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The Oral Pathway

A fundamental route for medication delivery, this guide delves into the intricacies of oral administration.

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What is Oral Administration?

Ingestion and Digestion

Oral administration is a method of delivering a substance, typically medication, by taking it through the mouth. Once ingested, the substance is processed by the digestive system. This route is widely utilized for numerous therapeutic agents due to its convenience and patient acceptance.

Advantages

Compared to other administration routes, oral intake is often preferred because it is generally less painful and invasive than injections. It is also more straightforward to administer, requiring less specialized training for the patient or caregiver.

Considerations and Limitations

The effectiveness of oral administration can be influenced by several factors. Absorption may be inconsistent if the substance is not properly processed in the gastrointestinal tract or if it is degraded by digestive enzymes before reaching the bloodstream. Furthermore, some medications may induce gastrointestinal side effects such as nausea or vomiting. This route is only feasible for conscious patients capable of swallowing.

Terminology

Per Os (P.O.)

The Latin phrase per os, often abbreviated as P.O., literally translates to "through the mouth" or "by mouth." This designation is commonly used in medical contexts, particularly on prescriptions, to specify that a medication should be taken orally.

It is important to distinguish that "per os" refers to substances taken orally and then swallowed, not those used locally within the mouth, such as for caries prophylaxis.

Scope of Oral Administration

Enteral Routes

Oral administration falls under the broader category of enteral administration, which involves the gastrointestinal tract. This encompasses several specific methods:

  • Buccal: Administration within the cheek, allowing for absorption through the oral mucosa.
  • Sublabial: Placement under the lip, also facilitating mucosal absorption.
  • Sublingual: Dissolution under the tongue; due to rapid absorption, it is sometimes classified as a parenteral route.
  • Oral (PO): The standard method involving swallowing a tablet, capsule, or liquid.

Dosage Forms: Solids

Medications administered orally are available in various solid dosage forms, each designed for specific release profiles and administration methods:

  • Tablets: Can be swallowed whole, chewed, or dissolved in water.
  • Capsules: Contain medication in a gelatin shell that dissolves in the stomach or intestines.
  • Chewable Capsules: Designed for easier administration and faster dissolution.
  • Time-Release/Sustained-Release: Formulations engineered to release medication gradually over an extended period.
  • Osmotic Delivery Systems: Utilize osmotic pressure to control the rate of drug release.

Dosage Forms: Liquids

Liquid formulations offer alternative methods for oral drug delivery:

  • Teas/Decoctions: Aqueous preparations of plant materials.
  • Drops: Concentrated liquid formulations for precise dosing.
  • Syrups/Elixirs: Sweetened, viscous solutions or hydroalcoholic solutions, respectively.
  • Suspensions: Solid particles dispersed in a liquid medium.
  • Emulsions: Mixtures of oil and water stabilized by an emulsifying agent.

Facilitating Methods

Hydration for Swallowing

The concomitant ingestion of water is essential for facilitating the swallowing of solid dosage forms like tablets and capsules, ensuring they pass smoothly through the esophagus and into the stomach.

Palatability Enhancement

For substances with an unpleasant taste, the addition of flavors can significantly improve palatability, thereby encouraging patient compliance and facilitating ingestion. This is particularly relevant for pediatric formulations.

Protecting Dental Health

When administering substances that may be harmful to dental enamel, utilizing a drinking straw can help minimize direct contact with the teeth, thereby protecting oral health.

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References

References

  1.  TheFreeDictionary > oral administration of medication Citing: Mosby's Medical Dictionary, 8th edition. 2009
A full list of references for this article are available at the Oral administration Wikipedia page

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