THE TREATMENT OF ADDISON'S DISEASE BY THE INTRAORAL ADMINISTRATION OF DESOXYCORTICOSTERONE ACETATE TABLETS

Abstract

MANY substances are effectively absorbed through the oral mucosa, as has long been known to physicians; but until recently this route of administration has been used almost solely for water-soluble drugs, such as nitroglycerine and morphine sulfate. The efficacy of the route was shown experimentally when Meltzer (1) in 1899 gave strychnine orally to dogs having the esophagus tied just above the cardia. In two hours, the animals were dead from strychnine poisoning. Karmel (2), in 1873, had likewise studied the absorption of drugs through the oral mucosa. In 1923, Mendel (3) demonstrated in patients the rapid absorption of nitroglycerine, morphine and other drugs when given in tablets placed under the tongue. Interest in the intraoral route of administration wras renewed when Anderson, Haymaker and Henderson (4) reported in 1940 that desoxycorticosterone acetate (DCA) when given sublingually in solution was an effective treatment of adrenal insufficiency. Their observations were confirmed by Turnoff and Rowntree (5) and by Thaddea (6). Other reports showed the effectiveness of estrogens and of androgens in patients receiving sublingual solutions (7–11).