Referência: Brito EMT. Manual de Normas Rotinas e Procedimentos de Enfermagem - Atenção Básica /SMS-SP - 2ª ed. p - Disponível em. Some medicines can be given sublingual, which means "under the tongue". The reason for this method of administration is that some medications can enter the. Sublingual (abbreviated SL), from the Latin for "under the tongue", refers to the pharmacological route of administration by which substances diffuse into the.
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.
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.
One drawback, however, is tooth discoloration and decay caused by long-term use of this method with acidic or otherwise caustic drugs and fillers.
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.
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. 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 , Roder published work showing sublingual immunotherapy with grass pollen is not effective in symptomatic youngsters in primary care. A relatively new way of administration of therapeutic peptides and proteins such as cytokines , domain antibodies , Fab fragments or single chain antibodies is sublingual administration.
Peptides and proteins are not stable in the gastro-intestinal tract , mainly due to degradation by enzymes and pH differences. As a consequence, most peptides such as insulin , exenatide , vasopressin , etc Recently, new technologies have allowed sublingual administration of such molecules. Increased efforts are underway to deliver macromolecules peptides, proteins and immunotherapies by sublingual route, by companies such as Novo Nordisk , Sanofi and BioLingus .
The sublingual route may also be used for vaccines against various infectious diseases. It contains the sublingual gland, the deep portion of the submandibular gland, the submandibular duct, the lingual artery and vein, the lingual nerve and the cranial nerves IX and XII. The relationships of the sublingual space are very important since lesions originating from the oropharynx and oral cavity can extend into this area whereas lesions arising from the sublingual space readily spread to involve the adjacent submandibular space.
The authors present an anatomical and functional description of the structures within the sublingual space and discuss the diseases occurring in this region. Imaging methods are useful in the assessment and understanding of the lesions in the sublingual space and may help in the clinical and surgical management of the patients. Sublingual space; Computed tomography; Magnetic resonance imaging. Ocasionalmente, dois desses ductos menores fundem-se e formam o ducto de Bartholin, que se abre no ducto de Wharton Nas imagens de RM apresenta sinal hiperintenso, que se perde no sinal similar do tecido gorduroso circundante 4, No ESL encontramos estruturas como os nervos lingual e hipoglosso.
Nas imagens ponderadas em T2, abscesso e celulite possuem intensidade de sinal alta e semelhante. Hemorragia e necrose podem ocorrer. Testut L, Latarjet A. NMR anatomy of the larynx and tongue base. Mukherji SK, Castillo M. A simplified approach to the spaces of the suprahyoid neck. Radiol Clin North Am ; MRI of the floor of the mouth, tongue and orohypopharynx.
MR features of normal and diseased states. Arterial supply to the floor of the mouth and lingual gingiva. Hemiatrophy of the tongue and floor of the mouth demonstrated by computed tomography. J Comput Assist Tomogr ;9: The pharynx and oral cavity.
Sublingual and buccal medication administration are ways to take certain oral drugs. Learn the differences, pros, cons, and considerations for each. Can't decide which cannabis consumption method to choose? In this blog, we discuss two popular alternatives to smoking, sublingual and oral. Find patient medical information for Nitrostat Sublingual on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.