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Granulation and Production Approaches of Orally Disintegrating Tablets
Published in Dilip M. Parikh, Handbook of Pharmaceutical Granulation Technology, 2021
Tansel Comoglu, Fatemeh Bahadori
The application of a dosage form in the mouth without using water intensifies the bad taste of the drug molecule. Successful masking of the bitter taste of the drug must be achieved to accomplish patient compliance. Flavors and sweeteners are the main excipients used in this order. Flavor oils, fruit essences, and aromatic oils are the most commonly used flavoring agents. Sweeteners, on the other hand, play multiple roles in ODT formulations. Sugar-based sweeteners are hydrophilic materials with bulking property and provide fast disintegrating while masking the drug taste. Artificial sweeteners like aspartame and sugars derivatives, and bulking agents like dextrose, fructose, isomalt, lactilol, maltitol, maltose, mannitol, sorbitol, starch hydrolysate, polydextrose, and xylitol are applied for these purposes.
The administration of medicines to children
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Sucrose is a common and useful sweetener used to disguise poor taste. It can cause dental caries in long term use if dental hygiene is poor [7–9]. Aspartame is commonly used as an alternative but is a source of phenylalanine unsuitable for some patients with phenylketonuria [10]. Sorbitol and mannitol may induce diarrhoea in large amounts [11] whilst lactose (a common bulking agent) may not be tolerated in lactase deficiency, for example following severe gastroenteritis.
Peripheral Mechanisms of Mammalian Sweet Taste
Published in Robert H. Cagan, Neural Mechanisms in Taste, 2020
William Jakinovich, Dorothy Sugarman
In a structure-activity study using the gerbils’s whole nerve response, Jakinovich9 found that turanose and palatinose, two disaccharides which closely resemble sucrose, are not as potent stimuli as sucrose (Figure 1, Table 2). Even though these two compounds contain the same monosaccharides as sucrose (glucose and fructose) with alpha glycosidic linkages, the linkage carbons of the fructose molecules are different, thus allowing the fructose moiety to mutarotate. Among the glucopyranosides tested, those with the alpha linkage, such as maltose and maltitol, are more potent stimuli than those with the beta linkage, such as cellobiose and cellobiitol. On the other hand, galactopyranosides with the beta linkage, such as lactose and lactitol, are more potent to the gerbil than melibiose and melibiitol, which contain the alpha linkage. In human psychophysical investigations, Moskowitz21 and Lee30 reported maltose to be sweeter than cellobiose and lactose to be sweeter than melibiose, suggesting that humans and gerbils have the same structure-activity requirements for these disaccharides.
Recommendations for the management of diarrhea with trofinetide use in Rett syndrome
Published in Expert Opinion on Orphan Drugs, 2023
Eric D. Marsh, Arthur Beisang, Timothy Buie, Timothy A. Benke, Brian Gaucher, Kathleen J. Motil
Excipients in both the trofinetide and placebo formulations used in the LAVENDER trial were water, maltitol, strawberry flavor, sucralose, methylparaben sodium, propylparaben sodium, and FD&C Red #40. While sugar alcohols such as maltitol (and sorbitol, a metabolite of maltitol) are known to have a laxative effect [15], identical amounts of maltitol were used in the preparations of trofinetide and placebo in the LAVENDER trial. The composition of the gut microbiome influences the ability to metabolize sugar alcohols [17], and the gut microbiome may be altered in individuals with RTT relative to healthy controls [16,18], so the gut microbiome may play a role in the susceptibility to developing diarrhea with the use of trofinetide. Further, the use of certain classes of antibiotics, such as aminopenicillins and aminoglycosides, was shown to shift the composition of the gut microbiome and increase sugar alcohol–induced diarrhea in mice [17], so the benefit of the use of these medications should be assessed in individuals with RTT who will be treated with trofinetide. In addition, macrolide antibiotics such as erythromycin are often used to increase gastric motility in individuals with RTT, but these may also cause antibiotic-associated diarrhea [38].
COVID-19: quarantine, isolation, and lifestyle diseases
Published in Archives of Physiology and Biochemistry, 2023
Heena Rehman, Md Iftekhar Ahmad
The glycaemic response of the body directly depends on the amount of carbohydrate consumed. The recommended carbohydrate depends on the metabolic needs of a person, the type of medication, insulin, and individual preferences. For better management of diabetes, foods with added sugars and refined grains should be limited (American Diabetes Association 2019). Glycaemic control can be improved by choosing foods with a low glycaemic index. Lower glycaemic foods and whole grains, and minimally processed foods have a low glycaemic index. Sugar alcohols such as maltitol and sorbitol can be used as sugar substitutes. Fifty grams of fibre per day has been shown to improve glycaemic control (American Diabetes Association 2013). The Mediterranean diet containing unsaturated fats helps in controlling sugar levels. A higher intake of protein (28–40% of total kcal) has been shown to improve glycaemic control (Layman and Baum 2004).
Colesevelam – a bile acid sequestrant for treating hypercholesterolemia and improving hyperglycemia
Published in Expert Opinion on Pharmacotherapy, 2022
Oluwayemisi Esan, Adie Viljoen, Anthony S. Wierzbicki
Colesevelam is available as a 625 mg tablet formulation, a powder for oral suspension (3.75 g single dose for mixing with water) and a chewable formulation which are all bioequivalent. The latest chewable formulation is flavored but also contains maltitol which may affect its tolerability [26]. Food intake increases the release of BAs, so administration of colesevelam with meals and liquid is advised. The recommended starting doses are 2–3 tablets taken with meals either in monotherapy or in combination therapy. Caution applies to concurrent therapies which are hydrophobic and have a narrow therapeutic index, and these need to be administered at least 4 hours before colesevelam [24–26]. Colesevelam is licensed in children aged over 11 years in some countries. Caution is advised on its use in pregnancy or in women who are breast-feeding.