Buccal Drug Administration

Buccal area: Where is it located?

The Buccal mucosa lines the inner cheek
Buccal Drug Administration

ADVANTAGES
Avoids first pass effect
Abundance of blood vessel
Less hostile environment than GIT
Ease of administration and termination
Fast cellular recovery
Directly & easily modify microenvironment
Lower intersubject variability as compared to transdermal patches
Permeability enhancers
Rapid absorption possible & hence relatively rapid onset of action
In comparison to TDDS, mucosal surfaces do not have a stratum corneum thus, the major
barrier layer is absent

DISADVANTAGES
Relatively small absorptive surface area (0.01 sq m vs 100 sq m for GIT)
Movement affects mucoadhesive systems
Less permeable than the small intestine
Salivation and swallowing
Taste of the drug

BUCCAL DRUG DELIVERY AND MUCOADHESIVITY

Mucoadhesion of the device is a key element
The term mucoadhesive is commonly used for materials that bind to the mucin layer of a
biological membrane
Achieve systemic

BUCCAL FORMULATION
BUCCAL DRUGS
How to administer Buccal medications
Nursing Considerations

1. INTRODUCTION
The Buccal mucosa lines the inner cheek
Placed between the upper gingivae and cheek
Treat local and systemic conditions
2. An ideal dosage regimen in the drug therapy of any disease is the one, which immediately
attains the desired therapeutic concentration of drug in plasma (or at the site of action) and
maintains it constant for the entire duration of treatment
3. ADVANTAGES
Avoids first pass effect
Abundance of blood vessel
Less hostile environment than GIT
Ease of administration and termination
Fast cellular recovery
Directly & easily modify microenvironment
Lower intersubject variability as compared to transdermal patches
Permeability enhancers
Rapid absorption possible & hence relatively rapid onset of action
In comparison to TDDS, mucosal surfaces do not have a stratum corneum thus, the major
barrier layer is absent
5. DISADVANTAGES
Relatively small absorptive surface area (0.01 sq m vs 100 sq m for GIT)
Movement affects mucoadhesive systems
Less permeable than the small intestine
Salivation and swallowing
Taste of the drug
6. BUCCAL MUCOSA: ENVIRONMENT
The cells of the oral epithelia are surrounded by an intercellular ground substance, mucus.
The oral cavity is marked by the presence of saliva produced by the salivary glands Mucus
which is secreted by the major and minor salivary glands as part of saliva
7. Role of Saliva

Continuous mineralization / demineralization of the tooth enamel

Protective fluid for all tissues of the oral cavity
To hydrate oral mucosal dosage formsRole of Mucus
Bioadhesion of mucoadhesive drug delivery systems
Made up of proteins and carbohydrates
Cell-cell adhesion
Lubrication
8. DRUG DELIVERY PATHWAYS
Two possible routes of drug absorption through oral mucosa
9. BUCCAL DRUG DELIVERY AND MUCOADHESIVITY
Mucoadhesion of the device is a key element
The term mucoadhesive is commonly used for materials that bind to the mucin layer of a
biological membrane
Achieve systemic delivery of drugs include tablets, patches, tapes, films, semisolids and
powders

10. BIOADHESIVE DDS FOR MUCOSAL DRUG DELIVERY

13. CONSIDERATIONThe drug must resist, or be protected by salivary and tissue
enzymesThe drug and adhesive materials must not damage the teeth, oral cavityNo
keratinolysis, discoloration, and irritation
25. CONCLUTION
Buccal drug delivery is a promising area for systemic delivery of orally inefficient drugs as
well as an attractive alternative for noninvasive delivery of potent peptide and perhaps protein
drug molecules
26. REFERENCES Michael J Rathbone, in: Oral Mucosal Drug Delivery M.S. Wani*, Dr.
S.R. Parakh, Dr. M.H. Dehghan, S.A. Polshettiwar, V.V. Chopade, V.V. Pande, in: Current
Status In Buccal Drug Delivery System: A review Amir H Shojaei, Faculty of Pharmacy and
Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada T6G 2N8, in:
Buccal Mucosa As A Route For Systemic Drug Delivery: A Review Yie W. Chien, in: Novel
Drug Delivery System Hitesh R. Patel*, Dr. M.M. Patel, in: Draw Attention Towards
Mucoadhesive Buccal Drug Delivery System Bio-Images Research Ltd, in: Applications of
gamma scintigraphy in oral drug delivery

Buccal administration refers to a topical route of administration by which drugs diffuse through
the oral mucosa (tissues which line the mouth) and enter directly into thebloodstream. Buccal
administration typically results in higher bioavailability of a drug and a more rapid onset of action.[citation
needed]
This is because the medication does not pass through the digestive system and thereby
avoids first pass metabolism. There is current research on developing buccal morphine and fentanyl,
as well as insulin. Some sedatives can be given buccally, e.g. midazolam.

The first-pass effect (also known as first-pass metabolism or presystemic metabolism) is a

phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced before it
reaches the systemic circulation.[1][2] It is the fraction of lost drug during the process of absorption
which is generally related to the liver and gut wall. Notable drugs that experience a significant firstpass effect
are imipramine, morphine, propranolol, buprenorphine, diazepam, midazolam, demerol, cimetidine,
and lidocaine.
After a drug is swallowed, it is absorbed by the digestive system and enters the hepatic portal
system. It is carried through the portal vein into the liver before it reaches the rest of the body. The
liver metabolizes many drugs, sometimes to such an extent that only a small amount of active drug
emerges from the liver to the rest of the circulatory system. Thisfirst pass through the liver thus
greatly reduces the bioavailability of the drug. Alternative routes of
administration like suppository, intravenous, intramuscular, inhalational aerosol, transdermal
and sublingual avoid the first-pass effect because they allow drugs to be absorbed directly into
the systemic circulation. Note that the intravenous route also avoids the absorption phase.
The four primary systems that affect the first pass effect of a drug are the enzymes of
the gastrointestinal lumen, gut wall enzymes, bacterial enzymes, and hepatic enzymes.
In drug design, drug candidates may have good druglikeness but fail on first-pass metabolism,
because it is biochemically selective.
http://aaangeline.blogspot.com/2012/05/how-to-administer-sublingual-and-buccal.html
Nursing Considerations:
Preparation:
Wash hands.
Check medication against doctors order.
Check expiration date
Educate the patient about the rights of medication administration and medication info.
Administration
Inform the patient that these medications are not to be chewed or swallowed, but instead should
dissolve completely in the mouth to assure reaching therapeutic blood levels.

Check whether the patient has any open sores in your mouth. This may affect drug absorption.
Most patients can place these medications in their mouth by themselves. If you do have to place
one of these medications in a patients mouth, be sure to wash hands wear gloves to avoid
contact with the patients saliva.

If the patient is NPO, check agencys policy, but in most cases you can still give sublingual and
buccal medications.

Tell patient not to drink, swallow, eat, or smoke while taking the medication.

After Administration

Document.
Sometimes the medication can irritate the mouth. Provide oral care, as
necessary.

Monitor patients reaction to the drug. Inform physician in case of

adverse reactions.

Preparation
Know the reason why the client is receiving the medication, the drug
classification, contraindications, usual dosage range, side effects,
and nursing considerations for administering and evaluating the
intended outcomes for the medication.
Check for the drug name, dosage, frequency, route of
administration, and expiration date for administering the
medication., if appropriate
Organize the supplies.

Prepare the medication.

Calculate the medication dosage accurately.
Prepare the correct amount of medication for the required
dose.
Perfrom the Three Checks
FIRST CHECK
Read the doctors order and remove the medication(s) from the
clients drawer. Verify that the clients name match the doctors
order
SECOND CHECK
While preparing the medication, look at the medication label and
check against the doctors order
THIRD CHECK
Recheck the label on the container returning to its storage place.
Administration
Introduce self and verify the clients identity using agency protocol.
Use at least 2
Provide for client privacy.

Explain the purpose of the medication and how it will help, using
language that the client can understand.
Administer the medication.
10 rights
After Administration
Dispose of all supplies appropriately.
Document the medication given, dosage, time, any complaints or
assessments of the client, and your signature.
Evaluate the patient.
EVALUATION
Return to the client when the medication is expected to take
effect (usually 30 minutes) to evaluate the effects of the medication
on the client. Observe for desired effect (e.g., relief of pain or
decrease in body temperature).
Note any adverse effects or side effects (e.g., nausea, vomiting, skin
rash, or change in vital signs). Relate to previous findings, if
available. Report significant deviations from normal to the
primary care provider.