Oro-mucosal Administration Flashcards by Anish Khakhria

What can mucosal delivery include?

oral
nasal
intestinal
vaginal
pulmonary
rectal
ocular
*

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Label the image

1 tongue

2 soft palate

3 hard palate

4 gums and teeth

5 lips

6 uvula

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What are the three types of stratified squamous epithelia in the mouth and where are they found?

Masticatory mucosa

keratinised
sustains mechanics of chewing
found in hard palate, gums

Lining mucosa

non-keratinised
less of a barrier to drug absorption
found in lips, cheeks, sublingual area, soft palate

Specialised mucosa

taste buds on tongue

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What does saliva contain?

water
electrolytes
glycoproteins
enzymes (amylases)
natural antimicrobials

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What are the 3 main glands producing saliva and where are they located?

sublingual
parotid (close to ears)
submandibular (lower jaw)

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What is the pH of the oral cavity and what enzymes are present?

6.2-7.4
amylases

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What are the roles of the oral cavity?

mastication
taste
deglutition

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What conditions are treated with oro-buccal administration for local effect? What are the considerations?

dry mouth
infection
irritation
pain
ulceration

Consider:

contact with site of action
residence time
organoleptic properties
- sugar content
- acidity

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What are the characterisitics of lozenges and considerations?

easy to administer
manufacture by compression or moulding
pH
sugar content
- sugar free alternatives
organolpetic properties

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Describe the properties of hard lozenges.

similar to hard candy
low moisture content (0.5-1.5%)
potentially high sugar content (55-65% sucrose)
prepared at high temp

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Describe the properties of soft lozenges.

bases
- PEG 1-1.45 Da
- fatty base
- gelatin
- glycerin
- sugar/acacia (50 degrees)
silica gel (suspending agent)
chewed or left to dissolve

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Describe the properties of chewable lozenges.

Composition
- glycerin and gelatin
- API
- colour
- flavour
caution in paediatric use - may be percieved as candy

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How do you treat mouth ulcers?

Can heal on their own but to help:

mouthwash (saling/antiseptic)
gels
sprays
soft lozenges

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What is xerostomia and what can it be a result from?

Dry mouth

ADR to
- anticholingernic drugs
- diuretics
- chemo or radiotherapy
medical condition eg
- sjogren syndrome
- nerve damage
- dehydration
others
- smoking
- breathing through mouth
- stress

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What does dry mouth increase the risk of?

dental and peridontal conditions

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How can xerostomia be treated?

adressing the underlying cause or using measures that increase salivation such as

lozenges
sprays
gels
soft lozenges

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How can you treat infection?

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hydrogen peroxide
chlorhexidine
antifungals
- nystatin suspension
- miconazole gel

How do you treat herpes labialis and what is it?

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cold sore

treat with topical treatment unless immunocompromised

creams
- antiviral
- disinfectants
patches
- non medicated helps with wound healing and provides a barrier effect

Where can products for systemic effect be absorbed from?

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sublingual compartment
bucal mucosa
labial mucosa (lining of lips)

What are barriers to absorption for products for systemic effect?

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physiological barriers
physiochemical barries
formulation barriers

What are advantages of products for systemic effect?

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quick onset of action (lack of FPM, direct absorption into bloodstream)
ease of administration
patient adherences (possiblility for sustained release)
neutral envrionment in oral cavity (lower metabolic activity, close to neutral pH)

What are disadvantages of products for systemic effect?

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unsuitable for irritant drugs (damage to mouth mucosae)
limit to dose administered
require adequate use by patient (possible restrictions on timing of eating/drinking)
difficulties in dose splitting
impact of saliva (drug wash out into saliva)

Summarise the surface area, pH, fluid volume and enzyme activity in different sections of the GIT.

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Small intestine has highest surface area
Stomach is most acidic pH 1-3
Fluic volume lowest in buccal but quick turnover of saliva
Largest enzyme activity in stomach and small intestine, least in rectum

Fill out the gaps.

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What are the drug properties to consider for buccal delivery?

* ionisation (pH 6.2-7.4) * solubility/permeability * absorption * dissolution rate * MW

What molecules are suitable for passing through thr paracellular pathway to blood?

Small, hydrophilic molecules

What increases permeability?

permeation enhancers

How does a oro-bucal solution work?

it must stay in contact with the lining mucosa (eg cheek) and is administered using the applicator provided eg midazolam

What are the benefits and limitations of medicated chewing gum?

* oral care * no water required * stress relief * organoleptic properties * variable release * production costs * similar issues as non-medicated gum

Describe oro dispersible formulations

* can be films or tablets * quick dissolution, no water required * some sre not meant for oromucosal absorption, patient may be expected to swallow drug after tablet or film has dissolved

What are advantages of orodisperible formulations?

* convenience * immediate release * ease of administration * can be suitable for patient with difficulty swallowing * less obtrusive than bucal tablets * improved bioavailability * provided it stays in contact with site

What are disadvantages of orodisperible formulations?

* difficult to split dose * very hygroscopic * organolpetic properties * fraction of drug may be swallowed

Describe compressed lozenges.

* produced through compression of a powder blend * high mechanical strength * low porosity * formulated using dextrates as diluent and without disintegrant * should not be chewed or swallowed whole * high inter and intra individual variability

How does cationic material work?

through electrostatic interactions with the negatively charged mucus layer

How does anionic and neutral material work?

through hydrophobic and/or hydrogen bond formation

What are the properties of mucoadhesive material?

* biocompatible * non-toxic * non-irritant * form strong bonds * produce quick adhesion * have no imcompatabilities * have good stability * be cost effective

What is non specific and specific adhesion to the mucosal surface?

Non-specific * electrostatic * hydrophobic * hydrogen bond Specific * carbohydrates * proteins

What are advantages of mucoadhesive tablets?

* slow dissolution * improved contact with site of absorption * increased residence time

What are disadvantages of mucoadhesive tablets?

* discomfort * can be irritant * can detach from mucosa * risk if it adheres to different mucosal surface

What are advantages of sublingual administration?

* rapid onset of action * ease of administration * extensive drug absorption * thin lining mucosa * can be used in emergencies * fast dissolution of dosage form * no need for water intake

What are disadvantages of sublingual administration?

* can interfer with drinking/eating * not used for sustained drug release * may be hard to use in unconcious patients * smoking may reduce absorption * size limit to ensure patient comfort

Oro-mucosal Administration Flashcards

(41 cards)