Question

ow would you teach a client about transmucosal medication administration?

Answer 1

You can give drugs transmucosal at three sites: inside the cheek (buccally), under the tongue (sublingually), or on the tongue (translingually). Take a look at each one:

• Buccal: To give a drug buccally, insert it between the patient’s cheek and gum (as shown below). Tell him to close his mouth and hold the tablet against his cheek until it’s absorbed. One benefit of this approach is that you can remove what’s left of a tablet from the patient’s mouth if he has an adverse reaction. You also can use this method instead of the sublingual route if a sublingual drug causes too much unpleasant tingling under the patient’s tongue.
• Client pointers:

• Make sure the patient doesn’t mistakenly swallow a tablet intended for delivery by the buccal route.

• Alternate sides of the patient’s mouth when giving more than one dose via this route.

• Administer drugs via this route after you’ve given the patient all of his oral drugs.

• Tell your patient not to eat or drink while the tablet is dissolving in his mouth. If he smokes, tell him not to smoke until after the drug dissolves; nicotine’s vasoconstrictive effects will slow drug absorption.

• Sublingual: To give a drug sublingually, put it under the patient’s tongue (as shown below) and ask him to leave it there until it’s dissolved.
• Client pointers:

• Make sure the patient doesn’t mistakenly swallow a tablet intended for delivery by the sublingual route.

• If your patient has trouble opening his mouth or raising his tongue, place one end of straw under his tongue and drop the tablet into the other end.

• Alternate sides of the patient’s mouth when giving more than one dose via this route.

• Administer drugs via this router you’ve given the patient all of his oral drugs

. • Inspect the patient’s oral mucosa before each dose of medication for irritation caused by repeated sublingual administration.

• Tell your patient not to eat, drink or smoke while the tablet is dissolving in his mouth.

• If your patient is taking nitroglycerin, tell him that he may experience a tingling or burning sensation when he puts the tablet under his tongue. If the tingling bothers him, he can move the tablet to the buccal pouch between his cheek and gum.

• If your patient takes nitroglycerin tablets at home, teach him to wet the tablet with saliva before putting it under his tongue to speed absorption.

• Translingual: Apply the drug to the top of the patient’s tongue. Most drugs given by this route are administered as a mist or spray.
• Client pointers:

• Some translingual drugs can be sprayed under the patient’s tongue instead of on top of it; the manufacturers’ directions will confirm which drugs can be given this way.

• Tell the patient not to inhale while you spray the drug onto his tongue.

• Warn him not to drink or eat anything or to rinse his mouth after administering the drug because doing so would decrease its effectiveness.

• If he’ll be using the drug at home, teach him to keep track of the number of sprays administered so he’ll know when the canister is nearly empty and can replace it before the drug runs out.