The sublingual route of administration happens when a medicine is administered under the tongue, which is a faster form of absorption by the body, compared to pills taken orally, where the pill still needs to disintegrate and be metabolized by the liver, to only after it is absorbed and exerts its therapeutic effect.
Only a few active substances are available to be administered sublingually, as they need to have specific characteristics to be viable through this route, which has a rapid systemic effect, because in addition to being absorbed directly into the bloodstream, they are not metabolized by the liver.
For what situations is indicated
The sublingual route is a widely used option, in cases where it is necessary to administer medications urgently, such as in a heart attack, for example, when nitroglycerin is administered under the tongue, which takes effect in about 1 to 2 minutes.
In addition, it is also an option for active substances that are altered or degraded by gastric juices and / or by hepatic metabolism, since absorption occurs in the oral mucosa, which is highly vascularized. The substances are quickly absorbed by the veins that are under the oral mucosa and transported by the brachiocephalic and internal jugular veins and then drained into the systemic circulation.
The sublingual route is also an alternative to use in the elderly and children who are unable to swallow pills.
What are the advantages and disadvantages
The main advantages of sublingual medication administration are:
- Allows the absorption of drugs more quickly; Prevents the drug from being inactivated by gastric juice; Facilitates adherence to therapy in people with difficulty swallowing pills, such as children, the elderly or people with psychiatric / neurological problems; Prevents the first effect passage in the liver and has a better bioavailability; quick dissolution of the medicine, without the need for water.
The main disadvantages of the sublingual route are:
- Interferes with drinks, food or speech; Has a short duration of action; Cannot be used when the person is unconscious or uncooperative; Allows only the administration of small doses; Difficult to use with active substances with unpleasant taste.
Understand how a medicine works since it is absorbed until it is eliminated.
Examples of remedies
Some examples of remedies that are available to be administered sublingually are nitroglycerin, for cases of infarction, in which it is necessary to act urgently to avoid sequelae, zolmitriptan, which is a remedy indicated for migraine, to quickly relieve symptoms, or buprenorphine, which is indicated for very severe and / or chronic pain.
