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Contents
[hide]
1Principle
2Forms
3Substance
4Psychoactives
5Allergens
7Vaccines
8Footnotes
9External links
Principle[edit]
When a chemical comes in contact with the mucous membrane beneath the tongue, it is absorbed.
Because the connective tissue beneath the epithelium contains a profusion of capillaries, the
substance then diffuses into them and enters the venous circulation. In contrast, substances
absorbed in the intestines are subject to first-pass metabolism in the liver before entering the general
circulation.
Sublingual administration has certain advantages over oral administration. Being more direct, it is
often faster,[quantify] and it ensures that the substance will risk degradation only by salivary enzymes
before entering the bloodstream, whereas orally administered drugs must survive passage through
the hostile environment of the gastrointestinal tract, which risks degrading them, by either stomach
acid or bile, or by enzymes such as monoamine oxidase (MAO). Furthermore, after absorption from
the gastrointestinal tract, such drugs must pass to the liver, where they may be extensively altered;
this is known as the first pass effect of drug metabolism. Due to the digestive activity of the stomach
and intestines, the oral route is unsuitable for certain substances, such as salvinorin A.
Ketika suatu bahan kimia bersentuhan dengan selaput lendir di bawah lidah, ia terserap.
Karena jaringan ikat di bawah epitel mengandung banyak kapiler, substansi kemudian
berdifusi ke dalamnya dan memasuki sirkulasi vena. Sebaliknya, zat-zat yang diserap di
dalam usus tunduk pada metabolisme aliran pertama di hati sebelum memasuki sirkulasi
umum.
Administrasi sublingual memiliki kelebihan tertentu dibandingkan pemberian oral. Menjadi
lebih langsung, seringkali lebih cepat, [quantify] dan memastikan bahwa substansi akan
berisiko degradasi hanya oleh enzim saliva sebelum memasuki aliran darah, sedangkan obat
yang diberikan secara oral harus bertahan hidup melalui lingkungan yang tidak bersahabat
dari saluran pencernaan, yang berisiko menurunkan mereka. , baik oleh asam lambung atau
empedu, atau oleh enzim seperti monoamine oxidase (MAO). Selanjutnya, setelah
penyerapan dari saluran pencernaan, obat-obatan tersebut harus lolos ke hati, di mana
mereka dapat secara luas diubah; ini dikenal sebagai efek lulus pertama dari metabolisme
obat. Karena aktivitas pencernaan lambung dan usus, rute oral tidak cocok untuk zat-zat
tertentu, seperti salvinorin A.
Forms[edit]
Pharmaceutical preparations for sublingual administration are manufactured in the form of:
Sublingual tablets—tablets which easily melt in the mouth, dissolve rapidly and with little or
no residue. Nitroglycerine tablets are an example, the anti-emetic ondansetron is another.
Sublingual strips—similar to tablets in that they easily melt in the mouth and dissolve
rapidly. Suboxone is an example of medication that comes in a sublingual strip.
Multi-purpose tablets—Soluble tablets for either oral or sublingual (or buccal) administration,
often also suitable for preparation of injections, Hydrostat (hydromorphone) and a number of
brands of morphine tablets and cubes.
Sublingual drops—a concentrated solution to be dropped under the tongue, as with some
nicocodeine cough preparations,
Sublingual spray—spray for the tongue; certain human and veterinary drugs are dispensed
as such.
Lozenge—effects a metred and patient-controlled-rate combination of sublingual, buccal,
and oral administration, as with the Actiq fentanyl lozenge-on-a-stick (lollipop).
Effervescent buccal or sublingual tablets—this method drives the drug through the mucous
membranes much faster (this is the case in the stomach with carbonated or effervescent liquids
as well) and is used in the Fentora fentanyl buccal tablet.
Substance[edit]
Almost any form of substance may be amenable to sublingual administration if it dissolves easily in
saliva. Powders and aerosols may all take advantage of this method. However, a number of factors,
such as pH, molecular weight, and lipid solubility, may determine whether the route is practical.
Based on these properties, a suitably soluble drug may diffuse too slowly through the mucosa to be
effective. However, many drugs are much more potent taken sublingually, and it is generally a safer
alternative than administration via the nasal mucosa. [citation needed] This method is also extensively used
by people administering certain psychoactive drugs. One drawback, however, is tooth
discoloration and decay caused by long-term use of this method with acidic or otherwise caustic
drugs and fillers.
Hampir semua bentuk substansi dapat menerima administrasi sublingual jika mudah larut
dalam air liur. Bubuk dan aerosol semuanya dapat memanfaatkan metode ini. Namun,
sejumlah faktor, seperti pH, berat molekul, dan kelarutan lemak, dapat menentukan apakah
rute tersebut praktis. Berdasarkan sifat-sifat ini, obat yang dapat larut yang sesuai dapat
menyebar terlalu lambat melalui mukosa untuk menjadi efektif. Namun, banyak obat yang
jauh lebih manjur diambil secara sublingual, dan umumnya merupakan alternatif yang lebih
aman daripada pemberian melalui mukosa hidung. [Rujukan?] Metode ini juga banyak
digunakan oleh orang-orang yang memberikan obat psikoaktif tertentu. Satu kelemahan,
bagaimanapun, adalah perubahan warna gigi dan pembusukan yang disebabkan oleh
penggunaan jangka panjang dari metode ini dengan obat-obatan dan pengisi asam atau
obat-obatan.
Psychoactives[edit]
In addition to Salvinorin A, other psychoactives may also be applied
sublingually. LSD, MDMA, morphine, alprazolam, clonazepam, and many other substances including
the psychedelic tryptamines and phenethylamines are all viable candidates for administration via this
route.[citation needed] Most often, the drug in question is powdered and placed in the mouth (often directly
under the tongue). If held there long enough, the drug will diffuse into the blood stream, bypassing
the GI tract. This may be a preferred method to simple oral administration, because MAO is known
to oxidize many drugs (especially the tryptamines such as DMT) and because this route translates
the chemical directly to the brain, where most psychoactives act. The method is limited by excessive
salivation washing the chemical down the throat. Also, many alkaloids have an unpleasant taste
which makes them difficult to hold in the mouth. Tablets of psychoactive pharmaceuticals usually
include bitter chemicals such as denatonium in order to discourage abuse and also to discourage
children from eating them.[citation needed]
Selain Salvinorin A, psikoaktif lain juga dapat diterapkan secara sublingual. LSD, MDMA,
morfin, alprazolam, clonazepam, dan banyak zat lain termasuk tryptamine psychedelic dan
phenethylamines adalah semua kandidat yang layak untuk administrasi melalui rute ini.
[Rujukan?] Paling sering, obat tersebut adalah bubuk dan ditempatkan di mulut (sering
langsung di bawah lidah). Jika ditahan di sana cukup lama, obat akan berdifusi ke aliran
darah, melewati saluran pencernaan. Ini mungkin metode yang lebih disukai untuk
pemberian oral sederhana, karena MAO dikenal untuk mengoksidasi banyak obat (terutama
tryptamines seperti DMT) dan karena rute ini menerjemahkan kimia langsung ke otak, di
mana sebagian besar psikoaktif bertindak. Metode ini dibatasi oleh air liur yang berlebihan
mencuci zat kimia ke tenggorokan. Juga, banyak alkaloid memiliki rasa tidak enak yang
membuat mereka sulit untuk ditahan di dalam mulut. Tablet obat psikoaktif biasanya
termasuk bahan kimia pahit seperti denatonium untuk mencegah penyalahgunaan dan juga
untuk mencegah anak-anak memakannya. [Rujukan?]
Allergens[edit]
Allergens may also be applied under the tongue, and the FDA is currently reviewing this method
of allergen immunotherapy but it is not yet approved in the US. In 2007, Roder published work
showing sublingual immunotherapy with grass pollen is not effective in symptomatic youngsters in
primary care.[2]
Alergen juga dapat diterapkan di bawah lidah, dan FDA saat ini sedang meninjau metode
imunoterapi alergen ini tetapi belum disetujui di AS. Pada 2007, Roder menerbitkan karya
yang menunjukkan imunoterapi sublingual dengan serbuk sari rumput tidak efektif pada
anak-anak bergejala dalam perawatan primer. [2]
Vaccines[edit]
The sublingual route may also be used for vaccines against various infectious diseases. Thus,
preclinical studies have found that sublingual vaccines can be highly immunogenic and may protect
against influenza virus[3][4] and Helicobacter pylori,[5] but sublingual administration may also be used
for vaccines against other infectious diseases.
Rute sublingual juga dapat digunakan untuk vaksin melawan berbagai penyakit menular.
Dengan demikian, studi praklinis telah menemukan bahwa vaksin sublingual dapat sangat
imunogenik dan dapat melindungi terhadap virus influenza [3] [4] dan Helicobacter pylori,
[5] tetapi pemberian sublingual juga dapat digunakan untuk vaksin terhadap penyakit
menular lainnya.
Footnotes[edit]
1. Jump up^ "ATIVAN® 1 mg SUBLINGUAL TABLETS; ATIVAN® 2 mg SUBLINGUAL
TABLETS". home.intekom.com. Retrieved 2016-07-08.
2. Jump up^ Roder; Berger, MY; Hop, WC; Bernsen, RM; De Groot, H; Gerth Van Wijk, R
(2007). "[sublingual immunotherapy with grass pollen is not effective in symptomatic youngsters in
primary care]". J Allergy Clin Immunol. 119 (4): 892–
8. doi:10.1016/j.jaci.2006.12.651. PMID 17321581.
4. Jump up^ Song, J.-H.; Nguyen, H. H.; Cuburu, N.; Horimoto, T.; Ko, S.-Y.; Park, S.-H.;
Czerkinsky, C.; Kweon, M.-N. (2008). "Sublingual vaccination with influenza virus protects mice
against lethal viral infection". Proceedings of the National Academy of Sciences. 105 (5): 1644–
1649. doi:10.1073/pnas.0708684105. ISSN 0027-8424. PMC 2234198 .
5. Jump up^ Raghavan, S; Ostberg, AK; Flach, CF; Ekman, A; Blomquist, M; Czerkinsky, C;
Holmgren, J (October 2010). "Sublingual immunization protects against Helicobacter pylori infection
and induces T and B cell responses in the stomach". Infection and Immunity. 78 (10): 4251–
60. doi:10.1128/IAI.00536-10. PMC 2950356 . PMID 20696831.
External links[edit]
Sublingual Drug Administration at the US National Library of Medicine Medical Subject
Headings (MeSH)
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Pill
Digestive Tablet
tract (enteral) Capsule
Solids
Pastille
Elixir
Electuary
Emulsion
Extended-release syrup
Herbal tea
Hydrogel
Liquids
Molecular encapsulation
Powder
Softgel
Solution
Suspension
Syrup
Tincture
Film
Lollipop
Lozenges
Chewing gum
Mouthwash
Toothpaste
Liquids
Ointment
Oral spray
Vaporizer
Liquids
Nebulizer
Oxygen concentrator
Gas
Anaesthetic machine
Nasal spray
Ear drops
Eye drops
Ointment
Hydrogel
Nanosphere suspension
Insufflation
Ointment
Vaginal ring
Vaginal douche
Extra-amniotic infusion
Intravesical infusion
Ointment
Suppository
Enema
Solution
Hydrogel
Murphy drip
Nutrient enema
Ointment
Topical cream
Topical gel
Liniment
Paste
Film
Hydrogel
Liposomes
Transfersome vesicles
Cream
Lotion
Lip balm
Medicated shampoo
Dermal patch
Transdermal patch
Transdermal spray
Jet injector
Intradermal
Skin Subcutaneous
Transdermal implant
Organs Intracavernous
Intravitreal
Intra-articular injection
Transscleral
Intracerebral
Epidural
Intravenous
Intracardiac
Intramuscular
Intraosseous
Circulatory, musculoskeletal
Intraperitoneal
Nanocell injection
PIC line
Category
WikiProject
Pharmacy portal
After you swallow an oral tablet, there are three main steps before the
can move around your body to where it is needed. It needs to:
A sublingual tablet is a good option for this. It is simpler and safer than
other options, such as an injection, and can get the drug into your
bloodstream without needing to be absorbed from the stomach or
passing through the liver.
Definition
Sublingual and buccal medication administration are two different ways of
giving medication by mouth. Sublingual administration involves placing a drug
under your tongue to dissolve and absorb into your blood through the tissue
there. Buccal administration involves placing a drug between your gums and
cheek, where it also dissolves and is absorbed into your blood. Both sublingual
and buccal drugs come in tablets, films, or sprays.
The cheek and area under the tongue have many capillaries, or tiny blood
vessels. There, drugs can be absorbed directly into the bloodstream without
going through your digestive system.
Advantages
Sublingual or buccal forms of drugs have their advantages. Because the
medication absorbs quickly, these types of administration can be important
during emergencies when you need the drug to work right away, such as
during a heart attack.
Further, these drugs do not go through the digestive system, so they aren’t
metabolized through your liver. This means you may be able to take a lower
dose and still get the same results.
Another advantage is that you don’t have to swallow the drug. Drugs that are
absorbed under the tongue or between the cheek and gum can be easier to
take for people who have problems swallowing pills.
Disadvantages
On the other hand, sublingual and buccal drugs also have some
disadvantages. Eating, drinking, or smoking, can affect how the drug is
absorbed and how well it works. Also, these forms don’t work for drugs that
need to be processed slowly by your system, such as extended-release
formulations. Any open sores in your mouth can also become irritated by the
medication.
Definisi
Administrasi obat sublingual dan bukal adalah dua cara berbeda dalam memberikan obat
melalui mulut. Administrasi sublingual melibatkan menempatkan obat di bawah lidah Anda
untuk larut dan menyerap ke dalam darah Anda melalui jaringan di sana. Administrasi bukal
melibatkan menempatkan obat antara gusi dan pipi, di mana itu juga larut dan diserap ke
dalam darah Anda. Obat-obatan sublingual dan buccal datang dalam bentuk tablet, film,
atau semprotan.
Ketika obat-obatan sublingual dan bukal diberikan
Dokter Anda mungkin meresepkan obat-obatan sublingual atau bukal di bawah salah satu
keadaan berikut:
• obat perlu masuk ke sistem Anda dengan cepat
• Anda kesulitan menelan obat
• obat tidak menyerap dengan baik di perut
• efek obat akan menurun karena pencernaan
Pipi dan daerah di bawah lidah memiliki banyak kapiler, atau pembuluh darah kecil. Di sana,
obat-obatan dapat diserap langsung ke aliran darah tanpa melalui sistem pencernaan Anda.
Keuntungan
Bentuk obat sublingual atau bukal memiliki kelebihannya. Karena obat menyerap dengan
cepat, jenis pemberian ini dapat menjadi penting selama keadaan darurat ketika Anda
membutuhkan obat untuk segera bekerja, seperti selama serangan jantung.
Selanjutnya, obat-obatan ini tidak melalui sistem pencernaan, jadi mereka tidak
dimetabolisme melalui hati Anda. Ini berarti Anda mungkin dapat mengambil dosis yang
lebih rendah dan tetap mendapatkan hasil yang sama.
Keuntungan lainnya adalah Anda tidak perlu menelan obat itu. Obat-obatan yang diserap di
bawah lidah atau di antara pipi dan permen karet bisa lebih mudah diambil untuk orang
yang memiliki masalah menelan pil.
Kekurangan
Di sisi lain, obat-obatan sublingual dan bukal juga memiliki beberapa kelemahan. Makan,
minum, atau merokok, dapat mempengaruhi bagaimana obat diserap dan seberapa baik
kerjanya. Selain itu, formulir ini tidak berfungsi untuk obat-obatan yang perlu diproses
secara perlahan oleh sistem Anda, seperti formulasi pelepasan diperpanjang. Luka terbuka
apa pun di mulut Anda juga bisa terganggu oleh obat.