Oral liquids

For oral liquids, taste masking becomes essential. The effects of solubilizing agents such as complexing agents and cosolvents on taste need to be evaluated. 

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As with tablets and capsules, the prescribed dose of the drug may not be die same as what is on hand (or available). For example, die physician may order 20 mg of an oral liquid preparation and the bottle is labeled as 10 mg/5 mL. 

To measure an oral liquid drug in minims, a measuring glass calibrated in minims must be used. 

Oral liquid concentrates are available for use in patients who can more easily swallow a liquid. These concentrates are light sensitive and dispensed in amber or opaque bottles to help protect the concentrate from light. They are administered mixed in liquids such as fruit juices, tomato juice, milk, or carbonated beverages. Semisolid foods, such as soups or puddingy, may also be used. Perphenazine (Trilafon) concentrate should not be mixed with beverages containing caffeine (coffee, cola), tea, or apple juice because of the risk of incompatibility. 

If an oral liquid or a powder is prescribed, add the dose to 4 to 8 oz of cold water or juice and sip slowly during a period of 5 to 10 minutes. Measure the dose accurately. 

Clindamycin 20-30 mg/kg per day in 3-4 doses (adult 300 mg four times daily or 450 mg three times daily) Nausea, diarrhea, C. difficile colitis, anorexia S Oral liquid has very poor taste only for pneumococcal infection... 

Cefdinir Cefpodoxime proxetil Cefuroxime axetil 600 mg/day in 1-2 doses 200 mg twice daily 250-500 mg twice daily 14 mg/kg per day in 1-2 doses 1 0 mg/kg per day in 2 doses 1 5-30 mg/kg per day in 2 doses Preferred oral liquid cephalosporin owing to palatability... 

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. 

Sorbitol is a polyhydric alcohol, with a high caloric content. In a survey of 129 oral liquid dosage forms stocked at a large university teaching hospital, 42% contained sorbitol [66]. The sorbitol concentration in the identified products varied from 3.5 to 72% w/v (0.175-3.6 g/mL). 

Solid oral dosage forms, particularly tablets, are the preferred type of formulation in the United States. Not only are these products widely accepted by consumers, but they are also relatively cheaper to develop and manufacture than oral liquids or suspensions, par-enterals, or suppositories. Figure 4 shows, quite clearly, that even the elderly primarily make use of solid oral dosage forms [162]. 

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

D. Lutomski, M. Gora, S. Wright, and J. Martin, Sorbitol content of selected oral liquids, Ann. Pharmacother, 27, 269 (1993). 

Sodium iodide 131 is an oral liquid that concentrates in the thyroid and initially disrupts hormone synthesis by incorporating into thyroid hormones and thyroglobulin. Over a period of weeks, follicles that have taken up RAI and surrounding follicles develop evidence of cellular necrosis and fibrosis of the interstitial tissue. 

Quercia RA, Fan Cr Liu X, etaf. Stability of omeprazole in an extemporaneously prepared oral liquid Am J Health SystPharm 1997 54 1833-1836 and Dunn A, White M, Reddy P, et al Delivery of omeprazole and lansoprazole granules through a nasogastric tube in vitro. Am J Health Syst Pharm 1999 56 2327-2330. 

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 ... 

The present chapter deals with calculations involving oral liquid dosage forms including homogenous systems such as syrups and elixirs, and heterogenous systems such as suspensions. 

The doses of oral liquids may, sometimes, be calculated on the basis of body weight. This type of problem can also be solved by the method of proportion. 

Gradient HPLC Yes/No Complex Low Receiving site has extensive familiarity with other products and methodologies of this compound, but not with this dosage form, e.g. tablet product/method is established, but no experience of this oral liquid product. Method has a good history of reproducible performance. Method confirmation... 

Over the years it has been interesting to note that many compounded products eventually become commercially available products. Recent examples might include fentanyl lozenges, minoxidil topical solution, nystatin lozenges, clindamycin topical solution, tetracaine-adrenalin-cocaine (TAG) solution, dihydroergotamine mesylate nasal spray, buprenorphine nasal spray, buffered hypertonic saline solution, and erythromycin topical solution as well as numerous other dermatological and pediatric oral liquids and some... 

Compounding may hold different meanings to different pharmacists. It may mean the preparation of oral liquids, topicals, suppositories, the conversion of one dose or... 

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. 

Some compounded preparations are naturally preserved, as in the case of certain syrups and elixirs others require the addition of a preservative. Preservatives are commonly added to products to minimize microbial growth, as in the case of oral liquids, topicals, and multi-dose parenterals. A preservative is selected based upon its characteristics, including concentration, pH, taste, odor, and solubility. 

Suspensions are two-phase systems consisting of a finely divided solid dispersed in a liquid, solid, or a gas (Table 6). They are appropriate when the drug to be incorporated is not sufficiently soluble in an ordinary solvent or cosolvent system. They are used orally and topically. Examples of compounded suspensions include pediatric oral liquids where a commercial pediatric dosage form is not available. Commercial tablets and capsules are formulated into a vehicle and can be individually flavored to the patient s preference. 

The inclusion of the a routine microbial limit test in a marketed product stability protocol depends on the pharmaceutical dosage form. Typically, the test would be used only for nonsterile products, especially oral liquids, nasal sprays, and topical liquids, lotions, and creams that have sufficient water activity to support the growth of microorganisms. In contrast, tablets, powder- and liquid-filled capsules, topical ointments, vaginal and rectal suppositories, nonaqueous liquids and inhalation aerosols with a water activity too low to allow for the product to support the growth of microorganisms would not be routinely tested. 

The ionisation state of molecules in the solution state appears to be an important variable in photodegradation mechanisms. A recent pubhcation on riboflavin oral liquid preparations shows that the formulation is most photostable at pHs between 5 and 6, where the non-ionised form predominates [78]. The rate of photolysis increase 80-fold at pH 10.0, owing to increased redox potential. Conversely, at pH 3.0, the increased photolysis is associated with the excited singlet state, in addition to the triplet state. 

Absorption - Theophy ne is well absorbed from oral liquids and uncoated plain tablets maximal plasma concentrations are reached in 2 hours. Rectal absorption from suppositories is slow and erratic, the oral route is generally preferred. Enteric-coated tablets and some sustained-release dosage forms may be unreliably absorbed. 

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