Where is buccal medicine supposed to be placed?

Appeared in: JSSH Staff Nurse - 2019

Explanation

The term 'buccal' refers to the cheek. Therefore, buccal administration involves placing a medication in the mouth against the mucous membranes of the cheek.
The medication is placed in the pouch between the cheek and the gum, where it dissolves and is absorbed directly into the rich network of blood vessels in the oral mucosa.
This method allows for rapid absorption and avoids the breakdown of the drug by the digestive system and liver (first-pass metabolism).

Option A: Placing medication 'on the skin' describes the topical route of administration, not the buccal route.
Option B: Placing medication 'on the conjunctiva' describes the ophthalmic route, used for treating eye conditions.
Option D: Placing medication 'under the tongue' describes the sublingual route. While similar to buccal, the placement is different.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Routes of Medication Administration as background academic context rather than a clinical decision trigger.
Correct placement is crucial for the drug's effectiveness. Placing a buccal medication incorrectly (e.g., under the tongue) or swallowing it can alter its absorption rate and efficacy.
Nurses must provide clear instructions to patients on how to take buccal medications, emphasizing not to swallow the tablet and to alternate cheeks to prevent mucosal irritation.
What if the patient accidentally swallows the buccal tablet? The medication will be absorbed via the gastrointestinal tract, subjecting it to the first-pass effect in the liver. This will likely delay the onset of action and reduce the amount of active drug reaching systemic circulation, potentially rendering the dose subtherapeutic.

How to Approach the Question

First, identify the key term in the question: 'buccal medicine'.
Recall the anatomical definition of 'buccal', which relates to the cheek or the cavity of the mouth.
Evaluate the given options based on this definition.
Option A ('On the skin') is topical. Option B ('On the conjunctiva') is ophthalmic. Option D ('Under the tongue') is sublingual.
Option C ('Between the cheek and gum') directly corresponds to the definition of the buccal area, making it the correct placement for buccal medication.

Concept Tested & Keywords

QpivTCyzy05MTcEoEpaL95

E6 Pharmacology Nursing Lilley 11e Part 1 p. 40-42

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 137-139

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