Oral liquid medication

E. Hill, C. Flaitz, and C. Frost, Sweetener content of common pediatric oral liquid medications Am. J. Hosp. Pract, 45, 135 (1988). 

Intensol-The Intensol is a concentrated oral solution as compared to standard oral liquid medications. It is recommended that the Intensol be mixed with liquid or semisolid food such as water, juices, soda or soda-like beverages, applesauce, and puddings. Use only the calibrated... 

PG, similar to glycerin, is a multifunctional excipient that can be an effective preservative when used at concentrations of 15% to 30% in oral solutions. However, formulations containing 35% PG can cause hemolysis in humans. PG exhibits nonlinear pharmacokinetics and when elimination pathways are saturated, serum levels dramatically increase. Pyruvic and lactic acid are produced from the metabolic degradation of PG and can lead to acidosis. Neonates have a longer PG half-life (16.9 hours) compared with adults (5 hours) and seizures, and respiratory depression has occurred in children who have ingested oral liquid medications containing PG (9). Therefore, special consideration should be placed on the amount of PG in formulations that are intended for infants and children. 

Health care providers including nurses, pharmacists, and physicians should demonstrate to parents and older children how medications should be administered and offer appropriate dosing devices (oral syringe, dropper, cylindrical medication spoon, or a small-volume doser with attachable nipple) to enable parents to accurately measure liquid products. A household teaspoon or tablespoon should not be used for medication administration because they are inaccurate. Kraus and Stohlmeyer explain the use of a new oral liquid medication delivery system that can be used for infants and young children who still use a bottle for feeding. 

An oral liquid medication needed for an infant or young child should be shaken well, if required, accurately using an appropriate device. If a dropper or an oral syringe is used, the liquid should be administered toward the inner cheek. Administration in the front of the mouth may allow the child to spit out the medication, whereas administration toward the back of the mouth may result in gagging or choking. The oral syringe should be of an appropriate size to allow for administration into the inner cheek. 

Kraus, D.M. Stohlmeyer, L.A. Hannon, P.R. Infant acceptance and effectiveness of a new oral liquid medication delivery system. Am. J. Health-Syst. Pharm. 1999, 56, 1094-1101. 

The sucrose content of oral liquids may cause significant problems when these products are prescribed for long-term therapy (e.g., asthma, seizure control, recurrent infections). Oral liquid preparations can represent a substantial carbohydrate load to children with labile diabetes, particularly if a child is ingesting more than one liquid medication with a high sugar content. 

A wider problem exists with the possible role of liquid medications in dental caries formation [63], The extent of acid production in the oral cavity is closely related to caries formation. In a study of liquid medication, investigators have observed that medications with sucrose concentrations higher than 15% were able to significantly lower pH there was an inverse relation between sucrose content and a decrease in oral cavity pH [64], In a comparison of sorbitol and sucrose-sweetened liquid iron preparations, only sucrose-containing products produced a significant decrease in oral cavity pH [65],... 

If a patient needs one teaspoonful of Alupent oral liquid three times a day for ten days, how many fluidounces of medication should the pharmacist dispense ... 

Coloring is not always necessary, but may be of value in certain medications. For example, oral liquids are generally eolored using a dye to match the flavor of the medication. Pharmacists must be aware of the different oil, alcohol, and water solubilities of the dyes they use. 

Preservatives must fulfill certain criteria for acceptability. The major factors are those of safety and lack of toxicity after oral intake, particularly because liquid medications are often administered to children and the... 

Liquid medications, taken orally, can cause diarrhea and other GI symptoms, or they may aggravate GI distress that a patient is already experiencing. These GI... 

Adjustments in pH lo maintain water solubility cun sometimes lead lo chemical stability problems. An example is indomelhacin (HA acid pK ,4.S). which is unstable in alkaline media. Therefore. Ihc preferred oral liquid dosage form is a suspension buffered at pH 4 to 5. Because this is near the drug s pK . only. W f will be in the water-soluble form. There is a medical indication requiring intravenous administration of indomelhacin to premature infants. The intravenous dosage form is the lyophilized (freeze-dried) sodium salt, which is reconstituted just prior lo use. 

Liquid Medication is also administered using the oral route. There are three forms of liquid medication ... 

An oral syringe is a compliance aid as it allows for accurate measurement of small doses of liquid medication. The syringe itself is graduated and accompanied by a bung, with a hole in the centre, which fits into the neck of the medicine bottle. 

Sustained-release medications are usually oral preparations medications instilled into the Ommaya reservoir are liquid and are used immediately hy the body... 

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