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SoM 2 sim > Oro-mucosal Administration > Flashcards

Oro-mucosal Administration Flashcards

1
Q

What can mucosal delivery include?

A
  • oral
  • nasal
  • intestinal
  • vaginal
  • pulmonary
  • rectal
  • ocular
    *
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2
Q

Label the image

A

1 tongue

2 soft palate

3 hard palate

4 gums and teeth

5 lips

6 uvula

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3
Q

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

A

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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4
Q

What does saliva contain?

A
  • water
  • electrolytes
  • glycoproteins
  • enzymes (amylases)
  • natural antimicrobials
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5
Q

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

A
  • sublingual
  • parotid (close to ears)
  • submandibular (lower jaw)
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6
Q

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

A
  • 6.2-7.4
  • amylases
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7
Q

What are the roles of the oral cavity?

A
  • mastication
  • taste
  • deglutition
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8
Q

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

A
  • dry mouth
  • infection
  • irritation
  • pain
  • ulceration

Consider:

  • contact with site of action
  • residence time
  • organoleptic properties
    • sugar content
    • acidity
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9
Q

What are the characterisitics of lozenges and considerations?

A
  • easy to administer
  • manufacture by compression or moulding
  • pH
  • sugar content
    • sugar free alternatives
  • organolpetic properties
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10
Q

Describe the properties of hard lozenges.

A
  • 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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11
Q

Describe the properties of soft lozenges.

A
  • 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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12
Q

Describe the properties of chewable lozenges.

A
  • Composition
    • glycerin and gelatin
    • API
    • colour
    • flavour
  • caution in paediatric use - may be percieved as candy
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13
Q

How do you treat mouth ulcers?

A

Can heal on their own but to help:

  • mouthwash (saling/antiseptic)
  • gels
  • sprays
  • soft lozenges
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14
Q

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

A

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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15
Q

What does dry mouth increase the risk of?

A

dental and peridontal conditions

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16
Q

How can xerostomia be treated?

A

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

  • lozenges
  • sprays
  • gels
  • soft lozenges
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17
Q

How can you treat infection?

A
  • hydrogen peroxide
  • chlorhexidine
  • antifungals
    • nystatin suspension
    • miconazole gel
18
Q

How do you treat herpes labialis and what is it?

A

cold sore

treat with topical treatment unless immunocompromised

  • creams
    • antiviral
    • disinfectants
  • patches
    • non medicated helps with wound healing and provides a barrier effect
19
Q

Where can products for systemic effect be absorbed from?

A
  • sublingual compartment
  • bucal mucosa
  • labial mucosa (lining of lips)
20
Q

What are barriers to absorption for products for systemic effect?

A
  • physiological barriers
  • physiochemical barries
  • formulation barriers
21
Q

What are advantages of products for systemic effect?

A
  • 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)
22
Q

What are disadvantages of products for systemic effect?

A
  • 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)
23
Q

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

A
  • 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
24
Q

Fill out the gaps.

A
25
Q

What are the drug properties to consider for buccal delivery?

A
  • ionisation (pH 6.2-7.4)
  • solubility/permeability
    • absorption
    • dissolution rate
  • MW
26
Q

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

A

Small, hydrophilic molecules

27
Q

What increases permeability?

A

permeation enhancers

28
Q

How does a oro-bucal solution work?

A

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

eg midazolam

29
Q

What are the benefits and limitations of medicated chewing gum?

A
  • oral care
  • no water required
  • stress relief
  • organoleptic properties
  • variable release
  • production costs
  • similar issues as non-medicated gum
30
Q

Describe oro dispersible formulations

A
  • 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
31
Q

What are advantages of orodisperible formulations?

A
  • 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
32
Q

What are disadvantages of orodisperible formulations?

A
  • difficult to split dose
  • very hygroscopic
  • organolpetic properties
  • fraction of drug may be swallowed
33
Q

Describe compressed lozenges.

A
  • 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
34
Q

How does cationic material work?

A

through electrostatic interactions with the negatively charged mucus layer

35
Q

How does anionic and neutral material work?

A

through hydrophobic and/or hydrogen bond formation

36
Q

What are the properties of mucoadhesive material?

A
  • biocompatible
    • non-toxic
    • non-irritant
  • form strong bonds
  • produce quick adhesion
  • have no imcompatabilities
  • have good stability
  • be cost effective
37
Q

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

A

Non-specific

  • electrostatic
  • hydrophobic
  • hydrogen bond

Specific

  • carbohydrates
  • proteins
38
Q

What are advantages of mucoadhesive tablets?

A
  • slow dissolution
  • improved contact with site of absorption
  • increased residence time
39
Q

What are disadvantages of mucoadhesive tablets?

A
  • discomfort
  • can be irritant
  • can detach from mucosa
    • risk if it adheres to different mucosal surface
40
Q

What are advantages of sublingual administration?

A
  • 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
41
Q

What are disadvantages of sublingual administration?

A
  • 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

SoM 2 sim (21 decks)

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