Suppository
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2008-06-29T19:22:55Z
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/* 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.
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[[Category:Drug delivery devices]]
[[Category:Laxatives]]
[[cs:Čípek (léčivo)]]
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