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Intraoral and Peroral Drug Delivery Systems
Published in Ambikanandan Misra, Aliasgar Shahiwala, In-Vitro and In-Vivo Tools in Drug Delivery Research for Optimum Clinical Outcomes, 2018
Mohammed Shuaib Khan, Pranav J. Shah, Priya B. Dubey, Jaimini K. Gandhi
Oral mucosal drug delivery is a technique of systemic drug delivery that offers several advantages over both injectable and enteral methods. Due to the high vascularity of oral mucosa, drugs that are absorbed through it directly get entered into systemic circulation, and bypass the gastrointestinal tract, as well as first-pass metabolism. For drugs that require a rapid onset of action, it is a more comfortable and convenient delivery route than the intravenous route. Not all drugs, however, can be administered through the oral mucosa because of the characteristics of the oral mucosa and the physicochemical properties of the drug (Kulkarni et al. 2009). Different drug delivery system designs and characterizations are required due to anatomical and permeability differences between the sublingual and buccal mucosa. The sublingual route provides fast absorption, rapid onset of action, and high bioavailability, since it is highly permeable and has a rich blood supply. In contrast, the buccal mucosa is less permeable and does not provide the rapid absorption, which results in less bioavailability compared to the sublingual route. The following are the challenges associated with intraoral (buccal and sublingual) drug delivery.
Unsubstantiated diagnoses and treatments
Published in Herman Staudenmayer, Environmental Illness, 2018
The sublingual method used for diagnosis usually involves placing three drops of aqueous extract under the patient’s tongue and waiting up to 10 minutes for symptoms to appear. Similarly, a subcutaneous dose is injected, with subjective symptoms being the primary dependent variable, while the cutaneous response at the site of injection may be considered important or unimportant depending on the subjective symptoms. If no symptoms are reported, higher doses are administered in a serial fashion until symptoms are provoked. There is no standardization of the nature or intensity of the symptoms to interpret a positive test. Symptoms are not specific, those reported by the patient and attributed to EI need not be the ones experienced during testing. Even the absence of symptoms may be interpreted as a positive test. The neutralization dose is determined by progressively aciministering a series of lower doses until no symptoms are reported, and that dose is used for subsequent treatments. There are many variations of this protocol, but subjectivity is the consistent characteristic.
Optimization and Dose Reduction in Pediatric Medical Imaging
Published in Lawrence T. Dauer, Bae P. Chu, Pat B. Zanzonico, Dose, Benefit, and Risk in Medical Imaging, 2018
Ted S. Treves, Briana Sexton-Stallone, Frederic H. Fahey
Thyroid imaging with 123I-NaI provides a specific and sensitive method to image functioning thyroid tissue. In newborns with congenital hypothyroidism and young children with hypothyroidism, this method can effectively detect ectopic thyroid tissue, such as lingual or sublingual tissue, helping to determine the most appropriate therapeutic approach.
Significant biopolymers and their applications in buccal mediated drug delivery
Published in Journal of Biomaterials Science, Polymer Edition, 2021
Absorptive mucosae are considered a potential site for the delivery and absorption of the drugs. There are many mucosal routes such as buccal, nasal, vaginal, rectal, ocular, etc exist in the human system. Among them, the oral cavity is mostly preferred by the patients over other sites of mucosae that are rich in blood capillaries. The recovery time of the drug delivered through the mucosal route is small and it also eliminates the first-pass metabolism and also prevents enzymatic degradation of the drug in the GI tract, which makes it a suitable site for drug delivery. Drug delivery is classified into two broad categories within the oral cavity: a) sublingual drug delivery: It is the drug delivery through the mucosal lining in the floor of the mouth; b) buccal drug delivery: It is the systemic route of drug delivery by the mucosal sites at the walls of cheeks of the mouth.