Medicated chewing gums

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MEDICATED CHEWING GUMS. PREPARED BY: P.SOUNDARYA, I-M.PHARM, Reg no: 133G1S0313, PHARMACEUTICS .

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INTRODUCTION. ADVANTAGES AND DISADVANTAGES. COMPONENTS. MANUFACTURING PROCESS. FACTORS AFFECTING RELEASE OF ACTIVE INGREDIENT. APPLICATIONS. COMMERCIAL PRODUCTS. FUTURE TRENDS. CONCLUSION.

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INTRODUCTION Chewing gum has been used for centuries to clean the mouth and freshen the breath. Medicated Chewing Gum (MCG) contains masticatory gum base with pharmacologically active ingredient . It is intended to use for local treatment of mouth diseases or systemic absorption through oral mucosa. MCG is considered as vehicle or a drug delivery system to administer active principles and nutrition that can improve health.

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Does not require water to swallow. Hence can be taken anywhere. 2. Advantageous for patients having difficulty in swallowing . 4. Counteracts dry mouth, prevents candidiasis and dental caries. 5. Highly acceptable by children. ADVANTAGES

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6. Avoids First Pass Metabolism and thus increases the bioavailability of drugs. 7. Drugs that are released from chewing gum and swallowed, will be introduced in the gastrointestinal tract either dissolved or suspended in saliva and thus the drug will be presented in a readily bioavailable form. 8. Gum does not reach the stomach. Hence G.I.T. suffers less from the effects of excipients. 9. Stomach does not suffer from direct contact with high concentrations of active principles, thus reducing the risk of intolerance of gastric mucosa. CONT.,

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10. Fraction of product reaching the stomach is conveyed by saliva delivered continuously and regularly. Duration of action is increased. 11. Aspirin, Dimenhydrinate and Caffeine [9] shows faster absorption through MCG than tablets. 12. It may prove to be particularly suitable for the systemic delivery of drugs, which are susceptible to metabolism in the gut wall or liver. 13. The treatment can, if required, be terminated at any time. CONT.,

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1. Sorbitol present in MCG formulation may cause flatulence, diarrhea . 2. Additives in gum like flavoring agent, Cinnamon can cause Ulcers in oral cavity and Liquorice cause Hypertension. 3. Chlorhexidine oromucosal application is limited to short term use because of its unpleasant taste and staining properties to teeth and tongue 4. Chewing gum has been shown to adhere to different degrees to enamel dentures and fillers 5. Prolonged chewing of gum may result in pain in facial muscles and ear ache in children. DISADVANTAGES

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COMPONENTS OF MCG Water insoluble chewing gum base. Water soluble bulk portion. Elastomers Plasticizer Fillers Resins Sweeteners Colorants and whiteners Flavoring agents Anti caking agent Grinding agent Anti oxidant

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COMPONENT ROLE EXAMPLES Elastomers They provide elasticity, gummy texture and cohesion to the chewing gum. Natural elastomers Natural rubbers like Latex or Natural gums such as Jelutong , Lechi Caspi , Perillo , and Chicle . Synthetic elastomers polyisobutylene and butyl rubber. Plasticizers These are used to regulate cohesiveness of product. Natural Plasticizers Glycerol Esters or Partially hydrogenated Rosin, Glycerol Esters of Polymerized Esters Synthetic Plastisizers include Terpene Resins derived from α- pinene and or d-limonene. Fillers or Texturizers They provide the right texture, improve chewability , and provide reasonable size of the gum lump with low dose drug for the gum base. Magnesium and Calcium Carbonate, Ground Limestone, Magnesium and Aluminum Silicate, Clay, Alumina, Talc, Titanium Oxide & Mono/ di / tri Calcium Phosphate. Resins They serve two functions. One, as mastication substance and other as binding agent between elastomers and fillers. They contribute to the balance between the properties of elasticity and plasticity. Natural resin Glycerol esters from pine resins Synthetic resin polyvinyl acetate can be used. It reduces the tendency of the gum to adhere to the teeth.

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COMPONENT ROLE EXAMPLES Sweeteners (Aqueous & Bulk) To mask the bitter taste. Aqueous Sweeteners can be used as softeners to blend the ingredients and retain moisture. Aqueous Sweeteners Sorbitol , hydrogenated Starch hydrolysates and Corn Syrups. Bulk Sweeteners Sucrose, Dextrose, Maltose, Dextrin, Fructose, Galactose , Corn Syrup. Colorants & whiteners To give required color . FD & C type dyes and lakes, fruit and vegetable extracts, Titanium Dioxide. Flavoring agents To improve flavour in chewing gum . Essential oils, such as Citrus oil, fruit essences, Peppermint oil, Spearmint oil, Mint oil, Clove oil & Oil of Wintergreen.

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COMPONENT ROLE EXAMPLES Anti-caking agent To prevent agglomeration of the subsequently ground chewing gum particles. Precipitated silicon dioxide can be mixed with chewing gum composition and solid carbon dioxide prior to grinding. Grinding agents: To prevent the gum from sticking to the grinding apparatus. 2-8% w/w of grinding aid such as alkaline metal phosphate, an alkaline earth metal phosphate or malto dextrin. Antioxidants To protect the gum base and flavors from oxidation. Ascorbic acid, tocopherol , butylhdroxytoluene . CONT.,

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MANUFACTURING PROCESS Conventional/ traditional Method: Components of gum base are softened or melted & placed in a kettle mixer to which sweeteners, syrups, active ingredients &other excipients are added at a definite time. The gum is then sent through a series of rollers that form into a thin, wide ribbon. During this process, a light coating of finely powdered sugar or sugar substitutes is added to keep the gum away from sticking and to enhance the flavor. In a carefully controlled room, the gum is cooled for up to 48 hours. This allows the gum to set properly. Finally the gum is cut to the desired size and cooled at a carefully controlled temperature and humidity.

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FACTORS AFFECTING RELEASE OF ACTIVE INGREDIENT 1. Contact Time: The local or systemic effect is dependent on time of contact of MCG in oral cavity. In clinical trial chewing time of 30 minutes was considered close to ordinary use. 2. Physicochemical properties of active ingredient: Physicochemical properties of active ingredient plays very important role in release of drug from MCG. The saliva soluble ingredients will be immediately released within few minutes whereas lipid soluble drugs are released first into the gum base and then released slowly. 3. Inter individual variability: The chewing frequency and chewing intensity which affect the drug release from MCG may vary from person to person. In-vitro study prescribed by European Pharmacopoeia suggest 60 cycles per minute chewing rate for proper release of active ingredient. 4. Formulation factor: Composition and amount of gum base affect rate of release of active ingredient. If lipophilic fraction of gum is increased, the release rate is decreased .

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Applications The MCGs can also be used as an alternative tool to buccal and sublingual tablets which are intended to act systemically because active ingredient is released more uniformly and cover greater area of absorption in oral cavity. Oral diseases are prevented or cured with MCG. MCGs can be used for systemic effect in conditions like vitamin C deficiency, pain & fever, alertness, motion sickness, smoking cessation, as well as for local effect in conditions like plaque acid neutralization, fresh breath, dental caries, antiplaque, fungal, and bacterial infections Prevention and cure of oral diseases is a prime target for chewing gum formulations.

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1. Dental caries: Fluoride containing gums have been useful in preventing dental caries in children and in adults with. Xerostomia(dry mouth) Chlorhexidine chewing gum can be used to treat gingivitis, periodontitis , oral and pharyngeal infections. It can also be used for inhibition of plaque growth. Chlorhexidine chewing gum offers large flexibility in its formulation as it gives less staining of the teeth and is distributed evenly in the oral cavity.[42] The bitter taste of chlorhexidine can be masked quite well in a chewing gum formulation.

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2. Systemic therapy: Pain- chewing gum can be used in treatment of minor pains, headache and muscular aches. Smoking cessation- Chewing gum formulation containing nicotine and lobeline have been clinically tested as aids to smoking cessation. Obesity - Active substances like chromium, guaran and caffeine are proved to be efficient in treating obesity. Chromium is claimed to reduce craving for food due to an improved blood-glucose balance. Caffeine and guaran stimulate lipolysis and have a thermogenic effect (increased energy expenditure) and reduce feeling of hunger. Other indications - Xerostomia, Allergy, Motion sickness, Acidity, etc are all indications for which chewing gum is a means of drug delivery.

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Chewing gum is no longer seen simply as confectionary. It not only offers clinical benefits but also is an attractive, discrete and efficient drug delivery system. A few decades ago, the only treatment for some diseases was surgical procedure but now more and more diseases can be treated with Novel Drug Delivery Systems. Dental health chewing gum is here to stay, as is medicated gum for smoking cessation and travel sickness. A bright future for a preparation with a long history .

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Finally, in the future , we may see drugs formulated into chewing gum in preference to other delivery systems to deliver drugs locally to the oral cavity. The reason is simple - that the chewing gum delivery system is convenient, easy to administer - anywhere, anytime and its pleasant taste improves patient compliance.

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Do you know???

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A review article published in journal of Indian drugs- volume 43(3). http://www.ijrpbsonline.com Journal of pharmacy research 2011,4(3),848-851. http://www.fertin.com Google images.

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