Why do some drugs need to be put under the tongue. Sublingual administration (under the tongue) Yellowish tablets for sublingual use

Few people know what it means to take medicine buccally. This way of using drugs is often indicated in the instructions, but they do not give detailed explanations.

There are several main ways of introducing drugs into the body. This largely depends on the specifics of their action and dosage form. Most tablets, capsules, potions, powders are taken orally, swallowed and washed down with water. In the treatment of young children or patients with digestive disorders, the rectal method is often used - the introduction of suppositories into the anus. V rare cases It is recommended not to swallow, but to take tablets or lozenges buccally.

Translated from Latin, parts of this word mean "through the cheek." Now everything becomes clear: the tablet must be placed in the oral cavity behind the cheek.

The specific way how the drug will be taken does not matter, since the pill can:

just hold in your mouth until completely dissolved;
lightly hold the tongue on the inside of the cheek;
place between the gum upper jaw and lip.

The main thing is that the delivery of medicinal substances occurs in the same way - by absorption from the surface of the mucosa. An important role in this method is played by saliva, which helps the medicine dissolve and enter the bloodstream.

Do not smoke for several hours before taking the tablets. Smoke constricts blood vessels, which negatively affects the efficiency of absorption.

The main advantages and disadvantages of the method

Advantages of the method:

Simplicity and ease of use.
Medicinal components immediately enter the bloodstream, bypassing the gastrointestinal tract and liver. The effect of enzymes in most cases destroys some of the ingested pharmaceuticals.
Absorption of active substances occurs quickly, which provides an almost instantaneous effect. In pathological conditions requiring emergency care, this route of administration can prevent many serious consequences.

Of the disadvantages, mention should be made of the fact that during resorption the patient will feel the taste of the drug, and it is often quite unpleasant. Some patients may feel nauseated and even vomit. Fortunately, one of the most common drugs is Glycine, which has a pleasant sweetish taste, so even children are happy to dissolve it.

If there are wounds or sores in the mouth, then when the components of the medicine get into the damaged area, a person may feel pain and irritation. Also, some pharmaceuticals can have a negative effect on tooth enamel.

What drugs are prescribed buccal

In this way, only highly active drugs in small doses can be administered. This is due to the fact that the suction surface of the mucous membrane is relatively small.

Groups of funds that are received in this way:

Vascular. The most common drug of them is Glycine. Its scope is quite wide: it improves metabolic processes in the brain, quickly eliminates psycho-emotional stress, reduces the risk of brain disorders.
Steroid hormones. They help to instantly raise the level of essential hormones in the blood.
Local remedies for the treatment of angina. A striking example is Septefril. Probably everyone is familiar with these sweet pills, which are often prescribed for an inflammatory process in the throat.
Heart drugs. Hearts are well aware of how quickly Nitroglycerin relieves angina attacks.
Painkillers. One example is Analgin, which helps to quickly stop an attack of acute toothache.

Patients of dental and otolaryngological offices are especially familiar with this method of using drugs.

The patient must know the rules of admission. He needs:

wash hands with antibacterial soap and dry with a disposable towel;
rinse the mouth with water;
put the pill in your mouth;
hold the medicine in your mouth until completely dissolved (it takes 2-3 minutes).

After resorption, you should not immediately rinse your mouth or drink water, even if an unpleasant aftertaste remains on the tongue. You need to be a little patient so that the medicine is completely dissolved and absorbed without residue.

If the medicine needs to be administered to the baby, a problem may arise, since at an early age not everyone can understand what mom and dad want from them. In this case, the product must be crushed to a powder and in small portions very carefully placed behind the gum.

What is the difference from sublingual technique

Many are wondering if there is a difference between taking sublingual or buccal tablets. The sublingual method means that the medicine must be placed under the tongue. The reason is quite simple: it is there that the most important vessel is located. oral cavity- hypoglossal artery that supplies blood to the entire tongue. Therefore, active substances quickly enter the bloodstream and produce a medicinal effect.

This method has an advantage over buccal administration if the patient is unconscious or semi-conscious. If the tablet is simply put on the tongue or on the cheek, it may accidentally enter the respiratory tract, which will further aggravate the situation. Placing the medicine under the tongue makes it much less likely to be inhaled.

This method of taking drugs is best known to people who have to constantly stop angina attacks.

There is nothing unusual in taking drugs in this way. Everything is very simple. Difficulties arise only because of the complex name, which few people understand.

1 Suction

At the stage of absorption, the medicinal substance from the intestinal lumen penetrates into the blood. The efficiency of this process may depend on the pH of the environment.

The degree of absorption of the drug also depends on intestinal motility. So, with increased motility of the gastrointestinal tract, the absorption of digoxin decreases, and with a weakening, it increases.

Inhibition of enzymes that promote absorption is another type of interaction.

2 Enteral routes of drug administration

enteral route includes: the introduction of the drug inside through the mouth (per os) or orally; under the tongue (sub lingua) or sublingually, into the rectum (per rectum) or rectally.

oral route

The oral route (also called oral administration) is the most convenient and simplest, therefore it is most often used for the administration of drugs. Absorption of drugs taken by mouth occurs mainly by simple diffusion of non-ionized molecules in the small intestine, less often in the stomach. The effect of the drug when taken orally develops after 20-40 minutes, so this route of administration is not suitable for emergency therapy.

At the same time, before entering the general circulation, the drugs pass through two biochemically active barriers - the intestines and the liver, where they are affected by hydrochloric acid, digestive (hydrolytic) and hepatic (microsomal) enzymes, and where most drugs are destroyed (biotransformed). A characteristic of the intensity of this process is bioavailability, which is equal to the percentage of the amount of the drug that has reached the bloodstream to the total amount of the drug introduced into the body. The greater the bioavailability of the drug, the more completely it enters the bloodstream and the greater the effect it has. Low bioavailability is the reason why some drugs are not effective when taken orally.

The rate and completeness of drug absorption gastrointestinal tract depends on the time of the meal, its composition and quantity. So, on an empty stomach, acidity is less, and this improves the absorption of alkaloids and weak bases, while weak acids are absorbed better after a meal. Medications taken after a meal can interact with food components, which affects their absorption. For example, calcium chloride taken after a meal can form insoluble calcium salts with fatty acids, limiting its ability to be absorbed into the blood.

sublingual way

The rapid absorption of drugs from the sublingual region (with sublingual administration) is provided by the rich vascularization of the oral mucosa. The action of drugs comes quickly (after 2-3 minutes). Sublingually, nitroglycerin is most often used for an attack of angina pectoris, and clonidine and nifedipine for the relief of a hypertensive crisis. With sublingual administration, drugs enter the systemic circulation, bypassing the gastrointestinal tract and liver, which avoids its biotransformation. The drug should be kept in the mouth until it is completely absorbed. Often sublingual use of drugs can cause irritation of the oral mucosa.

Sometimes, for quick absorption, drugs are used on the cheek (buccally) or on the gum in the form of films.

rectal route

The rectal route of administration is used less frequently (mucus, suppositories): in diseases of the gastrointestinal tract, in the unconscious state of the patient. The bioavailability of drugs with this route of administration is higher than with oral administration. About 1/3 of the drug enters the general circulation, bypassing the liver, since the inferior hemorrhoidal vein flows into the system of the inferior vena cava, and not into the portal.

3Parenteral routes of drug administration Intravenous administration

Drugs are administered intravenously in the form aqueous solutions, which provides:

rapid onset and precise dosing of the effect;

rapid cessation of the drug's entry into the blood in the event of adverse reactions;

the possibility of using substances that are collapsing, non-absorbable from the gastrointestinal tract or irritating its mucous membrane.

At intravenous administration the drug immediately enters the bloodstream (absorption as a component of pharmacokinetics is absent). In this case, the endothelium is in contact with a high concentration of the drug. The absorption of the drug when injected into a vein is very fast during the first minutes.

In order to avoid toxic manifestations, potent drugs are diluted with an isotonic solution or glucose solution and administered, as a rule, slowly. Intravenous injections are often used in emergency care. If it is not possible to administer drugs intravenously (for example, in burned patients), it can be injected into the thickness of the tongue or into the floor of the mouth to obtain a quick effect.

There are many ways to introduce drugs into the body. The route of administration largely determines the rate of onset, duration and strength of drug action, spectrum and severity. side effects. In medical practice, it is customary to subdivide all routes of administration into enteral, that is, through the gastrointestinal tract, and parenteral, which include all other routes of administration.

Enteral routes of drug administration

enteral route includes: the introduction of the drug inside through the mouth (per os) or orally; under the tongue (sub lingua) or sublingually, into the rectum (per rectum) or rectally.

oral route

The oral route (also called oral administration) is the most convenient and simplest, therefore it is most often used for drug administration. Absorption of drugs taken by mouth occurs mainly by simple diffusion of non-ionized molecules in the small intestine, less often in the stomach. The effect of the drug when taken orally develops after 20-40 minutes, so this route of administration is not suitable for emergency therapy.

At the same time, before entering the general circulation, drugs pass through two biochemically active barriers - the intestine and liver, where they are affected by hydrochloric acid, digestive (hydrolytic) and hepatic (microsomal) enzymes, and where most drugs are destroyed (biotransformed). A characteristic of the intensity of this process is bioavailability, which is equal to the percentage of the amount of the drug that has reached the bloodstream to the total amount of the drug introduced into the body. The greater the bioavailability of the drug, the more completely it enters the bloodstream and the greater the effect it has. Low bioavailability is the reason why some drugs are ineffective when taken orally.

The rate and completeness of absorption of drugs from the gastrointestinal tract depends on the time of the meal, its composition and quantity. So, on an empty stomach, acidity is less, and this improves the absorption of alkaloids and weak bases, while weak acids are absorbed better after eating. Medications taken after a meal may interact with food ingredients, which affects their absorption. For example, calcium chloride taken after a meal can form insoluble calcium salts with fatty acids, limiting its ability to be absorbed into the blood.

sublingual way

Sometimes, for quick absorption, drugs are used on the cheek (buccally) or on the gum in the form of films.

rectal route

Parenteral routes of drug administration

Intravenous administration

Medicinal substances are administered intravenously in the form of aqueous solutions, which provides:

rapid onset and precise dosing of the effect;
rapid cessation of the drug's entry into the blood in the event of adverse reactions;
the possibility of using substances that are collapsing, non-absorbable from the gastrointestinal tract or irritating its mucous membrane.

When administered intravenously, the drug immediately enters the blood (absorption as a component of pharmacokinetics is absent). In this case, the endothelium is in contact with a high concentration of the drug. The absorption of the drug when injected into a vein is very fast during the first minutes.

In order to avoid toxic manifestations, potent drugs are diluted with an isotonic solution or glucose solution and administered, as a rule, slowly. Intravenous injections are often used in emergency care. If the drug cannot be administered intravenously (for example, in burned patients), it can be injected into the thickness of the tongue or into the bottom of the mouth to obtain a quick effect.

Intra-arterial administration

It is used in cases of diseases of certain organs (liver, blood vessels, limbs), when medicinal substances are rapidly metabolized or bound by tissues, creating a high concentration of the drug only in the corresponding organ. Arterial thrombosis is a more serious complication than venous thrombosis.

Intramuscular administration

Aqueous, oily solutions and suspensions of medicinal substances are administered intramuscularly, which gives a relatively quick effect (absorption is observed within 10-30 minutes). The intramuscular route of administration is often used in the treatment of depot drugs that give a prolonged effect. The volume of the injected substance should not exceed 10 ml. Suspensions and oily solutions, due to slow absorption, contribute to the formation of local soreness and even abscesses. The introduction of drugs near the nerve trunks can cause their irritation and severe pain. It can be dangerous if the needle accidentally enters a blood vessel.

Subcutaneous administration

Water and oil solutions are injected subcutaneously. With subcutaneous administration, the absorption of the drug substance occurs more slowly than with intramuscular and intravenous injections, and the manifestation of the therapeutic effect develops gradually. However, it lasts longer. Solutions of irritating substances that can cause tissue necrosis should not be injected under the skin. It should be remembered that in case of insufficiency of peripheral circulation (shock), subcutaneously administered substances are poorly absorbed.

Local application

To obtain a local effect, drugs are applied to the surface of the skin or mucous membranes. When applied externally (lubrication, baths, rinses), the drug forms a complex with a biosubstrate at the injection site - a local effect (anti-inflammatory, anesthetic, antiseptic, etc.), in contrast to the resorptive one that develops after absorption.

Some drugs that are used externally for a long time (glucocorticoids), in addition to a local effect, can also have a systemic effect. In recent years, developed dosage forms on an adhesive basis, providing slow and prolonged absorption, thereby increasing the duration of the drug (nitroglycerin patches, etc.).

Inhalation

In this way, gases (volatile anesthetics), powders (sodium chromoglycate), aerosols (beta-agonists) are introduced into the body. Through the walls of the pulmonary alveoli, which have a rich blood supply, medicinal substances are quickly absorbed into the blood, providing a local and systemic effect. With the termination of inhalation of gaseous substances, a rapid termination of their action is also observed (ether for anesthesia, halothane, etc.). By inhalation of an aerosol (beclomethasone, salbutamol), their high concentration in the bronchi is achieved with a minimal systemic effect. Irritant substances are not introduced into the body by inhalation, in addition, drugs entering the left heart through the veins can cause a cardiotoxic effect.

Intranasal (through the nose) drugs are administered that have a local effect on the nasal mucosa, as well as some drugs that affect the central nervous system.

electrophoresis

This path is based on the transfer of medicinal substances from the surface of the skin to deep-lying tissues using galvanic current.

Other routes of administration

In and for spinal anesthesia, subarachnoid drug administration is used. In cardiac arrest, adrenaline is administered intracardiac. Sometimes drugs are injected into the lymphatic vessels.

Movement and transformation of drugs in the body

The drug is introduced into the body in order to have any therapeutic effect. However, the body also affects the drug, and as a result of this, it may or may not enter certain parts of the body, pass or not pass certain barriers, modify or retain its chemical structure, leave the body in certain ways. All stages of the movement of the drug through the body and the processes that occur with the drug in the body are the subject of study of a special section of pharmacology, which is called pharmacokinetics.

There are four main stages pharmacokinetics drugs - absorption, distribution, metabolism and excretion.

Suction- the process of entry of the drug from the outside into the bloodstream. Absorption of drugs can occur from all surfaces of the body - skin, mucous membranes, from the surface of the lungs; when taken orally, the entry of drugs from the gastrointestinal tract into the blood occurs using the mechanisms of absorption of nutrients. It should be said that drugs are best absorbed in the gastrointestinal tract, which have good solubility in fats (lipophilic agents) and have a small molecular weight. Macromolecular agents and substances insoluble in fats are practically not absorbed in the gastrointestinal tract, and therefore they must be administered by other routes, for example, in the form of injections.

After the drug enters the blood, the next stage begins - distribution. This is the process of penetration of a drug from the blood into organs and tissues, where the cellular targets of their action are most often located. The distribution of the substance is the faster and easier, the more it is soluble in fats, as in the stage of absorption, and the lower its molecular weight. However, in most cases, the distribution of the drug over the organs and tissues of the body occurs unevenly: more drugs get into some tissues, and less into others. There are several reasons for this circumstance, one of which is the existence of so-called tissue barriers in the body. Tissue barriers protect against foreign substances (including drugs) entering certain tissues, preventing tissue damage. The most important are the blood-brain barrier, which prevents the penetration of drugs into the central nervous system (CNS), and the hematoplacental barrier, which protects the body of the fetus in the uterus of a pregnant woman. Tissue barriers, of course, are not completely impenetrable to all drugs (otherwise we wouldn't have drugs that affect the CNS), but they significantly change the distribution pattern of many chemicals.

The next step in pharmacokinetics is metabolism, that is, a modification of the chemical structure of the drug. The main organ where drug metabolism occurs is the liver. In the liver, as a result of metabolism, the drug substance in most cases is converted from a biologically active to a biologically inactive compound. Thus, the liver has antitoxic properties against all foreign and harmful substances, including drugs. However, in some cases, the opposite process occurs: the drug substance is transformed from an inactive "prodrug" into a biologically active drug. Some drugs are not metabolized at all in the body and leave it unchanged.

The last step in pharmacokinetics is breeding. The drug and its metabolic products can be excreted in various ways: through the skin, mucous membranes, lungs, intestines. However, the main route of excretion of the vast majority of drugs is through the kidneys with urine. It is important to note that in most cases the drug is prepared for excretion in the urine: during metabolism in the liver, it not only loses its biological activity, but also turns from a fat-soluble substance into a water-soluble one.

Thus, the drug passes through the entire body before leaving it as metabolites or unchanged. The intensity of the pharmacokinetic steps is reflected in the concentration and duration of the presence of the active compound in the blood, and this, in turn, determines the strength of the pharmacological effect of the drug. In practical terms, to assess the efficacy and safety of a drug, it is important to determine a number of pharmacokinetic parameters: the rate of increase in the amount of drug in the blood, the time to reach the maximum concentration, the duration of maintaining the therapeutic concentration in the blood, the concentration of the drug and its metabolites in urine, feces, saliva and other secretions, etc. .d. This is done by specialists - clinical pharmacologists, who are designed to help attending physicians choose the optimal tactics of pharmacotherapy for a particular patient.

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The mucous membrane of the gastrointestinal tract is a barrier that significantly limits the flow of drugs. Charged non-lipophilic drugs (muscle relaxants, certain antibiotics, heparin, etc.) do not pass through the epithelium, many substances are not completely absorbed. After absorption, many of them can be metabolized and partially inactivated in the liver. (effect"first pass"). medicinal substances with highly polar molecules can be secreted by hepatocytes, returned to the intestine with bile, and then reabsorbed, etc. (“enterohepatic drug circulation” or “hepato-enteric circulation”).

In this way, absorption drugs depends on their properties, the state of the mucous membrane, the motor activity of the stomach and intestines, the characteristics of the intake and nature of the food. For the total bioavailability the drug affects the nature of the primary metabolism when entering the liver.

Oral route of administration

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Taking medications by mouth (by mouth) is called oral by introduction. Its advantages include: ease of use, the presence of natural barriers that make the administration of drugs safer, as well as the convenience of topical use of non-absorbable drugs (passage with food).

The disadvantages of the oral route are: inapplicability in a number of situations (swallowing disorder, persistent vomiting, unconsciousness, drugs that are not absorbed or destroyed in the gastrointestinal tract): significant variability in absorption and bioavailability of drugs, slow onset (15-40 minutes after administration) and a lower potency of administered drugs, which limits use of this pathway in emergency care.

Features of oral use of drugs:

simple medicinal forms (solutions, suspensions, emulsions, powders) are absorbed better than ready-made ones (tablets, capsules, dragees), but less convenient to use;
weakly alkaline preparations are absorbed faster with reduced acidity of gastric juice (achilia, taking neutralizing agents of soda, milk), weakly acidic preparations, on the contrary (due to an increase in the degree of ionization);
meal slows down absorption of most drugs (delayed gastric emptying), but increases the absorption of fat-soluble drugs (fat-soluble vitamins, anticoagulants) and the bioavailability of a number of drugs due to the competitive weakening of their metabolism in the liver during the “first pass” (anaprilin, apressin, verapamil, morphine, nitrates, etc.), they are best taken immediately after meals;
drugs with an irritant effect on the gastric mucosa (non-steroidal anti-inflammatory drugs, corticosteroids, reserpine, doxycycline, potassium, etc.) are recommended to be taken after meals;
hypoglycemic oral agents are taken immediately before meals or during meals;
solid medicines (tablets, capsules) for the prevention of esophageal ulceration are washed down with 150 ml of water (3-4 large sips) in a standing position, less preferably sitting.

Sublingual (sublingual) way

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Advantages the sublingual route are as follows: suitability due to rapid absorption for emergency care (nitroglycerin: nifedipine, propropolol), no “first pass” effect (drugs bypass the liver during absorption). For planned therapy, it is used with the introduction of steroid hormones and their derivatives, which are significantly destroyed in the liver.

disadvantages sublingual drug use are inapplicability for drugs with an irritant effect or an unpleasant taste and poor absorption of many drugs.

rectal route

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Advantages: possibility of use when the oral route is inaccessible (vomiting, impaired swallowing), rapid absorption with minimal destruction by digestive juices and the liver (absorption and bypass of the liver determines the potency about a third higher than with oral intake).

Flaws: inconvenience of use, getting part of the medicine into the portal bloodstream (when the suppository is moved upwards), limiting the volume of the therapeutic enema to 50-100 ml.

Injection routes

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Advantages: the strongest and fastest effect (indispensable in emergency care), high bioavailability, good dose control, allows the introduction of non-absorbable drugs.

Flaws: pain upon injection, trauma, risk of intoxication and severe systemic reactions, risk of infection, the need for special preparation of solutions and their high cost, difficulties in long-term treatment.

1. Intravenous route

usage features:

must be carried out under the supervision of a physician;
the speed of the onset of the effect is maximum (sometimes “at the tip of the needle”);
the potency is 5-10 times greater than with oral administration of the same dose;
the duration of action is shorter than with other routes of administration;
with the introduction of irritants, it is desirable to “wash” the vein with warm saline;
exists jet and slower drip route of administration, jet injection with maximum speed called bolus.

2. Intramuscular route

usage features:

the speed of the onset of the effect is 10-15 minutes (aqueous solutions);
the strength of action is 2-3 times greater than when taken orally;
the duration of action is less than with oral administration;
when introducing insoluble substances (oily solutions, suspensions), it is necessary to make sure that the needle does not enter the vessel;
convenient for the introduction of depot drugs that provide a stable concentration of the drug for many days;
the best injection sites are the gluteal and deltoid muscles;
absorption can be accelerated with a heating pad or slowed down with an ice pack.

3. Subcutaneous route

usage features:

the speed, strength and duration of the effect are close to the intramuscular route;
significant pain on insertion;
do not inject irritating, hypo- and hyperosmolar solutions;
used for the introduction of prolonged forms of drugs:
injection sites (limbs and abdomen) are the most accessible, which is convenient for self-help and mutual assistance (syringe-tubes).

Non-injection routes (without breaking the integument of the body)

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1. Inhalation route

usage features:

the depth of penetration of drugs into the airways depends on the particle size of the aerosol or fine powder, the best penetration is achieved by gases that through the alveolo-capillary barrier very quickly enter the systemic circulation;
used for local effects on mucous membranes respiratory tract(bronchodilators, corticosteroids) and based on the systemic effect during absorption (gases - oxygen, general anesthetics);
for the introduction of drugs, special devices are used - inhalers, stationary and portable;
even with methodically correct inhalation of an aerosol, a significant part of it (up to 90%) remains in the oral cavity and nasopharynx, which can lead to undesirable local effects (after inhalation, for example, corticosteroids, you should rinse your mouth with alkaline solutions);
with a pronounced violation of bronchial patency (emphysema, severe bronchospasm), the effectiveness of inhalation agents decreases.

2. Application path

Application path - in the clinic of internal diseases, transdermal can be used. Its advantages are non-traumatic and the absence of the effect of the primary passage through the liver. For transdermal administration, special patches with a prolonged uniform release of the drug are used, for example, Pitroderm, a system for releasing nitroglycerin.

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Sometimes the instructions for medicines are written so abstrusely that it is very difficult for the average user to understand them. And doctors and pharmacists most often do not have enough time or energy to explain to customers all the features of each medication. V best case they can only explain in detail the recommended dosage. Therefore, today we will clarify some of the most common terms used in drug instructions. So, this is how to apply rectally, orally, buccally, sublingually?

Rectally - how to apply?

Rectal administration of drugs involves their introduction into the rectum - into the anus. This method allows the active components of the drug to quickly enter the bloodstream, they are absorbed by the blood vessels of the rectum and penetrate into the circulatory system. In the future, together with the blood, the drug is distributed throughout the organs, as well as through the systems, providing the expected therapeutic effect.

Medicines taken rectally tend to have a faster effect than tablets, have a higher bioavailability, and have a shorter peak effect than tablets and other drugs taken orally. In addition, the rectal method of administration avoids the occurrence of nausea and makes it possible to achieve a therapeutic effect even with vomiting.

Before administering the medicine rectally, it is imperative to wash and dry your hands well. When using suppositories (candles), it is better to keep your hands cold so that the product does not melt. When administering the medication, it is important to relax and not use force. After using the medicine, you must immediately connect the buttocks so that it does not immediately come out. Most rectal medications are advised to be used after a bowel movement. And after using them, it is advisable to lie down for twenty-five minutes.

Orally - how to apply?

Most medicines are used orally. This is through the mouth, by swallowing the drug. Most drugs for oral consumption are well absorbed by the mucous membranes of the digestive tract. Sometimes, on the contrary, medicines are used that are poorly absorbed, due to which it is possible to achieve their significant concentration in the right place in the gastrointestinal tract.

Orally, various solutions are usually used, as well as powders with tablets, capsules and pills. There are a number of medications complex shapes(for example, tablets having a multilayer shell), they allow active ingredient be released especially for a long time, which contributes to the prolongation of the therapeutic effect.
Almost all oral medications need to be taken with a sufficient amount of liquid. This allows them to easily move through the esophagus.

Some oral medications must be swallowed whole. Others, on the contrary, must be chewed, crushed or dissolved in a small amount of liquid. Similar subtleties of use are indicated in the instructions for the medicine.

Transbuccal - this is how to apply?

This method of using drugs involves placing medicinal product in the area between upper lip and gum or behind the cheek up to complete dissolution. With this method of application, the active substances of the drug enter the circulatory system through the mucous membranes of the oral cavity.

It is believed that this method of application allows you to deliver the drug into the bloodstream, bypassing hydrochloric acid in the stomach, as well as bypassing the liver. Medicines used buccally provide a rapid therapeutic effect, which makes them popular in a number of emergency conditions.

However, with this method of application, the drug can be absorbed only by a small surface of the mucous membranes of the oral cavity, therefore, only highly active substances are used in this way, which are characterized by a small dosage. In general, buccal medications are used to of cardio-vascular system(for example, nitroglycerin), some steroids and barbiturates. A similar use of certain vitamins and minerals is also possible.

Sublingual - how to apply?

The method of sublingual application of drugs at first glance is very similar to transbuccal. With sublingual use, the medication is placed under the tongue until completely dissolved. In this case, the drug is just as quickly absorbed into the blood, injected into the venous circulation and, after passing through the heart, disperses throughout the body with the arterial circulation. Sublingual active substances also provide a rapid therapeutic effect, are not exposed to the aggressive environment of the digestive tract and do not pass through the liver.

The only difference between the sublingual method and the transbuccal method is that the hyoid artery passes under the tongue, which is the largest vessel in the oral cavity. It is in it that all substances (and medicines) get the fastest.

Basically, for medicines that can be used sublingually, a buccal method of administration is also possible. These drugs include cardiovascular drugs, steroids, as well as barbiturates, certain enzymes, vitamin and mineral elements.