Mucosa buccal

Oral. The oral route for dmg dehvery includes the gastrointestinal (GI) tract and the oral cavity including the buccal mucosa. The buccal mucosa is considered separately because of differences in the approach to dmg dehvery via this route. 

This product is also only available by prescription. The recommended treatment period is up to 24 weeks (McNeil Consumer Products 1997). Using the inhaler by puffing 80 deep inhalations over 20 minutes results in a systemic absorption through the buccal mucosa of 2 mg of nicotine, with maximal nicotine concentrations occurring 15 minutes after the end of inhalation. When the product is used as directed, the patient will likely use 6-16 inhalers per day. This form of NRT is relatively contraindicated in patients with asthma because, although most of the nicotine is absorbed through the buccal mucosa and it is not delivered to the lungs (McNeil Consumer Products 1997), nicotine by inhalation may produce bronchial constriction. 

Petechiae are very small (usually less than 3 mm) pinpoint flat red spots beneath the skin surface caused by microhem-orrhaging. They occur in 20% to 40% of chronic IE, often found on the buccal mucosa, conjunctivae (Fig. 71-3A) and extremities1 (Fig. 71-3B). 

A 35-year-old woman presents to your clinic complaining of "burning and soreness in my mouth" along with a metallic taste and "this funny white stuff." On initial examination, she has white patches on her tongue, gums, and buccal mucosa. These patches are easily removed, revealing erythematous tissue underneath. 

Diffuse erythema on the surface of buccal mucosa, throat, tongue, and gums... 

White patches on tongue, gums, or buccal mucosa removal of patches reveals erythematous and bloody tissue ability to remove patches distinguishes OPC from oral hairy leukoplakia... 

There is very little evidence to suggest that soluble or particulate macromolecules can be transported across the buccal mucosa [31]. More work is needed to determine whether this route could be of any benefit in drug targeting. 

High, E. G. and H. G. Day (1951). Effects of different amounts of lutein, squalene, phytol and related substances on the utilization of carotene and vitamin A for storage and growth in the rat. J. Nutr. 43 245-260. Johnson, E. J. et al. (1997). Beta-carotene isomers in human serum, breast milk and buccal mucosa cells after continuous oral doses of -trans and 9-cis beta-carotene. J. Nutr. 127(10) 1993-1999. 

Buccal Avoid first pass Adhere to buccal mucosa Taste... 

Ohzawa et al [115] studied the plasma concentration, distribution, and metabolism of 14C miconazole, after application of 14C miconazole gel (10 mg/kg of miconazole) to oral mucosa of male rats. After application, the plasma radioactivity reached the maximum level of 1.82 pg eq./mL at 2 h, and then declined in a similar manner as after oral administration of 14C miconazole. At 1 h after application, high levels of radioactivity were observed in the epidermis of lip, palatum, tongue, and buccal mucosa on the enlarged autoradiograms, and the radioactivity was high in the epidermis of buccal mucosa, while low in the buccal muscle. 

Child, 6-year-old, accidently swallowed unknown amount of Gramoxone W (contains paraquat) Residue in urine 6 days after exposure was 3.6 mg paraquat/L death 7 days after onset of symptoms. Autopsy showed ulceration of buccal mucosa, emphysema, severe lung damage, jaundice, and renal failure (Campbell 1968)... 

Keywords Buccal mucosa Permeability barrier Passive diffusion Excised tissue Nonkeratinized epithelium Diffusion chamber... 

The buccal mucosa, which lines the inside of the cheek, has been investigated as an alternative route for drug delivery, especially for proteins and peptides. There are many advantages associated with the use of the buccal mucosa as a site for the delivery of drugs into the systemic circulation. Since blood flow from the buccal epithelium drains directly into the internal jugular... 

Figure 4.1 General structure of the buccal mucosa. Taken and modified with permission from Harris etal. [42],...

In addition to the intercellular lipids of the buccal mucosa, there appear to be other barriers which may reduce the ability of an exogenous compound to permeate the buccal mucosa. These include the salivary film and mucus layer, the basement membrane, and a metabolic barrier. 

A recent study, however, has shown that aminopeptidase activity is present on the surface of porcine buccal mucosa, and that various aminopeptidase inhibitors, including amastatin and sodium deoxycholate, reduce the mucosal surface degradation of the aminopeptidase substrate, leucine-enkephalin [149], Since the peptidases are present on the surface of the buccal mucosa, they may act as a significant barrier to the permeability of compounds which are substrates for the enzyme. In addition to proteolytic enzymes, there exist some esterases, oxidases, and reductases originating from buccal epithelial cells, as well as phosphatases and carbohydrases present in saliva [154], all of which may potentially be involved in the metabolism of topically applied compounds. 

Methods Employed to Assess the Permeability of the Buccal Mucosa... 

One of the most common in vivo methods used to assess the permeability of the buccal mucosa is the buccal absorption test of Beckett and Triggs [13]. In this test, a known volume of a drug solution is introduced into the oral cavity of a subject, who swirls it around for a specified period of time and then expels it. The subject then rinses his or her mouth with an aliquot of distilled water or buffer solution, and the expelled drug solution and rinse are combined and analyzed for drug content. The difference between the initial and final drug concentration in the solution is assumed to be the amount of drug taken up into the oral mucosa. 

Table 4.1 Epithelial thickness and permeability coefficient (P) for tritiated water through the buccal mucosa of different species together with epithelial thickness.

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