What does sublingual mean in pharmacology?
Sublingual administration. Sublingual ( abbreviated SL ), from the Latin for "under the tongue ", refers to the pharmacological route of administration by which substances diffuse into the blood through tissues under the tongue. Many drugs are designed for sublingual administration, including cardiovascular drugs, steroids,...
What is the difference between sublingual and buccal?
Definition. Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there. Buccal administration involves placing a drug between your gums and cheek, where it also dissolves and is absorbed into your blood. Both sublingual and buccal drugs come in tablets, films, or sprays.
What is sublingual route of Drug Administration?
Sublingual administration of drug refers to the placement of drug under the tongue (Rehfeld et al., 2017). The sublingual route bypasses the first-pass metabolism and hence facilitates rapid absorption of the drug into the systemic circulation. Drug directly reaches the systemic circulation using blood vessels.
Why is sublingual absorption of drugs better than oral ingestion?
Because gastric acid and intestinal and hepatic enzymes are bypassed, sublingual absorption can be more efficient overall for certain drugs than intestinal uptake. The onset of drug effect may also be quicker than with oral ingestion.
Is sublingual enteral?
Enteral administration involves the esophagus, stomach, and small and large intestines (i.e., the gastrointestinal tract). Methods of administration include oral, sublingual (dissolving the drug under the tongue), and rectal.
What are the 4 enteral routes of administration?
The enteral routes of administration are those in which the drug is absorbed from the gastrointestinal tract. These include thesublingual, buccal, oral, andrectal routes. Insublingual administration, a drug product is placed under the tongue.
What are the advantages of enteral route of drug administration?
Compared to parenteral routes of administration, enteral administration, including oral, sublingual and rectal, improves patient compliance being non-invasive, painless, generally safe, and economical (no specific personal training is needed, and no previous drug sterilization is required).
Are sublingual drugs parenteral?
Sublingual. Sublingual administration can be classified into Parenteral as well, it does not enter the lower GastroIntestinal Tract, however it is placed under the tongue thus going oral. The drug diffuses into the capillary network and enters the system circulation directly.
How are sublingual medications absorbed?
Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there.
Which is faster IV or sublingual?
The intravenous route is considered to be the fastest route of drug administration. The injections and the infusions are administered by this route have 100% bioavailability.
Is sublingual faster than oral?
The sublingual and buccal routes of administration have a number of advantages (De Boer et al., 1984; Allen et al., 2011; Teubl et al., 2013), especially for systemic drug delivery. In general, they produce faster onset of action compared to orally ingested drug formulations.
Which route of administration is used most often Why?
Oral route Many drugs can be administered orally as liquids, capsules, tablets, or chewable tablets. Because the oral route is the most convenient and usually the safest and least expensive, it is the one most often used. However, it has limitations because of the way a drug typically moves through the digestive tract.
What is difference between enteral and parenteral routes of administration?
Parenteral nutrition means feeding intravenously (through a vein). "Parenteral" means "outside of the digestive tract." Whereas enteral nutrition is delivered through a tube to your stomach or the small intestine, parenteral nutrition bypasses your entire digestive system, from mouth to anus.
What happens if you swallow sublingual?
by Drugs.com Subutex is readily absorbed into your bloodstream through the gastrointestinal and mucosal membranes. But because of what scientists call “first-pass metabolism,” if you swallow Subutex instead of letting it dissolve under your tongue, only a very small amount of the medicine will be absorbed.
Why does under the tongue absorb faster?
There are tablets, spray, and film sublinguals. Administration through direct absorption into the mouth provides an advantage to medications you swallow. Sublingual drugs go into effect more quickly because they don't have to go through your stomach and digestive system before being absorbed into the bloodstream.
Why are medications absorbed rapidly when administered sublingually?
Sublingual administration of drug refers to the placement of drug under the tongue (Rehfeld et al., 2017). The sublingual route bypasses the first-pass metabolism and hence facilitates rapid absorption of the drug into the systemic circulation.
What are the different types of enteral feeding?
Several types of tubes are used for enteral feeding:Nasogastric tubes. ... Nasojejunal tube (NJT) ... Jejunostomy tubes (JEJ, PEJ or RIJ tubes) ... Radiologically inserted gastrostomy tube (RIG) ... Percutaneous endoscopic gastrostomy tubes (PEG tube)
What are the 5 routes of drug administration?
Routes of administrationOral.Sublingual.Rectal.Topical.Parenteral – Intravenous, intramuscular, subcutaneous.
What are the 6 routes of drug administration?
TechniqueIntravenous Route. A tourniquet may be used over the site intended for the intravenous medication to make the vein more visible and easier to access. ... Intramuscular Route. ... Subcutaneous Route. ... Rectal Route. ... Vaginal Route. ... Inhaled Route.
What is the difference between enteral and parenteral routes?
Parenteral nutrition means feeding intravenously (through a vein). "Parenteral" means "outside of the digestive tract." Whereas enteral nutrition is delivered through a tube to your stomach or the small intestine, parenteral nutrition bypasses your entire digestive system, from mouth to anus.
What is effervescent tablet?
Effervescent buccal or sublingual tablets—this method drives the drug through the mucous membranes much faster (this is the case in the stomach with carbonated or effervescent liquids as well) and is used in the Fentora fentanyl buccal tablet.
Why is sublingual administration better than oral administration?
Being more direct, it is often faster, and it ensures that the substance will risk degradation only by salivary enzymes before entering the bloodstream, whereas orally administered drugs must survive passage through the hostile environment of the gastrointestinal tract, which risks degrading them, by either stomach acid or bile, or by enzymes such as monoamine oxidase (MAO). Furthermore, after absorption from the gastrointestinal tract, such drugs must pass to the liver, where they may be extensively altered; this is known as the first pass effect of drug metabolism. Due to the digestive activity of the stomach and intestines, the oral route is unsuitable for certain substances, such as salvinorin A .
What is sublingual spray?
Sublingual spray—spray for the tongue; certain human and veterinary drugs are dispensed as such.
What is sublingual medicine?
Pharmaceutical preparations for sublingual administration are manufactured in the form of: Sublingual tablets—tablets which easily melt in the mouth, dissolve rapidly and with little or no residue. Nitroglycerine tablets are an example, the anti-emetic ondansetron is another.
Which artery drains into the lingual vein?
These arteries are both branches of the external carotid artery. The sublingual vein drains into the lingual vein, which then flows into the internal jugular system. The sublingual glands receive their parasympathetic input via the chorda tympani nerve, which is a branch of the facial nerve via the submandibular ganglion.
Why are peptides not stable in the gastro-intestinal tract?
Peptides and proteins are not stable in the gastro-intestinal tract, mainly due to degradation by enzymes and pH differences.
What is the SL in medicine?
Sublingual ( abbreviated SL ), from the Latin for "under the tongue ", refers to the pharmacological route of administration by which substances diffuse into the blood through tissues under the tongue which is predominantly a mucous gland that produces a thick mucinous fluid and lubricates the oral cavity which allows for swallowing, initiating digestion, buffering pH, and dental hygiene.
How much buprenorphine is given?
The usual dose is 0.3 mg given parenterally, 0.2–0.4 mg by the sublingual route, or the application of transdermal patches that deliver doses of 5–70 µg/h.
Which two mechanisms release drug molecule from mucosal membrane to blood vessels?
A diagram showing buccal and sublingual tablets, which release the drug molecule from mucosal membrane to blood vessels by two mechanisms, that is, transcellular and paracellular.
Why do we need a tablet?
A tablet is usually for delivery of systemic metabolizable drugs or organic-based drugs, such as progesterone, and peptide-based drugs, such as insulin, via transmucosal route (sublingual and buccal mucosa) to improve the bioavailability of drugs. The transmucosal tablets are mainly designed for various reasons including immediate drug release or quick action for local diseases, pulsatile drug release to maintain the therapeutic activity, controlled drug release. The transport routes involved in absorption are transcellular and paracellular as depicted in Fig. 13.5.
How does isosorbide dinitrate (ISDN) work?
Isosorbide dinitrate (ISDN) is absorbed in the gut and extensively metabolized to active metabolites, especially the mononitrate ISMN, which also shows good oral absorption but, in contrast to ISDN, has low presystemic metabolism.
What happens when you give nitroglycerin?
When given intravenously, there is drug breakdown by the cells of the vascular endothelium. Nitroglycerin is broken down (bioactivated) to 1,2 glyceryl nitrate and NO by hepatic mitochondrial aldehyde dehydrogenase. Tolerance develops over time, as the enzyme is depleted by continuous exposure.
What does a positive buprenorphine screen mean?
A positive urine buprenorphine screen is generally considered to mean concentrations of parent drug or metabolite being present at concentrations exceeding 5 ng/mL.
How fast does sodium nitroprusside work?
Sodium nitroprusside is effective within 30 to 40 seconds of infusion, and offset is similarly rapid. It is broken down in the liver to cyanide and thiocyanate; together with the parent drug, both are excreted in the urine. Dose reduction is indicated for all nitrates in patients with renal or hepatic disease.
Why are sublingual and buccal forms of medicine important?
Because the medication absorbs quickly, these types of administration can be important during emergencies when you need the drug to work right away, such as during a heart attack.
What is sublingual administration?
Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there.
Can you eat when taking sublingual?
On the other hand, sublingual and buccal drugs also have some disadvantages. Eating, drinking, or smoking, can affect how the drug is absorbed and how well it works. Also, these forms don’t work for drugs that need to be processed slowly by your system, such as extended-release formulations. Any open sores in your mouth can also become irritated by the medication.
Can a doctor prescribe sublingual or buccal?
Your doctor may prescribe sublingual or buccal drugs under any of the following circumstances: the drug needs to get into your system quickly. you have trouble swallowing medication. the medication doesn’t absorb very well in the stomach. the effects of the drug would be decreased by digestion.
Can you take a lower dose of a drug and still get the same results?
This means you may be able to take a lower dose and still get the same results.
What is the sublingual route?
Sublingual Route: The Oral Piggyback. Underneath the tongue is a very vascular bed that contains numerous blood vessels. This site is quite potent in absorbing medications that drugs placed are easily utilized in a matter of seconds. This is called the sublingual route.
How are sublingual medications administered?
Sublingual medications are administered by placing the drug under the tongue, leaving it there until the drug’s fully absorbed.
Where do sublingual medications go?
While oral passes through the gastrointestinal tract, sublingual medications go underneath the tongue.
What is the best angle to sit up for oral medication?
A Fowler’s position is sitting upright at around 45 degrees while a high Fowler’s at a 90-degree angle.
Why are time release medications effective?
Time release medications are effective because their coating protects its contents from being absorbed in the stomach, rendering it useless. These types of medications must be absorbed in the duodenum or the first part of the small intestine to maximize its effects, making it last longer inside the body.
What is the first drug route?
The first and most popular drug route is orally or per orem (PO). The different types of oral medications are:
What is the most popular time release medication?
Morphine is one of the most popular time-release medications that is usually given to clients with chronic pain.
What happens to the drug after enteral administration?
During absorption after enteral dosing, drug passes through the intestinal wall, enters the portal venous circulation, and passes through the liver before reaching the systemic circulation ( Figure 19-3 ). For some drugs, nearly complete metabolism of a dose may occur in the intestinal wall or the liver (especially for drugs metabolized by cytochrome P450 3A4). When this occurs, the amount of parent drug reaching the systemic circulation is only a small fraction of the dose administered. 8,9 The fraction (F) of the oral dose that reaches the systemic circulation is that which remains after hepatic or intestinal metabolism expressed as the extraction ratio (ER) in the following equation:
How does enteral administration work?
Enteral administration delivers the compound into the body through the gastrointestinal (GI) tract. Both ends of the GI tract can be utilized – the mouth and the anus. Administering medications and other compounds by ingesting them orally is, by far, the most common route of administration for medications and supplements. Usually, a pill is swallowed, thus ingesting the substance into the stomach. Prescribers commonly refer to this method of administration as ‘by mouth’ or PO (from Latin ‘per os’). Usually, oral administration is most convenient because it is least invasive.
How much ibuprofen should I give to a newborn?
The usual dose is 10 mg/kg on day 1, followed by two doses of 5 mg/kg 24 hours apart. However, suggestions for variable dosing based on advancing postnatal age (14-7-7 mg/kg for postnatal ages of 4 to 7 days and 20-10-10 mg/kg for postnatal ages >7 days)43 due to increased clearance of ibuprofen after birth have been made. A reduced rate of failure to close the ductus arteriosus has been observed with high doses of ibuprofen compared with low doses (RR 0.27; 95% CI 0.11 to 0.64). 44 In a study of 60 preterm neonates with hsPDA, Pourarian et al. 45 reported a 70% ductal closure rate in infants treated with an oral high-dose ibuprofen regimen (20-10-10 mg/kg) compared with a 37% closure rate with standard dosing (10-5-5 mg/kg) with no difference in adverse renal or gastrointestinal side effects. Adaptive dosing in the form of continued doses of ibuprofen (up to six doses if PDA was not closed) was associated with an 88% closure rate (similar to indomethacin). 46 Doubling of the doses during the second course was associated with 60% closure rates compared with 10% in infants receiving the same dose when a consecutive treatment protocol was used, underscoring the need for further studies on ibuprofen dosing, pharmacokinetics, and pharmacodynamics. 47
How to determine F?
The F is determined from the ratio of the area under the plasma concentration curve after oral administration compared with that after intravenous administration. After an intravenous dose of medication, drug enters either the inferior or superior vena caval circulation, returns to the heart, and enters the systemic circulation before perfusing the liver. Drugs that undergo almost complete hepatic or intestinal metabolism before reaching the systemic circulation are described as having a high hepatic or intestinal intrinsic clearance. Some drugs used in the care of newborns that exhibit moderate to significant first-pass, presystemic clearance in adults and infants include midazolam, 14 morphine, 15 and propranolol. 16
What is the purpose of rectal administration?
Rectal administration via suppositories to produce a systemic effect is useful in situations in which the patient is unable to take medication orally (e.g., is unconscious, vomiting, convulsing). Drugs are absorbed through the rectal mucosa.
What is animal cell therapy?
Animal cell therapy. Cell therapy consists of the parenteral or enteral administration of cells or parts of cells obtained from animal organs and/or tissues from cattle, sheep, pigs, or rabbits.
How much glycine should I take for seizures?
If seizures persist, glycine should be added up to a maximal dose of 200 mg/kg/day. In cases with low 5-methyltetrahydrofolate (5-MTHF), additional treatment with folinic acid (10 mg/day) should be provided.
Overview
Sublingual (abbreviated SL), from the Latin for "under the tongue", refers to the pharmacological route of administration by which substances diffuse into the blood through tissues under the tongue.
The sublingual glands receive their primary blood supply from the sublingual and submental arteries, which are branches of the lingual artery and facial artery, respectively. These arteries are …
Principle
When a chemical comes in contact with the mucous membrane beneath the tongue, it is absorbed. Because the connective tissue beneath the epithelium contains a profusion of capillaries, the substance then diffuses into them and enters the venous circulation. In contrast, substances absorbed in the intestines are subject to first-pass metabolism in the liver before entering the general circulation.
Forms
Pharmaceutical preparations for sublingual administration are manufactured in the form of:
• Sublingual tablets—tablets which easily melt in the mouth, dissolve rapidly and with little or no residue. Nitroglycerine tablets are an example, the anti-emetic ondansetron is another.
• Sublingual strips—similar to tablets in that they easily melt in the mouth and dissolve rapidly. Suboxone is an example of medication that comes in a sublingual strip.
Substance
Almost any form of substance may be amenable to sublingual administration if it dissolves easily in saliva. Powders and aerosols may all take advantage of this method. However, a number of factors, such as pH, molecular weight, and lipid solubility, may determine whether the route is practical. Based on these properties, a suitably soluble drug may diffuse too slowly through the mucosa to be effective. However, many drugs are much more potent taken sublingually, and it i…
Psychoactives
In addition to salvinorin A, other psychoactives may also be applied sublingually. LSD, MDMA, morphine, alprazolam, clonazepam, diazepam, and many other substances including the psychedelic tryptamines and phenethylamines, and even recreational cannabis edibles (THC) are all viable candidates for administration via this route. Most often, the drug in question is powdered and placed in the mouth (often directly under the tongue). If held there long enough, the drug wil…
Allergens
Allergens may also be applied under the tongue as a part of allergen immunotherapy.
Therapeutic peptides and proteins
A relatively new way of administration of therapeutic peptides and proteins (such as cytokines, domain antibodies, Fab fragments or single chain antibodies) is sublingual administration. Peptides and proteins are not stable in the gastro-intestinal tract, mainly due to degradation by enzymes and pH differences. As a consequence, most peptides (such as insulin, exenatide, vasopressin, etc.) or proteins (such as interferon, EPO and interleukins) have to be administered by injection. R…
Vaccines
The sublingual route may also be used for vaccines against various infectious diseases. Thus, preclinical studies have found that sublingual vaccines can be highly immunogenic and may protect against influenza virus and Helicobacter pylori, but sublingual administration may also be used for vaccines against other infectious diseases.