Suppository 568901 222514922 2008-06-29T19:22:55Z 122.169.82.241 /* Mode of insertion */ [[Image:Suppository_casting_mould_2.jpg|thumb|right|300px|Suppository casting mould]] A '''suppository''' is a drug delivery system that is inserted either 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 [[pessary|pharmaceutical pessary]]. The general principle is that the suppository is inserted as a solid, and will dissolve inside the body to deliver the medicine. ==Vaginal suppositories== Vaginal suppositories are commonly used to treat [[gynecology|gynecological]] ailments, including vaginal infections such as [[candidiasis]]. ==Rectal suppositories== [[Image:Glycerin suppositories.jpg|right|thumb|[[Glycerin]] suppositories ([[laxative]])]]Rectal suppositories are commonly used for: * For [[laxative]] purposes, with chemicals such as [[glycerin]] or [[bisacodyl]]. * To treat a [[hemorrhoid]] by delivering a moisturizer or [[vasoconstrictor]]. * Delivery of many other systemically-acting medications, such as [[promethazine]] or [[aspirin]]. * For general medical administration purposes: the substance crosses the rectal [[mucosa]] into the bloodstream; examples include [[paracetamol]] ([[acetaminophen]]), [[diclofenac]], [[opiates]], and [[eucalyptol]] suppositories. ===Mode of insertion=== In 1991, Abd-El-Maeboud and his colleagues published a study in ''The Lancet''{{Fact|date=May 2008}} , 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 travelled internally — and, thus, upon its increased efficacy. 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 "pointy"-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 efficacy, they recommended that all rectal suppositories be inserted "blunt"-end first. ==Non-laxative rectal suppositories== [[Image:Panadol suppositories.jpg|right|thumb|Four 500 mg [[acetaminophen]]/paracetamol suppositories]] 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 a [[medical gloves|examination glove]] or a [[finger cot]] can ease insertion by protecting the rectal wall and the fingernail(s) from each other. ==Urethral suppositories== [[Alprostadil]] pellets are urethral suppositories used for the treatment of severe [[erectile dysfunction]]. They are marketed under the name ''Muse'' in the [[United States]].<ref>DrugDigest: [http://www.drugdigest.org/DD/DVH/Uses/0,3915,550749|Muse,00.html Muse overview]. Retrieved July 10, 2007.</ref> Its use has diminished since the development of oral impotence medications, but is still on the market. ==Constituents== Some suppositories are made from a greasy base, such as [[cocoa butter]], in which the active ingredient and other [[excipient]]s are dissolved; this grease will melt at body temperature (this may be a source of discomfort for the patient{{fact|date=August 2007}}, as the melted grease may pass through the [[anus]] during [[flatulence]]s). 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]].glycerogelatin is prepared by mixing glycerol n water n is solidified by gelatin. ==Indications== [[Image:Eucalyptol suppository.jpg|thumb|[[Eucalyptol]] suppository, for the treatment of some respiratory ailments]] Suppositories may be used for patients in the event it may be easier to administer than [[tablet]]s or [[syrup]]s. Suppositories may also be used when a patient has a vomiting tendency, as oral medication can be vomitted out. Drugs which often cause stomach upset, for example [[diclofenac sodium]] ([[Voltaren]]) are better tolerated in suppository form. =="Liquid suppositories"== The phrase "''liquid suppository''" is also sometimes applied to the activity of injecting a liquid, typically a [[laxative]], with a small syringe, into the rectum. == See also == * [[Artesunate suppositories]] * [[Clyster]] * [[Enema]] * [[Pessary]] ==Notes== <references/> ==References== * Abd-El-Maeboud, K.H., El-Naggar, T., El-Hawi, E.M.M., Mahmoud, S.A.R. & Abd-El-Hay, S., "Rectal Suppository: Commonsense and Mode of Insertion", ''The Lancet'', Vol.338, No.8770, (28 September, 1991), pp.798–800. * Doyle, D., "Per Rectum: A History of Enemata", ''Journal of the Royal College of Physicians of Edinburgh'', Vol.35, No.4, (December 2005), pp.367-370. * Payer, L., "How Medical Practice Reflects National Culture", ''The Sciences'', Vol.30, No.4, (July-August 1990), pp.38-42. {{Template:Dosage forms}} [[Category:Drug delivery devices]] [[Category:Laxatives]] [[cs:Čípek (léčivo)]] [[de:Suppositorium]] [[es:Supositorio]] [[fr:Suppositoire]] [[it:Supposta]] [[nl:Zetpil]] [[ja:坐剤]] [[no:Stikkpiller]] [[pl:Czopek]] [[pt:Supositório]] [[ru:Суппозитории]] [[sl:Svečka]] [[fi:Suppo]] [[sv:Stolpiller]] [[zh:栓剂]]