevent aspiration. [16]. Leibovitz A, Baumoehl Y, Lubart E, Yaina A, Platinovitz N, Segal R: Dehydration among long-term care elderly patients with oropharyngeal dysphagia.
2012, 11 (2): 513-521. In aged care skilled nursing facilities and hospitals where thickened liquids are made in bulk, large-scale industrial mixers are often used. Zijlstra N, Mars M, de Wijk RA, Westerterp-Plantenga MS, de Graaf C: The effect of viscosity on ad libitum food intake.
2006, 106 (7): 1049-1054. Dysphagia. Founded in 1971, Spectrum Chemicals & Laboratory Products, a division of Spectrum Chemical Mfg. World Population Ageing: 19502050. Thickened liquids are not a diet of choice, but one of safety, and have been used therapeutically to manage dysphagia for about 19years [10]. 10.1007/BF00630301. Polypeptide thickeners mainly include gelatin, sodium caseinate and cheese pastry, etc. 10.1093/ageing/afp100. 1984, 26: 279-281. Data pertaining to world population aging suggest that by the year 2050 one fifth of the population of the developed world will be over the age of 60yrs and that for the first time in history there will be more elders than young people [54]. This paper will review the literature for the impact of thickened liquids on hydration, medication bioavailability and physiologic feelings of satiety. Google Scholar. CAS Huupponen R, Seppala P, Iisalo E: Effect of guar, a fibre preparation on digoxin and penicillin absorption in man. They count on honest reviews like yours. Finestone HM, Greene-Finestone LS: Rehabilitation Medicine: 2. 10.1590/S1984-82502011000200011. This review searched the United Kingdom electronic medicines compendium (emc) and found over 100 excipients in 60 different liquid formulations of over the counter cough medicines. Two elements confound these results, however. Handbook of Pharmaceutical Excipients 9th Edition, https://doi.org/10.1007/s00408-020-00390-x, Pharmaceutical Excipients Some Definition, Inactive ingredient search for approved drug products in the USA, Partial Inverted Syrup (sucrose, fructose, and glucose). Glycerol was also listed as an active ingredient in 17 cough medicines and the SmPC often stated that Glycerol has demulcent properties and may possibly block sensory cough receptors in the respiratory tract. No evidence has been found in the literature to support glycerol acting on sensory cough receptors. 10.1208/s12249-009-9207-4. Oral ingestion is seen to be: more convenient, have high compliance, safety, efficiency, ease of accessibility and low production costs [30]. ExciPerience The great excipient event! 10.1001/archoto.2010.129. 2008, 31: 44-56. Pharmaceutical Manufacturing Resource Directory, Rate and Review Universal Preserv-A-Chem Inc, Rate and Review Spectrum Chemicals & Laboratory Products. Rolls BJ, Bell EA, Waugh BA: Increasing the volume of a food by incorporating air affects satiety in man. In Australia, people over 70years are expected to make up 20% of the population by 2051[2]. 10.1016/j.jada.2006.04.022. We can custom thickener excipients for customers, and we can also provide customers provide solutions for drug development research. 2022 - Pharma Excipients. Typically the least viscous liquid (akin to the thickness of nectar) is used for mild dysphagia, whilst increasingly thicker liquids are used to manage more severe forms of the condition. Starches such as modified corn starch swell, whilst gums cause meshes of entanglement that water molecules become lodged in [14]. Thickeners such as glycerol also provide a sweet taste, and others such as carrageenan can support antiviral and antibacterial claims. Springer Nature. When the added amount, working environment, compound combination, processing technology and other factors change, they also act as gelling agents, emulsifiers and film-forming agents. We'll email you as soon as it's published, (typically within 48 hours). We'll email you as soon as it's published, (typically within 48 hours). Lung (2020). Swallowing difficulty (dysphagia) has a prevalence of 13% in community dwelling elders, approximately 25% of hospitalized individuals and rises to 60% or more of elderly residents living in skilled nursing facilities [37]. Dehydration is a common concern for people with dysphagia [18, 19]. The food literature clearly demonstrates that increasing nutrient and caloric load slows gastric emptying [39, 40]. This effect holds true even for extremely thick fluids. 10.5172/conu.673.31.1.44. Corp., is a manufacturer and distributor of fine chemicals and laboratory products with quality and delivery you can count on every time.
0 However, this treatment modality is not without complications. 2011, 47 (2): 299-311. CAS This paper has demonstrated that although water is made bioavailable from all thickeners to even extreme levels of thickness, that individuals with dysphagia are frequently dehydrated. The prevalence of the use of thickened fluids has only been studied comprehensively for the aged care demographic. Download the full publication here: What is the Role of Over 100 Excipients in Over the Counter (OTC) Cough Medicines? As noted above, guar gum and xanthan gum tend to be broken down by the bacterial microflora of the colon. 2009, 90: 269-275. Dysphagia. However, absorption of penicillin (Class III) was found to be significantly reduced when mixed with guar gum at a concentration of 5gr to 200ml water [34]. In vivo studies of individuals with dysphagia are required to demonstrate the true effects of thickened liquids on medication bioavailability and satiety. spoon-thick or Extremely thick fluids Level 900) will struggle to meet hydration needs orally. PubMed found that partially hydrolysed guar gum did not affect mouthfeel, texture or satiety [45]. The studies used blood and saliva sampling. You can use your LinkedIn account to login to the Pharmaceutical Manufacturing Resource Directory. AAPS PharmSciTech. The physiological response to mouthful size and oral processing time inherently places individuals with dysphagia who require very thick liquids, at risk of dehydration. The stomach has a large epithelial surface, however, contents stay in the stomach for a relatively short period of time giving a short window for absorption. Cichero, J.A. Satiety relates to the state of being fed or gratified to, or beyond capacity. Thanks for submitting your review of FMC BioPolymer .
Dysphagia results from many conditions such as: stroke, Motor Neurone disease, Parkinsons disease, dementia, head and neck cancer, head injury and others. Garon BR, Engle M, Ormiston C: A randomised control study to determine the effects of unlimited oral intake of water in patients with identified aspiration. Active Pharmaceutical Ingredient Excipients, Solubility Improvement and Bioavailability Enhancement Services, Drug Formulation and Packaging Compatibility, Determination of Contact Angle of Pharmaceutical Excipients, Pharmaceutical Formulation Characterization Testing, Heavy Metal Testing Services in Pharmaceuticals, Cyclodextrin (-CD) Inclusion Complex Services, Self-emulsifying Drug Delivery System Services, Sealing Test of Pharmaceutical Packaging Materials, Detection of Fluorescent Whitening Agents in Pharmaceutical Packaging Materials, Packaging Design Services for Pharmaceuticals, Determination of Water Vapor Transmission Capacity of Pharmaceutical Packaging Materials, Headspace Gas Analysis for Pharmaceutical Packaging, Physical and Mechanical Properties Testing, Thermal Shrinkage Test of Pharmaceutical Packaging Materials. Propylene glycol was the second most commonly used thickening agent found in 20 of the cough medicines. Daily hydration target (1.7-2.0 litres) [17 ]and comparison volume of thin or thickened liquids consumed by individuals with dysphagia. Castellanos VH, Butler E, Gluch L, Burke B: Use of thickened liquids in skilled nursing facilities. We'll email you as soon as it's published, (typically within 48 hours). Arch Phys Med Rehabil. 2004, 104: 1222-1226. Stabilization refers to the thickener added to the drug mixture, which can make the mixture stable, not easy to change, and not easy to change the quality. A combination of poor flavour plus poor thirst quenching ability may begin to explain why patients consume less thickened liquids than un-thickened liquids. PubMed Clinicians should strive to prescribe only the least thickened liquid required for swallowing safety and aggressively pursue treatments to improve functional return to normal, un-thickened liquids. Given the aged population forecasts for the year 2050, improved dysphagia management should be a high priority. Has a masking effect on bad odors. Thanks for submitting your review of Vanderbilt Minerals, LLC. Glycerol and propylene glycol are unusual as a thickening agent as most thickening agents are synthetic long-chain polymer molecules such as hydroxyethylcellulose (Hyetellose, Natrosol), polyvinylpyrrolidone (Povidone), carboxymethylcellulose (Carmellose), and maltodextrin. 10.1007/s00455-009-9221-4. Article Age Ageing. Compared with the control condition, all aerated samples reduced the amount of food consumed immediately following by 12%. Although it is stated in the SmPC of 10 medicines that natural sugars can possibly block sensory cough receptors within the respiratory tract, no evidence has been found in the literature to support this mode of action. 10.1046/j.1365-277X.1997.00061.x. Neuromuscular impairment that results in delayed oral transit further compounds the effect of reduced intake. It has been hypothesised that textural qualities such as thickness provide cues as to the energy load within the drink. 2012, 1: 20-30. 1994, 9: 101-6. Am J Physiol- Gastr L. 2001, 280: G1227-1233. Thanks for submitting your review of BASF Catalysts LLC. In most medicines, the excipients play a supportive role in delivering the medicine, but in the case of cough medicines, excipients have more important and complex roles and they can also be the main active ingredient of the cough medicine. Thanks for submitting your review of BASF Corporation. Flavour suppression and off flavours of thickened liquids have been reported by Matta et al. The stomach selectively empties more dilute material whilst continuing to work on the more solid-like material. There appear to be only two studies that have specifically investigated the bioavailability of water when mixed with thickening agents, used for dysphagia treatment. 1998, 22: 906-909. J Pharm Sci. Although viscosity impedes drug dissolution and disintegration, a further complication presents in the form of electrical charge associated with the thickener and the way it interacts with the solution. 10.1007/s11095-004-9004-4. According to the ionic properties of thickeners, they can also be divided into two categories, namely ionic thickeners, such as alginic acid, sodium carboxymethyl cellulose and starch, etc. Cookies policy. Consequently, concern has been raised about the waterbinding capacity of gums, and their potential contribution to inadequacies of hydration in individuals with dysphagia. Reach this audience by promoting your company in this directory. Pretorius E, Bouic PJD: Permeation of four oral drugs through human intestinal mucosa. The list of excipients in the summary of product characteristics (SmPC) for each of the 60 cough medicines was searched and a list of all excipients and their frequency of occurrence was made. Thanks for submitting your review of BASF Catalysts LLC. demonstrated that water bioavailability was unaffected by water thickened with xanthan gum to pudding-thick level (mean 0.970.06 standard error) [23]. The thickener molecules contain many hydrophilic groups, such as hydroxyl, carboxyl, amino and carboxylate, which can hydrate with water molecules. hypothesised that one of the reasons why insufficient thick liquids are consumed is due to thickened liquids triggering gastric stretch receptors to satiety more so than thin liquids [14]. We'll email you as soon as it's published, (typically within 48 hours). High-resolution colour-coded images acquired through echoplanar magnetic resonance imaging shows that the same process occurs with locust bean gum and alginate thickened substances [39, 40]. Thanks for submitting your review of Vanderbilt Minerals, LLC. We will email you information to reset your password. Google Scholar. 2001, 82: 1744-1746.
JC has been an educational speaker for the Nestl Nutrition Institute and Wyeth. Whelan K: Inadequate fluid intakes in dysphagic acute stroke. Most medicines are white bitter powders that are formulated as tablets and capsules but cough medicines are an exception where the taste and appearance of the medicine are more important to the patient than the pharmacology of the active ingredient. National Research Council of the National Academies: Ageing and the Macroeconomy: Long-term implications of an older population. Sharpe et al. 1998, Texas: Pro-ed, Inc., 2. The active ingredients such as the antitussive dextromethorphan or expectorant guaifenesin, etc. 2005, 13 (3): 537-544. study suggests that aeration must be kept to minimum to reduce feelings of satiety in individuals with dysphagia [42]. The small intestines provide for fast absorption and a large surface area. Clinical recommendations to take small amounts of thickened fluids may result in less being consumed. Contemp Nurse. 10.1053/apmr.2001.27379. Kayser-Jones K, Pengilly K: Dysphagia among nursing home residents. However, liquids thickened with guar gum did not show phase separation, resulting in a homogenous gastric mass [39]. Malitol can be used as a low calorie sweetener and it has the advantage that it does not crystallize easily and therefore is less likely than natural sugars to cause bottle tops to stick. Privacy The time taken for medication to transit the small intestines will affect absorption rate and hence bioavailability of the drug. During oral manipulation and swallowing, liquid flow is turbulent, resulting in eddies and vortices [8]. Rolls ET, Verhagen JV, Kadohisa M: Representations of the texture of food in the primate orbitofrontal cortex: Neurons responding to viscosity, grittiness and capsaicin. J Nutr. Their role in most medicines is to act as a stable vehicle for the delivery of the active ingredient in the form of a tablet, capsule, cream, or liquid. Dysphagia. 75% of individuals in long-term care have been reported to be dehydrated when relying on thickened liquids for oral hydration [20]. inulin) did not have a satiating effect, even at high doses [46]. McGrail A, Kelchner LN: Adequate oral fluid intake in hospitalised stroke patients: Does viscosity matter?. Medications have preferred absorptive sites to maximise their effect. Robertson HM, Patillo MS: A strategy for providing food to the patient with neurologically based dysphagia. PubMed Liquid-access issues will contribute to reduce daily intake and, are largely remediable. Clin Nutr. 10.1038/jp.2011.105. Thickened liquids are used as one form of management for dysphagia.
Incorporated air has also been used to increase volume whilst keeping energy density, taste, and macronutrient contents the same [42]. Google Scholar. The information on cough medicines has been taken from the electronic medicines compendium (emc) [3] which contains freely available information about medicines licensed for use in the United Kingdom and lists over 14,000 documents. There is a great advantage in using food and beverage additives as excipients in cough medicines as they are generally recognized as safe (GRAS) by regulatory authorities and this makes the registration of new formulations of cough medicines much easier for companies marketing cough medicines.
Administration of medication with thickened liquids needs careful consideration and consultation with a pharmacist. Hill et al. JLiF ` H: Thickened liquids are often used in the management of dysphagia to improve bolus control and to help prevent aspiration. [16]. Leibovitz A, Baumoehl Y, Lubart E, Yaina A, Platinovitz N, Segal R: Dehydration among long-term care elderly patients with oropharyngeal dysphagia.