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The Metabolic Medicine Postoperative Bariatric Surgery Consultation
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Bariatric patients have a unique set of requirements in the immediate postoperative phase. They are generally nothing by mouth (NPO) and must avoid medications that can produce nausea and vomiting. Even if they are permitted clear liquids, solid pills may be difficult to ingest. Therefore, it is best to treat conditions such as hypertension, glucose control, infection and asthma with intravenous (IV), subcutaneous (SC), topical, sublingual, liquid and rectal suppository forms of medications. There is a small group of drugs that fit these categories for use in the postoperative bariatric setting.
Medicines management
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Kirsty Andrews, Martina O’Brien
There are two other forms of medicines, which, although taken into the mouth, are not swallowed: Sublingual medication. These are produced as sprays or tablets and are absorbed through the mucosa under the tongue. As the sublingual area is very vascular, absorption and effect of the drug occur rapidly.Buccal medication. These medicines are usually produced as tablets and are put on to the gum under the lip. Again, the effect of the drug is rapid.
More Complex Patients
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
Buprenorphine (see Chapter 4) is also commonly used as an OST, either as a sublingual tablet or mucoadhesive film, or more recently as subcutaneous or subdermal depot injection given at weekly, monthly, or even longer intervals (Rosenthal & Goradia, 2017). The sublingual preparations are now more commonly given in combination with naloxone rather than alone. Naloxone is poorly absorbed via the sublingual route, but if injected it will reverse the effects of the buprenorphine and precipitate withdrawal.
Development of canagliflozin nanocrystals sublingual tablets in the presence of sodium caprate permeability enhancer: formulation optimization, characterization, in-vitro, in silico, and in-vivo study
Published in Drug Delivery, 2023
Sammar Fathy Elhabal, Mohamed A El-Nabarawi, Nashwa Abdelaal, Mohamed Fathi Mohamed Elrefai, Shrouk A. Ghaffar, Mohamed Mansour Khalifa, Passant M. Mohie, Dania S. Waggas, Ahmed Mohsen Elsaid Hamdan, Samar Zuhair Alshawwa, Essa M. Saied, Nahla A. Elzohairy, Tayseer Elnawawy, Rania A. Gad, Nehal Elfar, Hanaa Mohammed, Mohammad Ahmad Khasawneh
Table 3 shows the composition of CFZ-NCs by direct compression is one of the most used techniques for the preparation of nanocrystal-based sublingual tablets as it requires less setup and has a wide range of industrial applications. Furthermore, neither water nor an organic solvent is needed to be added (Sammar et al., 2023a,b). However, it can be difficult to formulate sublingual tablets for a medication that possesses a low solubility in water because the medication needs to quickly dissolve in a tiny amount of saliva. In our study, the CFZ sublingual tablets were prepared using the lyophilized nanocrystal formula CFZ-NCs-32. In addition, Pharma burst-V® (85% D-mannitol, <10% silicon dioxide, <10% sorbitol, 5% crospovidone) served as a powerful disintegrant (Zhao et al., 2022). Under these conditions, the obtained Pharma burst tablets would endure transit, storage, and removal from the blister, as well as a fast oral dissolution, as CFZ has limited basic characteristics. Adding an acidic excipient could result in an acidic microenvironment around the tablet, increasing drug solubility. Therefore, the lubricant of choice in the CFZ sublingual pills was boric acid. Aside from being utilized as a lubricant, it may improve the drug’s water solubility and dissolution (Sherje et al., 2017).
Cationic nanocapsule suspension as an alternative to the sublingual delivery of nifedipine
Published in Pharmaceutical Development and Technology, 2023
Bárbara Felin Osmari, Giovana Aime Medeiros, Jéssica Brandão Reolon, Vinícius Costa Prado, Natália Brucker, Letícia Cruz
Over the years, nanotechnology has been gaining emphasis in the pharmaceutical field due to the ability of nanocarriers to increase drug physicochemical stability. In addition, nanostructured systems enable controlled drug release, improving effectiveness and reducing adverse effects (Apolinário et al. 2020; Deng et al. 2020). The literature has reported on the benefits of incorporation of NIFE in nanostructured systems due to its ability to improve bioavailability (Weerapol et al. 2015), control the release profile (Granada et al. 2013), increase half-life time (Bi et al. 2020), and improve the photostability of NIFE (Tagliari et al. 2015). Among such structures, polymeric nanocapsules are reservoir systems composed of an oily core wrapped in a polymeric wall (Mora-Huertas et al. 2010; Jain and Thareja 2019). Sublingual administration is attractive because the formulations have properties that increase contact time with the mucosa when considering that part of the drug may be swallowed due to salivary flow (Mazzarino et al. 2014; Parodi et al. 2017). In this study, Eudragit® RS100 was chosen as a polymer for the development of nanocapsules due to its mucoadhesive characteristics (Adibkia et al. 2011; Chaves et al. 2018).
Updated strategies for the management of poor medication adherence in patients with bipolar disorder
Published in Expert Review of Neurotherapeutics, 2023
Molly McVoy, Jennifer B. Levin
Regarding advances in medication formulations, the most frequently studied alternative to oral medications for BD patients is long acting injectable forms of antipsychotics. Some early research suggests adding LAIs as the first line for BD patients, while most guidelines continue to support their use once adherence problems have arisen. Complicated medication regimens continue to be associated with suboptimal adherence, but limited research exists on combination medication technology, an area ripe for future study. Sublingual forms of medication have been developed to aid those who have difficulty swallowing pills. Novel technologies that combine medication with a tracking device for adherence are in development in other areas of medicine, but have not yet been studied in BD. Finally, pilot work suggests that the uptake of LAIs could be enhanced by co-delivering efficacious psychosocial intervention elements, which target specific adherence barriers [82] but more rigorous studies in this area are needed.