Clinician's Library

Slõ Medication: A breakthrough and a challenge

7 June 2016

Taking medication is a daily reality for a growing number of people – but no one’s life should be dictated by it.

For many, the only minor stress or inconvenience might be over a forgotten tablet or mislaid prescription, yet for those with swallowing disorders (dysphagia) the whole process can be overwhelming. What’s more, attempts to make it less time consuming or distressing can actually impact on the efficacy and even safety of the medication, creating a horrible catch-22.

At Slõ Drinks our mission to ensure people with dysphagia do not have to miss out on the drinks they want, whether it’s a zingy breakfast juice, a thirst-quenching cordial on a warm day or a relaxing glass of wine. We are determined that nobody should have to sacrifice the flavour or enjoyment of a favourite drink and, with Slõ sachets carefully formulated to the make-up of each specific drink, they don’t.

Now we have a greater challenge in our sights, another 1st – medication for those with dysphagia.

Delivering safe, easy ways for medication to be administered when standard methods don’t work is extremely complex. The majority of drugs enter the market as oral products because it is generally accepted that this offers the greatest convenience, have high compliance, safety, efficiency, ease of accessibility and low production costs. Sadly, the way things stand, many of these perceived benefits fail to hold true in the case of dysphagia patients.

With a new approach, people with swallowing disorders can tap into these advantages too.

The entire field of prescription medicine and use is a compromise – a delicate balance taking into consideration the individual needs of the patient, the product quality and licensed status, and the cost. In that order!

Here in the UK the National Health Services (NHS) guidelines stipulate that licensed medicines, which have been manufactured to exacting standards and assessed in depth for their safety and efficacy, should be used wherever possible.

Prescriber’s are advised that if a licensed medicine cannot be administered normally, the first consideration should be using the same drug in an unlicensed manner – generally crushing and dispersing tablets or opening hard gelatin capsules and adding their contents to water. This is not appropriate for all medication and should be decided on a case-by-case basis but it is often seen as the most straightforward (and least costly) option for those with issues swallowing pills.

Yet this method brings its own problems for dysphagia patients, chief among which – when they have multiple medications to take within a day – is the volume they are expected to drink in the process and the amount of time this can take.

Delivering precise amounts of medication to the intended part of the body at the right time is a tricky equation under any circumstances. Different medicines should be absorbed at different sites within the body for maximum efficacy and, along with their solubility and permeability, the patient’s schedule and means of ingestion also have an important part to play. The stomach, for example, has a relatively short window for absorption and as the process is slowed down by the presence of food, medications that need to be absorbed quickly are taken on an empty stomach.

The time it can take a person with dysphagia to consume a glass of water containing the dispersed medication, combined with the fact that increased viscosity impedes drug dissolution, can play havoc with a delicate formula.

Just as importantly, that pressure and the laborious nature of the process can turn the act of taking medication into a dreaded and stressful occurrence patients have to suffer several times a day – every day.

No one should struggle on like this there are better ways.

The first issue – the critical question – is obviously how our products will interact with the drug and what impact this might have on its functions. That must be kept to a minimum.

While there has been a general move away from choosing starch as a thickener towards gum-based options, these do affect medication. We are therefore striking out alone in using cellulose based thickeners – the preferred thickener for medication.

Our first, simplest and most immediate solution is the Slõ Medi Cup.

Crushing tablets or opening capsules is an acceptable practice for dysphagia patients.
There is a lot of guidance on it – but none on the liquid or food it is being added too.

Is it the right consistency – to reduce the risk of aspiration to a minimum; what affect does it have on the dissolution of the drug and how much of the drug is actually consumed?

Slõ Medi Cups

Our Slõ Medi Cups are the size of a shot glass. They contain 3cl of sterile water, in Stage 1 (syrup/nectar) and Stage 2 (honey/custard) consistency.

Slõ Medi Cups keep quantities accurate and manageable. 3cl is a small enough volume for a dysphagia patient to cope with several times a day and the cellulose thickener reduces the interaction with the drug.

As such, the Slõ Water in the cup only acts as a carrier, holding the crushed medication in suspension delivering it safely to the stomach.

This solution will not work for everyone – or every drug – and we know we can do more. Our second solution is to prepare Slõ Liquid Medications.

Current special-order liquid preparations are widely used for dysphagia patients but are prohibitively expensive, and their consistency is not identified. That makes them inappropriate and a huge waste of money.

Slõ Medications will therefore be the alternative and the 1st medications to identify their consistency. Comprising of commonly prescribed – high demand liquid medications such as painkillers, anti-inflammatories and anti-depressants they will include Slõ Paracetamol Stage 1 or 2, Slõ Allopurinol 1 or 2, Slõ Domperidone Stage 1 or 2; and so on.

They will provide concern-free administration for those who need them most AND cost between 35 and 50% less than the alternative liquid preparations that are currently available and not fit for purpose.

These are solutions we can do now.

With expert analysis, research and development we can evidence that medication crushed and put into our Slõ Medi Cups or Slõ Liquid Medication are as effective as the current alternatives then make some of these products available here in the UK, Europe and beyond within 2 years.

As for the ultimate solution – that will eliminate the need for crushing or liquid preparations.

Slõ Sprinkles…pre-crushed medication in a single measured dose to sprinkle into Slõ Medi Cups.

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