Medicated straw: an innovative drug delivery system for paediatrics.

Abstract

Improving patient compliance and acceptability has always inspired formulators to innovate novel drug delivery systems. Conventional and innovative pediatric dosage forms have been developed over the last two decades that consider factors such as medication preferences, compliance, acceptability, and therapeutic outcomes. Ideally, pediatric dosage forms must be safe, palatable, and possess an accurate dose with minimal medication errors. The Europe Pediatric Translational Research Infrastructure (EPTRI) is a funded project that strengthens collaboration in the scientific pediatric community throughout Europe to cover the gaps in pediatric medical research. Additionally, EPTRI aims to support driven innovative research in pediatric drug discovery and pharmaceutical product development [1]. Swallowing tablets and/or capsules may be problematic and is a major causes of poor patient compliance, especially for children and elderly patients. Additionally, patients who are bedridden or struggling with paralysis and are unable to take conventional dosage forms need an alternative option for drug administration. The medicated straw is an innovative delivery system that enables drug intake with nonviscous liquids such as water, tea, juice, or any other beverage. The basic design of a medicated straw is structured as a long hollow tube with openings at both ends. One end has to dip in a liquid, while the liquid is sipped from the other end. The drug may be filled inside the hollow tube in the form of powder or pellets/granules. It is a simple yet effective method for accurate drug administration to pediatric and geriatric patients [2,3]. Taste-masked polymer-coated crystals of paracetamol were loaded into a straw for children and patients with swallowing difficulties [4]. Medicated straws could be loaded with vitamins, minerals, antibiotics, probiotics, and taste-masked medicines for oral administration to enhance patient compliance and potential therapeutic benefits. β-galactosidase enzymecontaining particulates were loaded in polypropylene-based drinking straws. Fluid intake speed and fluid temperature significantly affect the rate of drug release from the medicated straw [5]. Another study developed carvedilol solid dispersionbased electrospun fibers which were loaded into plastic straws. The solid dispersion of carvedilol revealed an ultrafast drug release rate in liquid administration through the straw, as well as enhanced stability, drug dissolution, and better compliance [6]. Generally, active pharmaceutical ingredients are bitter, and sweeteners, flavoring agents, or polymer coatings are employed for enhancing drug palatability. The United States patent number US 5718681A is a medicine delivery system that delivers drugs held within a straw tube. The straw has a particle barrier at one end that prevents the falling out of powdered medicines from the straw. Additionally, the particle barrier allows simultaneous entry of fluid due to the presence of apertures. Moreover, the straw has a medicine sac whose walls allow fluid to pass to dissolve the medication. The patent covers all achievable ways of drug storage in the straw with some additional features, such as a straw with a funnel for filling drug particles, a medication sack, attaching pill crushers, and removable caps [7]. However, physicochemical properties, drug stability, economic factors, large-scale production, commercialization, and drug release are some of the challenges to be monitored and adequately addressed for exploring the common use of medicated straws. The United States patent number US8334003B2 explains the development of medicated straw loaded with pellets containing a predetermined dose of the active ingredient and flavoring agent. Pellets are filled within the elongated tube and a receptacle is placed at both ends of the tube to retain the pellets within the system. The perforations in the receptacle act as a sieve to retain the pellets and only allow the liquid to flow through them. The passage of carrier liquid through the receptacle leads to pellet dissolution resulting in the release of the active ingredient. The patent focuses on the specifications of the receptacle used in the straw [8]. However, the patent does not disclose the quality control testing required for medicated straws to ensure reproducibility and sustainability for better patient compliance and therapeutics. A functional straw having structural modification has been described in patent number CN210384428U. The modified straw comprises three parts, including the upper and lower parts, which have a straw-like structure with foldable features, and the middle part consists of a paddle that rotates with the flow of fluid and increases embedded drug dissolution and