A suppository is a drug delivery system that is inserted into the rectum (rectal suppository), vagina (vaginal suppository) or urethra (urethral suppository), where it dissolves.
They are used to deliver both systemically-acting and locally-acting medications.
The alternative term for delivery of medicine via such routes is pharmaceutical pessary.
The general principle is that the suppository is inserted as a solid, and will dissolve inside the body to deliver the medicine pseudo received by the many blood vessels that follow the larger intestine.
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Rectal suppositories are commonly used for:
In 1991, Abd-El-Maeboud and his colleagues published a study in The Lancet,[1] based upon their investigation into whether there was some hidden and forgotten knowledge behind the traditional shape of a rectal suppository.
Their research very clearly demonstrated that there was, indeed, a very good reason for the traditional torpedo shape; namely, that the shape had a strong influence on the extent to which the rectal suppository traveled internally — and, thus, upon its increased efficiency.
They (counter-intuitively) found that the ideal mode of insertion was to insert suppositories blunt end first, rather than the generally used mode of inserting the tapered end first. This conclusion was based on the greater distance of internal travel of the suppository once inserted, which was entirely a mechanical consequence of the natural actions of the bowel's muscular structure and the rectal configuration.
As a consequence, and in order to guarantee the maximum optimal efficiency, they recommended that all rectal suppositories be inserted blunt end first. The findings of this single study have been challenged as insufficient evidence on which to base clinical practice.[2]
Non-laxative rectal suppositories are to be used after defecation, so as not to be expelled before they are fully dissolved and the substance is absorbed. The use of an examination glove or a finger cot can ease insertion by protecting the rectal wall from fingernail(s).
Vaginal suppositories are commonly used to treat gynecological ailments, including vaginal infections such as candidiasis.
Alprostadil pellets are urethral suppositories used for the treatment of severe erectile dysfunction. They are marketed under the name Muse in the United States.[3] Its use has diminished since the development of oral impotence medications.
Some suppositories are made from a greasy base, such as cocoa butter, in which the active ingredient and other excipients are dissolved; this grease will melt at body temperature (this may be a source of discomfort for the patient, as the melted grease may pass through the anus during flatulences). Other suppositories are made from a water soluble base, such as polyethylene glycol. Suppositories made from polyethylene glycol are commonly used in vaginal and urethral suppositories. Glycerin suppositories are made of glycerol and gelatin.
Suppositories may be used for patients in the event it may be easier to administer than tablets or syrups.
Suppositories may also be used when a patient has a vomiting tendency, as oral medication can be vomited out.
Drugs which often cause stomach upset, for example diclofenac sodium (Voltaren) are better tolerated in suppository form.
Liquid suppository involves injecting a liquid, typically a laxative, with a small syringe, into the rectum.
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PACKAGING OF SUPPOSITORIES Glycerine suppositories are packaged in tightly closed glass containers to prevent a change in moisture content.Suppositories prepared from cocoa butter base are usually indivisually wrapped or other wise separated in the compartment boxes to prevent contact and adhesion. Suppositories containing light sensitive drugs are indivisually wrapped in an opaque material such as metallic foil, mostly they are packed indivisually either in plastic or foil. Some are packaged in a continuous strip.they are commonly packaged in slide boxes or in plastic boxes. STORAGE OF SUPPOSITORIES: Because suppositories are adversely affected by heat, it is necessary to maintain them in a cool place. Cocoa butter suppositories mustbe stored below 30 degree Celsius and preferably in a refrigerator. Glycerinated gelatin suppositories can be stored at controlled room temperature. Poly ethylene-base suppositories may be stored at usual room temperatures. Suppositories store in high humidity may absorb moisture and tend to become spongy, whereas suppositories stored in places of extreme dryness may lose moisture and become brittle. reference book of pharmaceutical preparations ansels