From the Guidelines
In patients with short bowel syndrome (SBS), alternative drug delivery methods to liquids, such as crushed tablets or topical formulations, should be considered when applicable, as sustained- and delayed-release medications should be avoided 1. When managing SBS, it's crucial to consider the absorption process of oral medications, which primarily occurs in the proximal jejunum.
- Medications in solid dosage forms, like tablets, need to undergo disintegration and dissolution before being absorbed.
- Sustained- and delayed-release medications are not recommended for patients with SBS.
- Alternative drug delivery methods, such as liquids or topical formulations, can be used in SBS patients.
- Monitoring medication levels in the blood is essential to ensure the effectiveness of the treatment. In cases where there's a lack of clinical response to a drug, the solution may involve escalating the dose, changing the dosing schedule or frequency, or switching to a different drug formulation, such as a crushed tablet or liquid, or route of administration, like intravenous or transdermal 1.
From the FDA Drug Label
Alternate means of administration are to add the required amount of suspension to formula, milk, fruit juice, water, gingerale, or cold drinks. The alternative to liquid is to use the oral suspension and add it to formula, milk, fruit juice, water, gingerale, or cold drinks.
- Key points:
- The suspension can be added to various liquids for administration.
- The preparations should be taken immediately after mixing.
- It is recommended to shake the oral suspension well before using. 2
From the Research
Alternatives to Liquid
- In the context of medical treatments, alternatives to liquid formulations can include oral or solid forms of medications, such as tablets or capsules.
- For example, a study comparing oral vs intravenous ciprofloxacin in the initial empirical management of severe pyelonephritis or complicated urinary tract infections found that oral ciprofloxacin is as effective as the intravenous regimen in the initial empirical management of serious UTIs, including bacteremic forms, in patients without severe sepsis, obstruction, or renal foci of suppuration 3.
- Another study on sequential intravenous-oral ciprofloxacin plus amoxycillin/clavulanic acid in infected non-severe neutropenic patients found that this combination allowed for a sequential therapy, first intravenously and later orally, enabling patients to be discharged sooner 4.
- A study on the management of brain abscesses with sequential intravenous/oral antibiotic therapy also demonstrated the effectiveness of oral antibiotic therapy after an initial intravenous course in selected cases 5.
- However, when considering alternatives to liquids in a broader sense, such as in chemical or physical contexts, the options can vary widely depending on the specific application or need.
- For instance, in the context of chemical potential calculations in non-homogeneous liquids, research has focused on developing robust techniques for accurate estimates at large average densities, including methods like the Widom insertion method and well-tempered metadynamics 6.
- In medical contexts, the choice between liquid and alternative formulations (like oral solids) can depend on factors such as patient compliance, the severity of the condition, and the specific pharmacokinetics of the drug in question, as seen in a comparison of two oral regimens for the outpatient treatment of low-risk cancer patients with chemotherapy-induced neutropenia and fever 7.