Recent Advances in Oral and Transmucosal Drug Delivery Systems for Patients with Dysphagia

Dysphagia is the difficulty or inability to swallow liquids, solids, or medications. It is often observed in older adults. This sensorimotor dysfunction can lead to poor treatment adherence, medication errors, and even treatment failure. It can also increase the risk of pulmonary aspiration. Traditional oral dosage forms, such as tablets and capsules, pose several problems for patients with dysphagia due to their size. Furthermore, some practices used to improve the administration of these dosage forms, such as crushing tablets, can compromise the safety and efficacy of treatment by altering the release mechanism of the active ingredient. Several pharmaceutical approaches have been developed to facilitate the oral administration of medications without requiring conventional swallowing. These technologies generally allow for the rapid dissolution of the active ingredient before swallowing or its absorption in the oral cavity. Examples of these approaches include solid oral dosage forms such as orodispersible, buccal, and sublingual tablets, 3D-printed tablets, oral lyophilisates, and medicated chewing gum. Other systems include mucoadhesive systems and multiparticle systems, as well as other forms such as modified liquids and oral or buccal gels.