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Kang YJ, Arafa HM, Yoo JY, Kantarcigil C, Kim JT, Jeong H, Yoo S, Oh S, Kim J, Wu C, Tzavelis A, Wu Y, Kwon K, Winograd J, Xu S, Martin-Harris B, Rogers JA. Soft skin-interfaced mechano-acoustic sensors for real-time monitoring and patient feedback on respiratory and swallowing biomechanics. NPJ Digit Med 2022; 5:147. [PMID: 36123384 PMCID: PMC9485153 DOI: 10.1038/s41746-022-00691-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/31/2022] [Indexed: 02/05/2023] Open
Abstract
Swallowing is a complex neuromuscular activity regulated by the autonomic nervous system. Millions of adults suffer from dysphagia (impaired or difficulty swallowing), including patients with neurological disorders, head and neck cancer, gastrointestinal diseases, and respiratory disorders. Therapeutic treatments for dysphagia include interventions by speech-language pathologists designed to improve the physiology of the swallowing mechanism by training patients to initiate swallows with sufficient frequency and during the expiratory phase of the breathing cycle. These therapeutic treatments require bulky, expensive equipment to synchronously record swallows and respirations, confined to use in clinical settings. This paper introduces a wireless, wearable technology that enables continuous, mechanoacoustic tracking of respiratory activities and swallows through movements and vibratory processes monitored at the skin surface. Validation studies in healthy adults (n = 67) and patients with dysphagia (n = 4) establish measurement equivalency to existing clinical standard equipment. Additional studies using a differential mode of operation reveal similar performance even during routine daily activities and vigorous exercise. A graphical user interface with real-time data analytics and a separate, optional wireless module support both visual and haptic forms of feedback to facilitate the treatment of patients with dysphagia.
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Affiliation(s)
- Youn J Kang
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- Department of Ocean System Engineering, Jeju National University, Jeju, Republic of Korea
| | - Hany M Arafa
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Jae-Young Yoo
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Cagla Kantarcigil
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Jin-Tae Kim
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Hyoyoung Jeong
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Seonggwang Yoo
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Seyong Oh
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Joohee Kim
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Changsheng Wu
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- Department of Materials Science and Engineering, National University of Singapore, Singapore, 117575, Singapore
- Institute for Health Innovation and Technology, National University of Singapore, Singapore, 117599, Singapore
| | - Andreas Tzavelis
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Yunyun Wu
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Kyeongha Kwon
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Joshua Winograd
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Shuai Xu
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bonnie Martin-Harris
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.
- Department of Otolaryngology-Head and Neck Surgery and Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - John A Rogers
- Querrey-Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.
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Bhidayasiri R, Phuenpathom W, Tan AH, Leta V, Phumphid S, Chaudhuri KR, Pal PK. Management of dysphagia and gastroparesis in Parkinson’s disease in real-world clinical practice – Balancing pharmacological and non-pharmacological approaches. Front Aging Neurosci 2022; 14:979826. [PMID: 36034128 PMCID: PMC9403060 DOI: 10.3389/fnagi.2022.979826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/18/2022] [Indexed: 12/23/2022] Open
Abstract
Gastrointestinal (GI) issues are commonly experienced by patients with Parkinson’s disease (PD). Those that affect the lower GI tract, such as constipation, are the most frequently reported GI problems among patients with PD. Upper GI issues, such as swallowing dysfunction (dysphagia) and delayed gastric emptying (gastroparesis), are also common in PD but are less well recognized by both patients and clinicians and, therefore, often overlooked. These GI issues may also be perceived by the healthcare team as less of a priority than management of PD motor symptoms. However, if left untreated, both dysphagia and gastroparesis can have a significant impact on the quality of life of patients with PD and on the effectiveness on oral PD medications, with negative consequences for motor control. Holistic management of PD should therefore include timely and effective management of upper GI issues by utilizing both non-pharmacological and pharmacological approaches. This dual approach is key as many pharmacological strategies have limited efficacy in this setting, so non-pharmacological approaches are often the best option. Although a multidisciplinary approach to the management of GI issues in PD is ideal, resource constraints may mean this is not always feasible. In ‘real-world’ practice, neurologists and PD care teams often need to make initial assessments and treatment or referral recommendations for their patients with PD who are experiencing these problems. To provide guidance in these cases, this article reviews the published evidence for diagnostic and therapeutic management of dysphagia and gastroparesis, including recommendations for timely and appropriate referral to GI specialists when needed and guidance on the development of an effective management plan.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Academy of Science, Royal Society of Thailand, Bangkok, Thailand
- *Correspondence: Roongroj Bhidayasiri,
| | - Warongporn Phuenpathom
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Valentina Leta
- Department of Basic and Clinical Neurosciences, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, Parkinson’s Foundation Centre of Excellence, King’s College London, London, United Kingdom
| | - Saisamorn Phumphid
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - K. Ray Chaudhuri
- Department of Basic and Clinical Neurosciences, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, Parkinson’s Foundation Centre of Excellence, King’s College London, London, United Kingdom
| | - Pramod Kumar Pal
- National Institute of Mental Health and Neurosciences, Bengaluru, India
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Correlation between Forced Vital Capacity and the Severity of Frailty-Induced Dysphagia. J Clin Med 2022; 11:jcm11071962. [PMID: 35407570 PMCID: PMC8999658 DOI: 10.3390/jcm11071962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/21/2022] [Accepted: 03/29/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction: Frailty syndrome is a complex condition characterized by the gradual deterioration of an individual’s physical, mental, and social functions. Dysphagia is a dysfunction triggered by frailty. However, in patients with frailty syndrome, dysphagia is often undermined, and a proper evaluation is not performed. Therefore, we tried to identify the factors that can provide proper information regarding dysphagia in the frail population. Methods: Patients with dysphagia were divided into those with frailty-induced dysphagia and those with brain-lesion-induced dysphagia. Factors related to the participants’ pulmonary function test (PFT) results were evaluated. The severity of dysphagia was evaluated by determining modified videofluoroscopic dysphagia scale (mVDS) and penetration−aspiration scale (PAS) scores based on videofluoroscopic swallowing studies. Statistical analysis was performed to determine the correlation between PFT results and the parameters indicating dysphagia severity. Results: Multivariate logistic regression analysis revealed that forced vital capacity (FVC) was significantly correlated with mVDS scores in frailty-induced dysphagia (p < 0.05). However, no such significance was detected in brain-lesion-induced dysphagia (p ≥ 0.05). Conclusion: FVC was correlated with the severity of dysphagia (mVDS scores) in patients with frailty-induced dysphagia. Thus, serial FVC-based follow-up can be helpful for understanding patients’ dysphagia status. However, studies with a general population of patients with frailty-induced dysphagia are needed for definite generalization.
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Suzuki T, Tsujimura T, Magara J, Hao N, Shiraishi N, Maekawa K, Matsushima K, Inoue M. Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia. Dysphagia 2021; 37:558-566. [PMID: 33929585 DOI: 10.1007/s00455-021-10306-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/20/2021] [Indexed: 11/24/2022]
Abstract
The factors affecting the survival of patients with aspiration pneumonia (AP) remain unclear. This study aimed to determine whether factors, including oral status, swallowing function, and oral intake level, were related to survival outcomes in older patients hospitalized for AP. The study enrolled patients with AP who were admitted to our hospital between February 2017 and November 2019. Patients were divided into two groups based on the 90-day mortality after the first swallowing function evaluation: survivors and deceased. The data were compared between the two groups. A total of 29 patients were diagnosed with AP. Of these patients, 13 died within 90 days. The numbers of patients who could not use removable dentures and required sputum suctioning and had cough reflex at rest were significantly higher in the deceased than in the survivors. The salivary pooling and pharyngeal clearance scores evaluated by videoendoscopy, International Dysphagia Diet Standardisation Initiative Functional Diet Scale score determined after swallowing function evaluation, and consciousness level were significantly worse in the deceased than in the survivors. There were significant differences in patients' oral status, swallowing function, oral intake level, and consciousness level between the survivors and deceased.
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Affiliation(s)
- Taku Suzuki
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan. .,Minamiuonuma City Hospital, 2643-1 Muika-machi, Minamiuonuma-shi, Niigata, 949-6680, Japan. .,Minamiuonuma City Yukiguni Yamato Hospital, 4115 Urasa, Minamiuonuma-shi, Niigata, 949-7302, Japan.
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Naohito Hao
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.,Minamiuonuma City Yukiguni Yamato Hospital, 4115 Urasa, Minamiuonuma-shi, Niigata, 949-7302, Japan
| | - Naru Shiraishi
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.,Minamiuonuma City Yukiguni Yamato Hospital, 4115 Urasa, Minamiuonuma-shi, Niigata, 949-7302, Japan.,Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai-shi, Miyagi, 980-8575, Japan
| | - Kazuya Maekawa
- Minamiuonuma City Yukiguni Yamato Hospital, 4115 Urasa, Minamiuonuma-shi, Niigata, 949-7302, Japan.,Niigata Minami Hospital, 2007-6 Toyano, Chuo-ku, Niigata, 950-8601, Japan
| | - Kazuo Matsushima
- Minamiuonuma City Yukiguni Yamato Hospital, 4115 Urasa, Minamiuonuma-shi, Niigata, 949-7302, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
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Kurosu A, Pratt SR, Palmer C, Shaiman S. Investigation of Embodied Language Processing on Command-Swallow Performance in Healthy Participants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:75-90. [PMID: 33332180 PMCID: PMC8608157 DOI: 10.1044/2020_jslhr-20-00048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Purpose During videofluoroscopic examination of swallowing, patients commonly are instructed to hold a bolus in their mouth until they hear a verbal instruction to swallow, which usually consists of the word swallow and is commonly referred to as the command swallow condition. The language-induced motor facilitation theory suggests that linguistic processes associated with the verbal command to swallow should facilitate the voluntary component of swallowing. As such, the purpose of the study was to examine the linguistic influences of the verbal command on swallowing. Method Twenty healthy young adult participants held a 5-ml liquid bolus in their mouth and swallowed the bolus after hearing one of five acoustic stimuli presented randomly: congruent action word (swallow), incongruent action word (cough), congruent pseudoword (spallow), incongruent pseudoword (pough), and nonverbal stimulus (1000-Hz pure tone). Suprahyoid muscle activity during swallowing was measured via surface electromyography (sEMG). Results The onset and peak sEMG latencies following the congruent action word swallow were shorter than latencies following the pure tone and pseudowords but were not different from the incongruent action word. The lack of difference between swallow and cough did not negate the positive impact of real words on timing. In contrast to expectations, sEMG activity duration and rise time were longer following the word swallow than the pure tone and pseudowords but were not different from cough. No differences were observed for peak suprahyoid muscle activity amplitude and fall times. Conclusions Language facilitation was observed in swallowing. The clinical utility of the information obtained in the study may depend on the purposes for using the command swallow and the type of patient being assessed. However, linguistic processing under the command swallow condition may alter swallow behaviors and suggests that linguistic inducement could be useful as a compensatory technique for patients with difficulty initiating oropharyngeal swallows.
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Affiliation(s)
- Atsuko Kurosu
- University of Pittsburgh, PA
- University of Wisconsin–Madison
| | - Sheila R. Pratt
- University of Pittsburgh, PA
- VA Pittsburgh Healthcare System, PA
| | - Catherine Palmer
- University of Pittsburgh, PA
- University of Pittsburgh Medical Center, PA
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Papadopoulou SL, Ploumis A, Exarchakos G, Theodorou SJ, Beris A, Fotopoulos AD. Versatility of Repetitive Transcranial Magnetic Stimulation in the Treatment of Poststroke Dysphagia. J Neurosci Rural Pract 2019; 9:391-396. [PMID: 30069097 PMCID: PMC6050778 DOI: 10.4103/jnrp.jnrp_68_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Various techniques and courses of treatment have been researched, proposed, and implemented to evaluate and treat poststroke dysphagia (PSD) which is one of the main medical conditions affecting not only elderly people, as previously assumed, but also in recent years younger populations as well. The effectiveness of therapeutic methods depends mainly on the expertise of an interdisciplinary team of therapists, as well as on the timely application of the treatment. The present review discusses the therapeutic benefits of repetitive transcranial magnetic stimulation (rTMS) in patients suffering from PSD regardless of the location of the lesion. The use of rTMS directly manipulates cortical brain stimulation to restore neuroplasticity in the affected brain areas. This review presents a synopsis of the available literature on the patient along with a discussion on the effectiveness of rTMS as a safe and easy to use promising technique in the rehabilitation of dysphagic patients. Although the results from the studies so far have been largely positive in that direction, the question still remains whether larger scale and longitudinal studies will be able to corroborate the aspiring future of rTMS. Therefore, research questions to advance further investigation on the application and future of this technique are much in need.
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Affiliation(s)
- Soultana L Papadopoulou
- Department of Orthopedic Surgery, University of Ioannina Medical School, University Hospital of Ioannina, Greece
| | - Avraam Ploumis
- Department of Physical Medicine and Rehabilitation, University of Ioannina Medical School, University Hospital of Ioannina, Greece
| | - G Exarchakos
- Department of Otorhinolaryngology, University of Ioannina Medical School, University Hospital of Ioannina, Greece
| | - S J Theodorou
- Department of Radiology, University of Ioannina Medical School, University Hospital of Ioannina, Greece
| | - A Beris
- Department of Orthopedic Surgery, University of Ioannina Medical School, University Hospital of Ioannina, Greece
| | - A D Fotopoulos
- Department of Nuclear Medicine, University of Ioannina Medical School, University Hospital of Ioannina, Greece
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Ploumis A, Papadopoulou SL, Theodorou SJ, Exarchakos G, Givissis P, Beris A. Cervical isometric exercises improve dysphagia and cervical spine malalignment following stroke with hemiparesis: a randomized controlled trial. Eur J Phys Rehabil Med 2019; 54:845-852. [PMID: 30626863 DOI: 10.23736/s1973-9087.17.04952-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hemiparesis following stroke can cause cervical spine scoliosis, kyphosis or hyperlordosis. These abnormal cervical alignments can contribute to dysphagia. The benefit of cervical isometric exercises to improve swallowing has not been previously studied. AIM To evaluate the use of cervical isometric exercises in dysphagic adult patients with cervical spine alignment disorders due to hemiparesis after stroke. DESIGN A randomized controlled trial. SETTING University Hospital, PMR Department. POPULATION Dysphagic adult patients with hemiparesis after stroke in the rehabilitation phase. METHODS In addition to the standard physical and speech therapy therapeutic approach for 12 weeks, cervical isometric exercises were conducted by a group of patients (experimental group). Patients had cervical spine radiographs in erect (sitting or standing) position coronal and sagittal C2-C7 Cobb angle and a videofluoroscopic swallowing study to evaluate deglutition (0=normal, 1=penetration, 2=aspiration) at 2 time points (at the beginning and at the end of the therapeutic program). RESULTS Seventy consecutive patients with hemiparesis of a mean (SD) age of 52±15 years were included in the study and were randomized in 2 groups. Thirty-seven of them (experimental group) conducted cervical isometric exercises in addition to their therapeutic program. At the last follow-up, patients had improved (P<0.001) cervical alignment, in both coronal and sagittal plane, and deglutition. Patients who conducted cervical isometric exercises (experimental group) had more pronounced correction (P<0.001) of cervical alignment in both planes and achieved greater improvement (P<0.05) of deglutition too, than patients who did not conduct such exercises (control group). CONCLUSIONS Dysphagic adult patients with hemiparesis after stroke in the rehabilitation phase who underwent cervical isometric strengthening exercises showed more significant correction of cervical alignment and more pronounced improvement in deglutition compared to patients who did not include cervical isometric exercises in their therapeutic program. CLINICAL REHABILITATION IMPACT The additional use of cervical isometric exercises in hemiparetic stroke patients with dysphagic symptoms lead to more pronounced improvement of their swallowing function compared to such patients who are subjected to speech therapy only. Furthermore, these exercises are shown to be beneficial for cervical spine alignment too.
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Affiliation(s)
- Avraam Ploumis
- Department of Orthopedics and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece -
| | - Soultana L Papadopoulou
- Department of Orthopedics and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
| | - Stavroula J Theodorou
- Department of Orthopedics and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
| | - George Exarchakos
- Department of Orthopedics and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
| | - Panagiotis Givissis
- Department of Orthopedics and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
| | - Alexander Beris
- Department of Orthopedics and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
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Tomita T, Goto H, Sumiya K, Yoshida T, Tanaka K, Kohda Y. Effects of Food Thickeners on the Inhibitory Effect of Voglibose Oral-disintegrating Tablets on Post-prandial Elevation of Blood Sugar Levels. YAKUGAKU ZASSHI 2016; 136:1171-6. [PMID: 27477734 DOI: 10.1248/yakushi.15-00272] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to examine the effects of food thickeners on the pharmacodynamics of voglibose, an α-glucosidase inhibitor. The pharmacodynamics of voglibose were examined in an open-label study in 9 healthy participants after the ingestion of a single oral dose of a voglibose oral-disintegrating tablet, with and without food thickener immersion. The area under the incremental blood sugar concentration-time curve was larger and the rate of increments in the blood sugar concentration was higher with the voglibose oral-disintegrating tablets immersed in the food thickener than with the tablets that were not immersed. Immersing the voglibose oral-disintegrating tablets in the food thickener possibly delayed their disintegration rate. This suggests that commercially available food thickeners may be associated with changes in the disintegration of voglibose oral-disintegrating tablets and should therefore be used carefully in certain clinical situations.
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Tomita T, Goto H, Yoshimura Y, Tsubouchi Y, Nakanishi R, Kojima C, Yoneshima M, Yoshida T, Tanaka K, Sumiya K, Kohda Y. [Effect of food thickener on disintegration and dissolution of magnesium oxide tablets]. YAKUGAKU ZASSHI 2015; 135:835-40. [PMID: 26028419 DOI: 10.1248/yakushi.15-00021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It has been reported that magnesium oxide tablets are excreted in a non-disintegrated state in the stool of patients when the tablets are administered after being immersed in a food thickener. Therefore we examined whether immersion in a food thickener affects the pharmacological effect in patients taking magnesium oxide tablets, and whether immersion affects its disintegration and solubility. The mean dosage (1705 mg/d) was higher for patients who took tablets after immersion in a food thickener than for those who took non-immersed tablets (1380 mg/d). The disintegration time and dissolution rate of the immersed tablets were lower than those of non-immersed tablets in vitro. Furthermore, components that constitute the food thickener and differences in composition concentrations differentially affect the disintegration and solubility of magnesium oxide tablets. This suggests that commercially available food thickeners are likely to be associated with changes in the degradation of magnesium oxide tablets, and they therefore should be carefully used in certain clinical situations.
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