Understanding Normal and Abnormal Swallowing: Patient Safety Considerations for the Perianesthetic Nurse

Orodispersible Films-Current State of the Art, Limitations, Advances and Future Perspectives

Orodispersible Films (ODFs) are drug delivery systems manufactured with a wide range of methods on a big scale or for customized medicines and small-scale pharmacy. Both ODFs and their fabrication methods have certain limitations. Many pharmaceutical companies and academic research centers across the world cooperate in order to cope with these issues and also to find new formulations for a wide array of APIs what could make their work profitable for them and beneficial for patients as well. The number of pending patent applications and granted patents with their innovative approaches makes the progress in the manufacturing of ODFs unquestionable. The number of commercially available ODFs is still growing. However, some of them were discontinued and are no longer available on the markets. This review aims to summarize currently marketed ODFs and those withdrawn from sale and also provides an insight into recently published studies concerning orodispersible films, emphasizing of utilized APIs. The work also highlights the attempts of scientific communities to overcome ODF's manufacturing methods limitations.

Development and Evaluation of Amorphous Oral Thin Films Using Solvent-Free Processes: Comparison between 3D Printing and Hot-Melt Extrusion Technologies

Conventional oral dosage forms may not always be optimal especially for those patients suffering from dysphasia or difficulty swallowing. Development of suitable oral thin films (OTFs), therefore, can be an excellent alternative to conventional dosage forms for these patient groups. Hence, the main objective of the current investigation is to develop oral thin film (OTF) formulations using novel solvent-free approaches, including additive manufacturing (AM), hot-melt extrusion, and melt casting. AM, popularly recognized as 3D printing, has been widely utilized for on-demand and personalized formulation development in the pharmaceutical industry. Additionally, in general active pharmaceutical ingredients (APIs) are dissolved or dispersed in polymeric matrices to form amorphous solid dispersions (ASDs). In this study, acetaminophen (APAP) was selected as the model drug, and Klucel™ hydroxypropyl cellulose (HPC) E5 and Soluplus^® were used as carrier matrices to form the OTFs. Amorphous OTFs were successfully manufactured by hot-melt extrusion and 3D printing technologies followed by comprehensive studies on the physico-chemical properties of the drug and developed OTFs. Advanced physico-chemical characterizations revealed the presence of amorphous drug in both HME and 3D printed films whereas some crystalline traces were visible in solvent and melt cast films. Moreover, advanced surface analysis conducted by Raman mapping confirmed a more homogenous distribution of amorphous drugs in 3D printed films compared to those prepared by other methods. A series of mathematical models were also used to describe drug release mechanisms from the developed OTFs. Moreover, the in vitro dissolution studies of the 3D printed films demonstrated an improved drug release performance compared to the melt cast or extruded films. This study suggested that HME combined with 3D printing can potentially improve the physical properties of formulations and produce OTFs with preferred qualities such as faster dissolution rate of drugs.

Recent advances of oral film as platform for drug delivery

Orally drug delivery film has received extensive interest duo to a distinct set of its advantageous properties compared to the traditional orally administered dosages, including faster rate of drug absorption, higher bioavailability and better patient compliance for children and elders with swallowing deficiencies. In particular, its potential capacity of delivering proteins and peptides has further attracted great attention. Lately, tremendous advances have been made in designing and developing both novel mucoadhesive films and orodispersible films to fulfill specific accomplishments of drug delivery. This review aims to summarize those newly developed oral films, discussing their formulation strategies, manufacturing methods as well as advantages and limitations thereof. Conclusions and future perspectives are also provided in brief.

Effect of Thermal Processing on Flow Properties and Stability of Thickened Fluid Matrices Formulated by Tapioca Starch, Hydroxyl Distarch Phosphate (E-1442), and Xanthan Gum Associating Dysphagia-Friendly Potential

The flow behavior of the administrated fluid matrices demands careful assessments for stability when consumed by individuals with dysphagia. In the present study, we incorporated tapioca starch (TS), hydroxypropyl distarch phosphate (HDP), and xanthan gum (XG) as thickeners into different nectars (300 ± 20 mPa.s) undergoing thermal processing and evaluated their stability. The thickened nectars presented better water holding and oil binding capacities at 25 °C than 4 °C, and the nectars with TS provided the best results for both capacities as well as the highest solubility index and swelling power (p < 0.05). All prepared nectars appeared to be shear-thinning fluids with yield stress closely fitting the power law and Casson models. XG-containing nectars presented a higher yield stress and consistency index. Matrices thickened by HDP exhibited a higher viscoelastic property compared to those thickened by TS during thermal processing. TS nectars presented viscous behavior, whereas HDP and XG nectars presented elastic behavior at 80 °C processing. The 3 min thermal processing HDP nectars remained stable and met dysphagia-friendly requirements under 4 °C storage for 28 days, regardless of the type of fluid base (distilled water, sport drink, or orange juice). The employed thickeners present adequate physicochemical properties to be potentially utilized for producing dysphagia-friendly formulations.