For something of treatment and healing, most medications have an amazingly harmful taste. From bitter taste syrup to the lasting metallic aftertaste of a certain tablet, why do many of our best treatments taste so bad, and how important is this actually?
Most modern drugs have been developed or inspired by compounds found in nature, particularly in static species such as plants and marine invertebrates such as sponges and corals.
You might like it
Over the course of millions of years, these plants and animals have evolved to produce compounds that interact with different receptors in predator species, such as cardiac glycosides that stop the heart of Kitulov, hallucinating alkaloids in belladonna, or toxic taxanes in yew berry.
In response, humans (and many other animals too) evolved taste receptors to detect these harmful compounds, and bitter taste served as a clear signal to avoid their potential foods. Therefore, bitterness is a warning sign that certain chemicals are likely to alter the body’s normal chemistry.
Fast forward tens of thousands of years ago, modern science has now been able to understand specifically how these compounds interact with our bodies and take advantage of the powerful physiological effects of safe and effective medicines. As these compounds are produced by organisms, relatively few drugs use these compounds. Rare examples are antibiotics such as penicillin and painkillers such as morphine. Instead, the majority draw inspiration from the chemical structure of natural products and mimic biological activities with several targeted improvements.
“The drug needs some characteristics. It has to have a good way of administration. It has to be absorbed, it has to reach the target, it has to be active,” Taglialatela Scafati said. “Therefore, it may be necessary to change the structure of the drug to achieve this.”
However, Bahijaraimia Braham, a pharmaceutical scientist and pharmacist at King’s College London, said that when it comes to drugs, he believes it is important to distinguish between the active drug compounds and the drug form that patients actually take.
In the drugs received by patients, the active ingredient is combined with biologically inert ingredients known as excitations that modulate drug properties such as absorption and stability, allowing the drug to be processed into easy-to-administered syrups, tablets, and capsules.
In theory, adding flavoring excipients should help tackle the unpleasant taste of the active ingredients in tablets and syrups. But how patients perceive drugs is actually much more complicated than flavor, Raimi Abraham told Live Science. “People have a big focus on taste, but in reality they need to focus on the taste,” she explained. “We’re not only thinking about the taste, we’re not only thinking about the smell, but also the aftertaste, texture, and appearance. These factors determine whether someone accepts the medicine or not.”
You might like it
This is a particularly important consideration when working with pediatric and geriatric patients. If drug therapy doesn’t taste good, there is a real risk that children and elderly patients will refuse (or struggle) the required dose. Not only could this put the health of more vulnerable patients at risk, but the inability to complete a course of prescribed medications could also contribute to a wider phenomenon of drug resistance, particularly with regard to antibiotics.
Therefore, while balancing the different aspects of the taste is extremely important, it is incredibly difficult. Improving one factor can often have a negative effect on another, and part of the challenge here is the physical mechanisms of taste in the human body.
“The main taste sensors that people think of are in the tongue, but other parts of the body, such as the esophagus and stomach, also have taste receptors,” said Raimi Abraham. Therefore, a flavorful formulation that covers the bitterness in the mouth can leave a troublesome aftertaste when the active ingredient dissolves in the stomach.
Despite these challenges, pharmaceutical companies invest millions each year to tackle this fascinating problem. “There are various strategies: sweeteners and flavorings, coatings, fine-tuning the chemical structure, and adding modifiers that change the feel of the mouth and hide the bitterness. And this is all about the differences in patients, such as age that affect the taste,” says Raimi-Abraham. “I think the reason some drug products still have a bitter taste is because it’s art and the science to get that formulation strategy for the overall taste.”
Source link
