For drug efficiency and easier administration, different routes have been devised just to ensure the body responds maximally well to the medication taken, and the drug interacts excellently well with the body.
There are different routes of drug administration; talk about the Oral route (through the mouth), the sublingual route (underneath the tongue), the intravenous route (through the veins), the intramuscular route (through the muscles), the topical route (on the skin), the subcutaneous route (underneath the skin), the rectal route (through the anus) and so many others.
Oral route and sublingual
But let’s talk about the oral and the sublingual route today.Why Oral Route medications given via this route are taken through the mouth.
One of the many advantages of this route is that it’s the safest. It can easily be overcome with antidotes like activated charcoal where poisoning happens.
If intravenous route were to be the case, providing antidotes after a wrong medication would be very difficult at times, very impossible.
But oral route provides an easy way out. Another advantage with oral route is it can be easily self-administered. Unlike injections or infusions, that you would definitely need the help of a trained nurse or a qualified doctor to help administer the specified dosage, you can easily throw some tablets into your mouth and swallow.
Also, taking drugs orally, has the advantage of low risk of systemic infections.
Aside this normal method of taking drugs, which is the most common method, there is also another very interesting route which is called the sublingual route.
The Sublingual Route medications given via this route are placed under the tongue. For some reasons I find this route very absurd. Why don’t I just swallow it? But then I discovered that even though both routes were located in the mouth, their mode of absorption are different..
Drugs that are taken through the throat for easier differentiation passes through the first pass metabolism which is a process where drug is significantly metabolized by the liver before it reaches the systemic circulation.
As a result, a substantial portion of the drug may be broken down or metabolized before it can begin to take effect, reducing its bioavailability.
What I’m saying in essence is, take for instance you took 500mg of paracetamol, once this drug passes the first pass metabolism about 20 percent would have been degraded by the liver and the GIT (Gastrointestinal tract) enzymes.
If 20 percent have been degraded, you are left with 80 percent that’s like 400mg. In your mind, you believed you have actually taken 500mg but what is actually getting to the site of action is 400mg.
No wonder you continue to feel pains even before six hours elapses.
Sublingual route over Oral Route
The interesting thing about the sublingual route is that it doesn’t go through the first pass metabolism. Instead it diffuses into the capillary network and therefore directly into the systemic circulation.
This would allow for rapid absorption and still protect the bioavailability of the drug.Hey, this is not to say you should start putting all the drugs you take under your tongue just so that the concentration of the drug won’t be reduced.
You must understand that all drugs have their prescribed routes of administration. Your doctor or pharmacist knows best when he/she tells you the prescribed route to use the drug.
If you were asked to take your medications orally, please do. I would also add that a drug is also tailored to its supposed route of administration.
A drug that is supposed to be taken orally would be produced in such a way that it can easily pass the first pass metabolism.
A drug that is also supposed to be taken sublingually would be produced in a way that it can also bypass the first pass metabolism.
I think one of the many reasons drugs are also coated is because of this first pass metabolism. In order for the integrity of the active ingredient to be maintained, the drug is being coated. Such that even after so many degradations by the liver and other enzymes, one can still have at least 90% of the active ingredient if not 100% after reaching its site of action..
