Activity 13.4: Critical thinking
What advice do you need to give to patients who are using the sublingual route of medication administration?
Drugs that come into contact with the mucous membrane underneath the tongue are readily absorbed. Since the connective tissue below the epithelium comprises a rich network of capillaries, the drug diffuses into them and enters the circulation. Substances swallowed into the GI tract have to be absorbed in the intestines and are therefore subject to first-pass metabolism in the liver prior to entering the general circulation.
Identify what may happen if the patient swallow’s tablets intended for the sublingual route.
Sublingual administration has some advantages over those drugs administered orally. They are more direct and absorbed much faster.
If your patient swallows a drug intended for sublingual route of administration the drug is likely to be destroyed by high levels of acids in the stomach and therefore rendered ineffective.
If a patient has open ulcers or mucositis how would this affect the administration of sublingual or buccal routes of administration?
If patients have open ulcers or mucositis sublingual or buccal routes of administration should be avoided. The surface areas required for the active absorption will be significantly reduced. Certain medications may further irritate the area, resulting in further complications.