Some types medicines It is recommended to use it by placing it under the tongue. This method of use is used mainly in relation to tablets - solid compressed dosage forms. However, in some cases it is also prescribed when taking other types of medications, such as powders, liquids, or aerosols.

Sublingual tablets

Tablets intended for use by placing in the sublingual area, in medical practice usually called sublingual. The origin of this term is related to its Latin roots: it is based on the words “lingua”, which translates as “language”, and “sub”, which was used to denote the preposition “under”. So literal medical term"sublingual tablets" - "sublingual tablets".

How to use sublingual tablets various types usually similar to each other. So, to use the drug, you need to place it in the sublingual area and keep it there until completely dissolved, without swallowing. In this case, the period of time required for complete resorption of the tablet may vary, depending on its composition and properties.

Use of sublingual tablets

Prescribing a sublingual form of medication is usually based on the need to ensure the most effective delivery active substance of this medicine into the blood. The point is that on back side and in the sublingual area contains a large number of blood vessels that have a high absorption capacity, that is, they absorb substances that enter this area well.

Thus, drugs placed under the tongue are absorbed directly into the blood of the patient taking them, without entering the digestive tract during this process, where they usually lose some of their properties. Besides, given drugs is also valuable because it significantly reduces the likelihood of occurrence allergic reactions, which may be especially important for patients prone to them.

However, the sublingual method of taking medications has its limitations. Thus, you should carefully monitor the dose of the drug taken, since the amount of the active substance entering the blood with this method of administration is higher than with the usual swallowing of tablets. In addition, with frequent use of this method, the integrity of tooth enamel is damaged.

1 Suction

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

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

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

2 Enteral routes of administration medicines

Enteral route includes: administration of the drug orally (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 taking the drug orally) is the most convenient and simplest, therefore it is most often used for administering medications. Absorption of drugs taken orally occurs primarily through simple diffusion of non-ionized molecules in the small intestine, and less commonly 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 bloodstream, drugs pass through two biochemically active barriers - the intestines and the liver, where they are affected by hydrochloric acid, digestive (hydrolytic) and liver (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 ratio of the amount of medicine that reaches the bloodstream to the total amount of medicine introduced into the body. The greater the bioavailability of a drug, the more completely it enters the bloodstream and the greater the effect it has. Low bioavailability is the reason that some drugs are ineffective when taken orally.

The speed and completeness of absorption of drugs from the gastrointestinal tract depends on the time of food intake, its composition and quantity. Thus, on an empty stomach, acidity is less, and this improves the absorption of alkaloids and weak bases, while weak acids are absorbed better after meals. Medicines taken after meals can interact with food components, which affects their absorption. For example, calcium chloride taken after a meal can form fatty acids insoluble calcium salts, limiting the possibility of its absorption into the blood.

Sublingual route

Rapid absorption of drugs from the sublingual area (with sublingual administration) is ensured by the rich vascularization of the oral mucosa. The effect of the drugs occurs quickly (within 2-3 minutes). Nitroglycerin is most often used sublingually for an attack of angina, and clonidine and nifedipine to relieve a hypertensive crisis. When administered sublingually, medications enter the systemic circulation, bypassing 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 rapid absorption, drugs are used behind the cheek (buccal) or on the gum in the form of films.

Rectal route

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

3 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 entering the bloodstream if adverse reactions occur;

the possibility of using substances that degrade, are not absorbed from the gastrointestinal tract or irritate its mucous membrane.

When administered intravenously, the drug immediately enters the blood (there is no absorption as a component of pharmacokinetics). In this case, the endothelium comes into contact with a high concentration of the drug. When administered into a vein, absorption of the drug occurs very quickly within the first minutes.

To avoid toxic effects, 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 medication intravenously (for example, in burnt patients), to obtain a quick effect, it can be injected into the thickness of the tongue or into the floor of the mouth.

Greetings, dear readers! Reception medical supplies can be done in different ways. And sometimes the terms that are used in medicine to denote methods of administration seem incomprehensible to us. For example, sublingually - few people know what this means. Let's figure it out.

Sublingual - how is it?

You can often find the term “sublingual” in medical prescriptions. How to apply this? – an ignorant layman will ask. Buccal (the same as sublingual) means that the tablets should be placed under the tongue and dissolved.

Sublingual drugs are used to treat various diseases internal organs. Among the main groups of medications are:

• vitamins;
• medicines for the treatment of cardiovascular diseases;
• psychotropic drugs;
• enzymes and others.

Administration of the active substance by taking the medication sublingually is very simple. The active substance comes into contact with the mucous membrane oral cavity. Absorption occurs through the epithelium at the bottom of the tongue. Since this area is literally riddled with capillaries, chemical compounds coming soon venous blood and are included in the blood circulation.

Knowing how a medicine taken under the tongue affects the body, one can understand the effectiveness of this method compared to drugs delivered directly to the intestines. Here the latter are exposed to enzymes, therefore most of active compounds decomposes. In the liver they undergo additional processing, and only then are distributed to the tissues.

Sublingual medications may be available in different forms, but, as a rule, it is a solid consistency: tablets, powder, lollipops. The liquid form is presented in the form of an aerosol. The drugs quickly dissolve and are absorbed. Contact with salivary enzymes may partially destroy active substances, but this type of administration is usually more effective than directly swallowing or chewing.

The only disadvantage this type of medication has is negative impact on tooth enamel. If you often have to put pills under your tongue, you should take good care of your oral health and visit your dentist regularly.

However, buccal preparations have several undeniable advantages:

• The medicine is minimally affected by enzymes and is immediately absorbed into the blood.
• Sublingual drugs have an active effect on the body.
• Medicines taken under the tongue work for a short period of time.
• A lasting and pronounced effect is achieved.
• Used when acute attacks, for example, for angina pectoris, when rapid action is required.

Thus, sublingual medications are a priority for physicians if there is a choice between direct oral and buccal administration.

How to take sublingual medications for children under one year of age?

The instructions for the medications give very specific instructions on how to take buccal medications. In the case of adults and children aged 2-3 years, it is enough to put a tablet or powder under the tongue and wait until the drug dissolves.

As a rule, manufacturers try to give these drugs pleasant taste, especially if they are intended for children. But sometimes the pills seem too sour or bitter to babies. In this case, you can do it another way.

Children under one year old or children who resist putting the product under the tongue can be dissolved in a small amount of water and given to drink in one gulp.

If the medicine does not taste very pleasant, children over 2 years of age can be given a small lollipop or piece of candy, a cookie, or just an extra glass of water in their mouth to eliminate discomfort. Children under one year old do not need this measure.

Doctors advise taking sublingual medications half an hour before or after meals. In this case, the composition of salivary enzymes will be suitable for the absorption of the drug. Infants can be offered breast milk after the procedure, because active compounds will go directly into the esophagus.

Buccal medications are rarely prescribed to children, but sometimes their use is simply necessary. In this case, you need to force the baby to drink the dissolved medicine, since his health depends on it.

You can also find out what it means to administer medications.

WHAT IS THE APPLICATION OF SUBLINGUAL SPRAYS AND WHY THE SUBLINGUAL METHOD OF APPLICATION IS THE MOST EFFECTIVE. The use of sprays sublingually is sprayed under the tongue. Just lift your tongue and spray. When the spray comes into contact with the oral mucosa, it is immediately absorbed into the epithelium at the bottom of the tongue. On this part of the tongue high density blood vessels and, as a result, by penetration, the substance is quickly introduced into the venous circulation, which returns the blood to the heart and then goes into the arterial circulation throughout the body. In contrast, substances passing through the intestines undergo a “first pass of metabolism” where they are processed in the liver before being distributed throughout the body. The sublingual method has an advantage over the usual method of taking medications. This route is FASTER, and administering the spray sublingually only ensures that the substance comes into contact with enzymes in the saliva before entering the bloodstream. Everything we simply swallow ends up in an extremely unfavorable environment in the gastrointestinal tract (GIT). This means that a high percentage of the original substance will be destroyed a large number enzymes in the gastrointestinal tract and the strong acids contained in it. In addition, after absorption from the gastrointestinal tract, the medicine is sent to the liver, where it will be significantly decomposed. This is known as the drug's "first pass effect" in metabolism. Due to the decline therapeutic effect When sprays pass through the stomach and intestines or dissolve in the gastrointestinal tract, sprays include a sublingual route of administration and must be absorbed by the mucous membrane. It is advisable not to smoke an hour before taking the sprays. This will significantly narrow the blood vessels, including those under the tongue, and the effectiveness of the sprays will decrease. Do not rush to rinse your mouth, as the remaining product may continue to be absorbed by the mucous membrane. Let's summarize: Firstly, contact of the active substance of the drug with an aggressive environment is excluded gastric juice. Simply put, there is no destruction useful substances located in sprays in hydrochloric acid. Secondly, in the sublingual space there is a dense network of capillaries, due to which the medicine is able to penetrate directly into the bloodstream, bypassing absorption through the mucous membrane digestive tract and metabolic primary decontamination by the liver. Accordingly, more active substance will remain, which will be manifested by its good concentration at the destination. Thirdly, taking into account direct entry into the systemic bloodstream, the rate of onset of the effect is several times higher than the rate when taken similar medicine orally. Sublingual is like an injection, only without a puncture. The only thing that limits this method, is that not every drug can be administered exactly this way in a simple way. It is especially effective when emergency and adequate assistance is needed. For all questions, write in a personal message, call on Skype alenastreltsova, WhatsApp +375447040657 Alla Streltsova

Few people know what it means to take medications buccally. This method of using drugs is often indicated in the instructions, but detailed explanations they don't give in.

There are several main ways to administer medications into the body. This largely depends on the specifics of their action and dosage form. Most tablets, capsules, mixtures, and 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. In 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 method of taking the drug does not matter, since the tablet can be:

• just hold in your mouth until completely dissolved;
• hold your tongue lightly with inside cheeks;
• place between the gums upper jaw and lip.

The main thing is that delivery medicinal substances occurs in the same way - by absorption from the surface of the mucosa. Saliva also plays an important role in this method, which helps the medicine dissolve and enter the blood.

Do not smoke for several hours before taking the tablets. Smoke narrows blood vessels, which negatively affects suction efficiency.

Main advantages and disadvantages of the method

Advantages of the method:

1. Simplicity and ease of use.
2. The medicinal components immediately enter the bloodstream, bypassing the gastrointestinal tract and liver. The action of enzymes in most cases destroys part of the pharmaceutical drugs ingested.
3. Absorption of active substances occurs quickly, which provides an almost instant effect. At pathological conditions, requiring emergency care, this route of administration can prevent many serious consequences.

Among the disadvantages, we should mention the fact that during resorption the patient will feel the taste of the drug, and it is often quite unpleasant. Some patients may feel nauseous and even vomit. Fortunately, one of the most common drugs is Glycine, which has a pleasant sweetish taste, so even children enjoy it.

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

What drugs are prescribed buccally?

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

Groups of drugs that are taken in this way:

1. Vascular. The most common drug of them is Glycine. The scope of its action is quite wide: it improves metabolic processes in the brain, quickly eliminates psycho-emotional stress, and reduces the risk of brain disorders.
2. Steroid hormones. Help you instantly level up essential hormones in blood.
3. Local remedies for the treatment of sore throat. A striking example- Septefril. Probably everyone is familiar with these sweetish tablets, which are often prescribed for inflammatory process in the throat.
4. Heart medications. Heart patients know well how quickly Nitroglycerin relieves angina attacks.
5. Painkillers. One example is Analgin, which helps to quickly relieve an attack of acute toothache.

Patients in dental and otolaryngology offices are especially familiar with this method of using medications.

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

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

After resorption, you should not immediately rinse your mouth or drink water, even if it remains on your tongue. bad taste. You need to wait a little for the medicine to completely dissolve and be absorbed without any residue.

If the medicine needs to be administered to a baby, a problem may arise, since 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 very carefully placed behind the gum in small portions.

What is the difference from the sublingual technique?

Many people wonder if there is a difference between taking the tablets sublingually or buccally. The sublingual method means that the medicine must be placed under the tongue. The reason is quite simple: this is where the most important vessel of the oral cavity is located - the sublingual artery, which supplies blood to the entire tongue. Therefore, the active substances quickly enter the blood 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 placed on the tongue or cheek, it may accidentally enter the Airways, which will further aggravate the situation. Placing the medication under the tongue greatly reduces the chance of inhalation.

People who have to constantly stop attacks of angina are most familiar with this method of taking drugs.

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