Buccal and sublingual administration

A wide range of formulations have been developed and tested for buccal and sublingual administration. Various advances have been made over the years, which counteract the... 

Buccal and sublingual administration Oromucosal drug administration is possible, although mainly limited by ability and compHance concerns in the younger age group. It might be difficult in babies due to feeding patterns. Safety needs to be established in children. 

Lamey PJ, Lewis MAO (1990) Buccal and sublingual delivery of drugs. In Florence AT, Salole EG (eds.) Routes of Drug Administration. Butterworth Co. (Publishers) Ltd., Norfolk, pp 30-47... 

ADVANTAGES AND DISADVANTAGES OF BUCCAL AND SUBLINGUAL ROUTES OF ADMINISTRATION... 

The buccal and sublingual routes of administration permit rapid delivery to the systematic circulation. Absorption from the buccal and sublingual vasculature and lymphatics bypasses hepatic circulation and, thereby, reduces first-pass metabolism. The driving force of absorption is the high thermodynamic activity of the compounds. Organic nitrates and testosterone have been administered by these routes to produce rapid plasma concentrations and to minimize hepatic metabolism. 

DRUGS AND PHARMACEUTICAL FORMULATIONS FOR ADMINISTRATION BY THE BUCCAL AND SUBLINGUAL ROUTES... 

A first-pass phenomenon may also occur after inhaperi-toneal and, partially, after rectal administration. It does not occur for parental routes of administration or after buccal or sublingual administration. For some orally administered... 

Compared with other routes of administration, different mucosa that line the oral cavity (buccal and sublingual sites of drug administration) offer advantages that include (1) being noninvasive, (2) producing a rapid onset of action,... 

However, pH does not always influence the rate or extent of absorption. For example, McElnay et al. found that captopril pharmacodynamic parameters (blood pressure, heart rate, and plasma renin activity) did not differ significantly between buffered and unbuffered sublingual administration, suggesting that manipulation of pH had little effect. It was, therefore, proposed that a mechanism other than passive diffusion was involved in the buccal absorption of this drug. 

Although not routinely given by the buccal or sublingual routes, several research studies have shown that absorption of morphine from the mouth gives rise to effective analgesia and that these routes may provide suitable alternatives to parenteral administration. " Clinical studies have suggested that the bioavailability of morphine is 40-50% greater after buccal than intramuscular administration as plasma morphine... 

A variety of protein and peptide pharmaceuticals has been evaluated for buccal/sublingual administration using animal models or human subjects, and the published reports comprehensively reviewed. ... 

Mouthwashes, toothpastes and other preparations are introduced into the oral cavity for local prophylactic and therapeutic reasons. It is not known to what extent components of these formulations are absorbed and give rise to systemic effects. The absorption of drugs through the oral mucosa, however, provides a route for systemic administration which avoids exposure to the gastrointestinal system. Dmgs absorbed in this way bypass the liver and have direct access to the systemic circulation. The sublingual, buccal and gingival... 

Many technicians may not be famihar with terms such as sublingual (under the tongue), buccal (between the cheek and gingiva), otic, and so on. A clear description of each of these nontraditional routes (i.e., other than gavage routes) should be discussed with technicians, and instructions may also be written down and given to them. Demonstrations are often useftd to illustrate selected techniques of administration (e.g., to use an inhaler or nebulizer). Some chemicals must be placed by technicians into body orifices (e.g., medicated intrauterine devices such as Proges-terset). 

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