Medication Lubricants for Oral Delivery of Drugs: Oral Processing Reduces Thickness, Changes Characteristics, and Improves Dissolution Profile.

Swallowing oral solid dosage forms is challenging for those who have medication swallowing difficulties, including patients with dysphagia. One option is to mix the drug (whole or crushed) with a thick vehicle (medication lubricant). Previous in vitro studies consistently suggest that thick vehicles could impact the dissolution of solid dosage forms, potentially influencing their therapeutic effectiveness, but do not account for changes that happen during oral processing and swallowing.

The prevalence and perceived effectiveness of using a medication-swallowing lubricant in aged care facilities across Australia.

Objective: To explore the extent of use and perceived effectiveness of using a medication lubricant that is specifically designed to help people who struggle to swallow their solid medications whole.

Method: Health care workers of varying professional levels in aged care facilities (ACFs) across Australia who are involved in medication administration were invited to participate in a structured online survey.

Results: Of the 355 health care workers who completed the survey, 48% had used the medication lubricant to aid administration of whole and/or crushed solid oral dosage forms, and of these 89% agreed with the statement that "it is effective method to facilitate medication swallowing in residents.

Dysphagia management: Does structured training improve the validity and reliability of cervical auscultation?

: Cervical auscultation (CA) uses a stethoscope or microphone to complement the clinical swallow examination by interpreting swallowing sounds and swallow-respiratory coordination. This study investigated the effects of structured CA training on CA-rating agreement with Flexible Endoscopic Evaluation of Swallowing (FEES) and CA rater reliability.: Thirty-nine speech-language pathologists participated in a structured CA training course at Gothenburg University.

A Difficult Pill to Swallow: An Investigation of the Factors Associated with Medication Swallowing Difficulties.

Background: Many medications are available as solid oral dosage forms such as tablets and capsules; however, some people find these medications difficult to swallow.

Aim: To identify whether certain psychological, oral sensory, and oral motor characteristics contribute to medication swallowing difficulties.

Methods: A sample of healthy adults from two academic institutions in Brisbane were assessed for their experiences with swallowing solid oral dosage forms, food preferences, and food neophobia.

Are Medication Swallowing Lubricants Suitable for Use in Dysphagia? Consistency, Viscosity, Texture, and Application of the International Dysphagia Diet Standardization Initiative (IDDSI) Framework.

Medication lubricants are thick liquids or gels that are designed to aid swallowing of solid oral dosage forms. Tablets and capsules are placed within a spoonful of the product for swallowing. The aim of this study was to describe and compare commercially available medication lubricants in terms of textural suitability for patients with dysphagia.

Factors that affect health-care workers' practices of medication administration to aged care residents with swallowing difficulties: An Australia-wide survey study.

Objectives: To understand the barriers and facilitators of medication administration to aged care residents with swallowing difficulties.

Methods: Health-care workers in aged care facilities across Australia involved in medication administration to residents completed an online survey.

Results: Of 355 respondents, 90.

Appropriateness of oral dosage form modification for aged care residents: a video-recorded observational study.

Background Dosage forms of oral medications are frequently modified in aged care facilities by crushing/splitting tablets or opening capsules to facilitate medication administration for residents with swallowing difficulties. These practices pose safety concerns including the risk of adverse events resulting from loss of dose during transfer and alteration in the rate of absorption. Objective To identify the incidence, methods, and appropriateness of oral dosage form modification practices in aged care facilities.

The Importance of Extensional Rheology in Bolus Control during Swallowing.

Thickened fluids are commonly used in the medical management of individuals who suffer swallowing difficulty (known as dysphagia). Previous studies have shown that the rheological properties of a liquid affect the flow behavior of the bolus in swallowing, such as pharyngeal transit time. While there is no doubt that shear rheology is a highly important factor for bolus flow, it is suspected that extensional properties of a liquid bolus also plays an important role in swallowing, due to elongation of the bolus as it flows through the oropharynx.

Evaluating chewing function: Expanding the dysphagia field using food oral processing and the IDDSI framework.

The dysphagia field is still in relative infancy with a sophisticated knowledge base amassed since the early 1980's. The desire to identify aspiration and prevent life threatening pneumonia has resulted in a focus on the complexities of swallowing liquids. However, humans also ingest saliva, food, and oral medications, with the potential for these substances to incompletely clear the pharynx, be aspirated or block the airway.

Age-Related Changes to Eating and Swallowing Impact Frailty: Aspiration, Choking Risk, Modified Food Texture and Autonomy of Choice.

Reductions in muscle mass and strength are well known complications of advancing age. All muscles of the body are affected, including those critical to chewing and swallowing. A diagnosis of frailty and its features of weakness and unintentional weight loss are particularly relevant to the aging swallowing system.

A spoonful of sugar helps the medicine go down? A review of strategies for making pills easier to swallow.

Solid oral dosage forms such as tablets and capsules are generally the preferred method of drug delivery due to their convenience, cost, and acceptability. However, for many people, it can be a challenge to swallow solid oral medications, even those with healthy swallowing function. This review describes current strategies available to facilitate medication administration to otherwise healthy people with pill-swallowing difficulties.

Dosage form modification and oral drug delivery in older people.

Many people cannot swallow whole tablets and capsules. The cause ranges from difficulties overriding the natural instinct to chew solids/foodstuff before swallowing, to a complex disorder of swallowing function affecting the ability to manage all food and fluid intake. Older people can experience swallowing difficulties because of co-morbidities, age-related physiological changes, and polypharmacy.

In vitro lipolysis of dairy and soy based infant formula.

Hydrolysed and non-hydrolysed dairy and soy proteins with vegetable oils are commonly used in infant formulations. Lipid digestion of these infant formula emulsions was studied under an in vitro gastrointestinal condition for 60 min in the stomach and 120 min in the small intestine (with and without the presence of enzyme proteases). The distribution of oil droplets, the released free fatty acids, and micro-structure changes of the digesta were monitored over the digestion period.

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale.

Objective: To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient.

Design: Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel.

Nurse experiences of medication administration to people with swallowing difficulties living in aged care facilities: a systematic review of qualitative evidence.

Objective: To identify nurses' experiences of administering oral medications to residents of aged care facilities (ACFs) with swallowing difficulties.

Introduction: Administering medicines to older people with swallowing difficulties is a challenging task. Nurses frequently modify oral medications e.

Unlocking opportunities in food design for infants, children, and the elderly: Understanding milestones in chewing and swallowing across the lifespan for new innovations.

Unlabelled: Intake of a variety of foods increases the likelihood of good general health. From as early as life in utero, humans are exposed to flavor. Further flavor imprinting occurs via breast milk, increasing the likelihood of acceptance of a variety flavors when solids are introduced.

Nurses' experiences of medication administration to people with swallowing difficulties in aged care facilities: a systematic review protocol.

The objective of this review is to identify the experiences of nurses in administering oral medications to residents of aged care facilities with swallowing difficulties.More specifically, the review question is:What problems do nurses experience when administering oral medicines to people with swallowing difficulties living in aged care facilities?

Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework.

Dysphagia is estimated to affect ~8% of the world's population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures.

"A Day in the Life of the Fluid Bolus": An Introduction to Fluid Mechanics of the Oropharyngeal Phase of Swallowing with Particular Focus on Dysphagia.

By following the path of a liquid bolus, from the oral preparatory phase to the esophagus, we show that a few fundamental concepts of fluid mechanics can be used to better understand and assess the importance of bolus viscosity during human swallowing, especially when considering dysfunctional swallowing (dysphagia) and how it can be mitigated. In particular, we highlight the important distinction between different flow regimes (i.e.

In vitro digestion of infant formulations with hydrolysed and non-hydrolysed proteins from dairy and soybean.

Digestion of hydrolysed and non-hydrolysed dairy (casein and whey proteins) and soy proteins commonly used in infant formulations was studied under in vitro gastrointestinal (without lipases) conditions for 60 and 120 minutes in the stomach and small intestine, respectively. The pH-drop, gel electrophoresis, microstructure, particle size distribution, and ninhydrin-reactive amino nitrogen of the digesta were monitored over the digestion period. The obtained results suggested that hydrolysed proteins were completely digested in the small intestine, while non-hydrolysed proteins (caseins, α-lactalbumin, β-lactoglobulin, conglycinin, glycinin) were only partially digested in the simulated gastrointestinal tract.

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

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.