Sublingual and buccal drug administration in medical emergencies

Med Clin (Barc). 2024 Dec 27;163(12):619-625. doi: 10.1016/j.medcli.2024.05.008. Epub 2024 Jul 14.
[Article in English, Spanish]

Abstract

Drug administration is crucial to achieve effective therapeutic drug outcomes. In medical emergencies, it is particularly convenient to use drugs that could be administered as an alternative to traditional routes (as oral or intravenous routes), that are not always suitable in these situations. Thus, sublingual and buccal routes offer an alternative to traditional routes, when a rapid onset of action is required. The main objective of this narrative review is to summarize the evidence for the use of sublingual and buccal drug administration in medical emergencies. The evidence obtained has been divided into four common scenarios found in the emergency department and intensive care units: cardiovascular emergencies, acute pain, agitation, and epileptic status. Moreover, the main advantages and disadvantages of sublingual and buccal routes are presented, as the future perspectives in the drug delivery field to overcome the limitations of these routes.

Keywords: Administración bucal; Administración sublingual; Buccal administration; Critical care; Emergencias médicas; Emergency department; Intensive care unit; Medical emergencies; Paciente crítico; Servicio de urgencias; Sublingual administration; Unidad de cuidados intensivos.

Publication types

  • Review

MeSH terms

  • Acute Pain / drug therapy
  • Administration, Buccal
  • Administration, Sublingual
  • Cardiovascular Diseases / therapy
  • Emergencies*
  • Emergency Service, Hospital
  • Epilepsy / drug therapy
  • Humans
  • Psychomotor Agitation / drug therapy