Nitroglycerin sublingual route

The oral route is, of course, the principal enteral route of drug administration. However, two other examples are worthy of note. First, the sublingual route (beneath the tongue) provides relatively good absorption because of its rich capillary bed it is routinely used for the administration of nitroglycerin tablets in the treatment of... 

As a result of salivary flow, drag concentrations in this region are sustained only for a relatively short period of time, probably in the order of minutes. For these reasons, the sublingual route is ideally suited to the delivery of low molecular weight lipophilic drags where rapid onset of action is required (e.g. nitroglycerin). Dosage forms that have been developed that are suitable for these types of applications include ... 

Promoting an Optimal Response to Therapy N URATES The nitrates may be administered by die sublingual (under die tongue), buccal (between the cheek and gum), oral, IV, or transdermal route Nitroglycerin may be administered by die sublingual, buccal, to peal, transdermal, oral, or IV route If die buccal form of nitroglycerin has been prescribed, die nurse instructs die patient to place die buccal tablet between die cheek and gum or between die upper lip and gum above die incisors and allow it to dissolve The nurse shows the patient how and where to place die tablet in die mouth. Absorption of sublingual and buccal forms is dependent on salivary secretion. Dry mouth decreases absorption. 

Short-acting nitrates, such as nitroglycerin, are predominantly used for the suppression of acute anginal symptoms. The well-known sublingual (oro-mucosal) route of administration is characterised by... 

Nitroglycerin, the prototype of the nitrates is characterized by a rapid onset and short duration of action. It is usually administered sublingually (via the oro-mucosal route), which allows a rapid and efficient absorption and avoids the strong first pass effect after oral administration. Nitroglycerin is available as tablets, capsules (for sublingual administration) but also as transdermal preparations, sprays, and ointments. 

The sublingual surface area is relatively small but has a rich blood supply. The major advantage of this route is avoidance of intestinal destruction and hepatic first pass metabolism. However, absorption can be highly variable critical factors are the residence time of the drug in the mouth and saliva flow. Premature swallowing or excessive saliva production preclude efficient absorption. Nitroglycerin, nifedipine, propranolol, and buprenorphine are all available as sublingual preparations. Rectal... 

Early recognition of buccal and sublingual absorption was manifested in the use of nitroglycerin by these dosage routes to treat severe headache and to relieve angina pectoris. 

With this route a drug tablet is placed under the tongue and dissolves in saliva. The drug is absorbed through the mouth s mucous membranes. Nitroglycerin, which is taken for treatment of angina pectoris (heart pain), usually is taken sublingually. Nicotine... 

Other nitrates are similar to nitroglycerin in their pharmacokinetics and pharmacodynamics. Isosorbide dinitrate is another commonly used nitrate it is available in sublingual and oral forms. Isosorbide dinitrate is rapidly denitrated in tbe liver to isosorbide mononitrate, which is also active. Isosorbide mononitrate is available as a separate drug for oral use. Several other nitrates are available for oral use and, like the oral nitroglycerin preparation, have an intermediate duration of action (4-6 hours). Amyl nitrite is a volatile and rapidly acting vasodilator that was used for angina by the inhalational route but is now rarely prescribed. 

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