A Spoonful Of Sugar

OTC Pharmaceuticals & Oral Hygiene Products

From toothpaste, mouthwash and breath mints to cough syrups, throat lozenges, chewable vitamins and antacids, many over-the-counter (OTC) products you buy from the pharmacy or the supermarket’s pharmacy aisle contain sugars, polyols, starches (including maltodextrins), and alternative sweeteners. Why? To make them taste better and/or to act as a binder so the ingredients stick together and solids and liquids don’t separate during storage and/or as a humectant to ensure they retain moisture and don’t dry up.

Read the label, carefully. Discovering exactly what ingredients are in your favourite OTC pharmaceuticals and oral hygiene products from the packet is typically not as easy as reading a food or beverage label.

Around the world, government authorities are responsible for regulating and supervising the ingredients industry can add to foods, beverages, pharmaceuticals, oral hygiene products, medications and dietary supplements etc. The ingredient list for many pharmaceutical products may only list active ingredients as required; others follow the example of the food and beverage industry and list all ingredients in descending order from most to least.

Because these are national regulations, the ingredients in your tube of toothpaste, mouthwash or cough lozenge may vary depending what country you buy it in. Here we look at the sweeteners used four products found in most bathroom cupboards.

TOOTHPASTE: the tube of Colgate® Total Original on an Australian bathroom shelf lists as its ingredients: “Water, silicon dioxide, glycerol, sorbitol, pvm/ma copolymer, sodium lauryl sulphate, flavour, carrageenan, titanium dioxide, saccharin sodium, triclosan, sodium fluoride.” The sweetener is saccharin sodium. Glycerol and sorbitol provide sweetness, but they are mainly here in their “humectant” capacity.

MOUTHWASH: Today’s mouthwash designed to strengthen tooth enamel, kill the germs that cause bad breath, plaque and gingivitis is much more multipurpose than the old-fashioned gargle. The bottle of Listerine® Teeth Defence with its challenging childproof top in the Australian bathroom cabinet lists as its ingredients: “Ethanol, benzoic acid, thymol, cineole (eucalyptol), sodium fluoride also contains saccharin. The sweetener is saccharin sodium.

THROAT LOZENGE: Strepsils® Honey and Lemon lozenges only list the active antiseptic ingredients dichloobenzyl alcohol and amylmetacresol. The back of the pack reveals, however, that each lozenge also contains sucrose and glucose. No mention of honey or lemon.

ANTACID: Gaviscon™ Chewable Tablets only list the active ingredients on the front of the pack: “sodium alginate, Sodium bicarbonate and calcium carbonate. But if you make your way through the “other information” on the back of the packet you’ll see that it contains mannitol and aspartame and carries the appropriate health warnings.

ANALGESIC: Nurofen® for Children lists the following ingredients on the manufacturer’s website: ibuprofen. sodium chloride, sodium saccharin and maltitol.

When Glucose Is Just What The Doctor Ordered

Sometimes glucose can be a life saver. There are two very common medical conditions where glucose, a source of fast-acting energy, is just what the doctor ordered. They are gastroenteritis and hypoglycaemia (or hypos).

REHYDRATION: Gastroenteritis is very common in children. It usually resolves within days, but babies and young children can rapidly become dehydrated through vomiting and diarrhea. That’s where oral rehydration solutions such as Gastrolyte, Pedialyte, and Hydralyte are useful. These drinks are specially formulated to help to replenish fluid and electrolytes (essential salts) that have been lost, as well as provide energy (that’s the glucose) until the baby or toddler can return to a normal diet.

Gastrolyte® Electolyte Rehydration Formula sachets list as the active ingredients: Glucose, potassium chloride, sodium chloride, sodium acid citrate; the other ingredients (excipients is what they are called) are saccharin sodium and flavouring. Why add a sweetener? To make the drink more palatable and mask the salty flavour. Glucose is not very sweet; it is only about 70% as sweet as regular sugar.

Did you know that worldwide, diarrheal diseases are a leading cause of mortality in children under five. Because the immediate cause of death in most cases is dehydration, these deaths are almost entirely preventable if dehydration is prevented or treated.

HYPO PREVENTION: Hypoglycemia (popularly called a “hypo”) occurs mostly in people with type 1 (insulin-dependent) diabetes, or insulin-requiring type 2 diabetes, when their blood glucose level has dropped too low (generally below 4 mmol/L or 70 mg/dL), although it can be experienced by people taking certain tablets (e.g., sulphonylureas) for their diabetes. When this happens they need to eat or drink food with a high level of carbohydrate immediately to prevent their BGLs from dropping further.

Here are Diabetes Australia’s tips for treating a hypo immediately to stop BGLs from dropping lower. Then have some quick acting carbohydrate that is easy to consume. For example:

Wait 10-15 minutes. If it isn't rising, eat another quick acting carbohydrate from the above list. If your next meal is more than 20 minutes away, eat some longer acting carbohydrate. This could be one of the following:

Healing Wounds

Long ago, the people of Mesopotamia washed wounds with water or milk and then dressed them with honey or resin. Sugar and honey help heal open wounds because bacteria needs water to grow, and applying sugar to a wound draws the water away, thereby depriving the bacteria of water. This prevents the bacteria from multiplying, and they die.

Moses Murandu, a senior lecturer in adult nursing at the University of Wolverhampton, is currently carrying out research the effect of sugar on wounds. “The patients we have tested it on in the pilot study have said that they never knew such a simple method could make such a difference to their quality of life. I was happy for the patients who suffer from terrible and debilitating wounds with little hope of getting better, as this treatment can ease their pain,” he said.

Murandu’s pilot study found that a 25 percent sugar concentration ensures that the microorganisms cannot survive. Nurses were amazed by the immediate and dramatic decrease in wound odor, which enabled them to move patients from isolation to the open ward within twenty-four hours of commencing treatment, and by the marked reduction in analgesic requirements, particularly in venous-ulcer patients who had previously refused bed rest and elevation on the grounds that this position was intolerably painful.