Editing Suppository

{{Short description|Dosage form used to deliver medications}}
{{Context|date=November 2021}}
A '''suppository''' is a [[dosage form]] used to deliver [[pharmaceutical drug|medications]] by insertion into a [[body orifice]] (any opening in the body), where it dissolves or melts to exert local or systemic effects. There are three types of suppositories, each to insert into a different sections: rectal suppositories into the [[rectal administration|rectum]], vaginal suppositories into the [[Intravaginal administration|vagina]], and urethral suppositories into the [[Urethra#Male|urethra of a male]].

Suppositories are ideal for infants, elderly individuals and post-operative patients, who are unable to swallow oral medications, and for individuals experiencing severe nausea and/or vomiting.<ref>{{Cite journal|last1=Jannin|first1=Vincent|last2=Lemagnen|first2=Gilles|last3=Gueroult|first3=Pascale|last4=Larrouture|first4=Denis|last5=Tuleu|first5=Catherine|date=2014-06-30|title=Rectal route in the 21st Century to treat children|journal=Advanced Drug Delivery Reviews|series=Drug delivery and the paediatric population: where are we at?|language=en|volume=73|pages=34–49|doi=10.1016/j.addr.2014.05.012|pmid=24871671|issn=0169-409X|doi-access=free}}</ref><ref>{{Cite web|title=Dulcolax 5 mg Suppositories - Summary of Product Characteristics (SmPC) - (emc)|url=https://www.medicines.org.uk/emc/product/5505/smpc|access-date=2021-12-11|website=www.medicines.org.uk}}</ref><ref>{{Cite magazine|last=Lowry|first=Michael|date=2016-02-22|title=Rectal drug administration in adults: how, when, why|url=https://www.nursingtimes.net/clinical-archive/neurology/rectal-drug-administration-in-adults-how-when-why-22-02-2016/|magazine=Nursing Times|language=en|access-date=2022-04-10|volume=112|number=8, 12–14}}</ref> Suppositories are administered through rectal route to reduce onset time of reaction.

==Composition==
Several different ingredients can be used to form the base of a suppository: [[cocoa butter]] or a similar substitute, [[polyethylene glycol]], [[Gel#Hydrogels|hydrogels]], and glycerinated [[gelatin]]. The type of material used depends on the type of suppository, the type of drug, and the conditions in which the suppository will be stored.<ref>{{cite book|last1=Troy|first1=David B.|last2=Beringer|first2=Paul|title=Remington: The Science and Practice of Pharmacy|date=2006|publisher=Lippincott Williams & Wilkins|pages=884–885|url=https://books.google.com/books?id=NFGSSSbaWjwC&q=Glycerinated+gelatin&pg=PA885|isbn=9780781746731}}</ref>

==Rectal suppositories==
[[File:Glycerin suppositories.jpg|right|thumb|[[Glycerin]] suppositories ([[laxative]])]]
In 1991, a study on suppository insertion in ''[[The Lancet]]'' found that the "torpedo" shape helps the device to travel internally, increasing its efficacy.<ref>{{cite journal | last = Abd-El-Maeboud | first = K. H. |author2=T. El-Naggar |author3=E. M. M. El-Hawi |author4=S. A. R. Mahmoud |author5=S. Abd-El-Hay | title = Rectal suppository: commonsense and mode of insertion | journal = The Lancet | volume = 338 | issue = 8770 | pages = 798–800  | date = 28 September 1991| doi = 10.1016/0140-6736(91)90676-G | pmid=1681170| s2cid = 23190075 }}</ref> The findings of this single study have been challenged as there is insufficient evidence on which to base clinical practice.<ref>{{cite journal
  | last =  Bradshaw
  | first = Ann
  | author2 = Lynda Price
  | title = Rectal suppository insertion: the reliability of the evidence as a basis for nursing practice
  | url = https://s3.amazonaws.com/academia.edu.documents/48198397/Rectal_suppository_insertion_the_reliabi20160820-21954-12vnm39.pdf?response-content-disposition=inline%3B%20filename%3DRectal_suppository_insertion_the_reliabi.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A%2F20200229%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20200229T174503Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=bba7b820f124c0dd1a70b15dd093db59f4037667e652a3d2bf0500900d2cbb6f
  | journal = Journal of Clinical Nursing
  | volume = 16
  | issue = 1
  | pages = 98–103
  | date = 20 December 2006
  | doi=10.1111/j.1365-2702.2005.01519.x
  | pmid=17181671| archive-url = https://web.archive.org/web/20200229174541/https://s3.amazonaws.com/academia.edu.documents/48198397/Rectal_suppository_insertion_the_reliabi20160820-21954-12vnm39.pdf?response-content-disposition=inline%3B%20filename%3DRectal_suppository_insertion_the_reliabi.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A%2F20200229%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20200229T174503Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=bba7b820f124c0dd1a70b15dd093db59f4037667e652a3d2bf0500900d2cbb6f
 | archive-date = 2020-02-29
 }}
</ref> Rectal suppositories are intended for localized or systemic action to relieve pain, constipation, irritation, inflammation, nausea and vomiting, fever, migraines, allergies, and sedation.<ref>{{Cite journal|last=Hua|first=Susan|date=2019-10-16|title=Physiological and Pharmaceutical Considerations for Rectal Drug Formulations|journal=Frontiers in Pharmacology|volume=10|pages=1196|doi=10.3389/fphar.2019.01196|issn=1663-9812|pmc=6805701|pmid=31680970|doi-access=free}}</ref><ref>{{Cite web|title=ANTIBIOTIC/ANESTHETIC/STEROID - RECTAL SUPPOSITORIES side effects, medical uses, and drug interactions.|url=https://www.medicinenet.com/antibioticanestheticsteroid-rectal/article.htm|access-date=2021-12-11|website=MedicineNet|language=en}}</ref> If they cause inflammation, chronic use of suppositories may cause [[rectal stricture]],<ref name="Ahmad 2021" >Ahmad, A; Krishnamurthy, P (June 2021). "[https://practicalgastro.com/2021/08/17/benign-rectal-strictures-a-review-article/ Benign Rectal Strictures: A Review Article]". ''Practical Gastroenterology.'' '''45''' (6): 16-33.</ref> but overall this is a safe method of drug delivery.<ref name="Gupta2007">{{cite journal |last1=Gupta |first1=PJ |title=Suppositories in anal disorders: a review. |journal=European Review for Medical and Pharmacological Sciences |date=May 2007 |volume=11 |issue=3 |pages=165–70 |pmid=17970232}}</ref> [[File:Panadol suppositories.jpg|right|thumb|Four 500 mg [[paracetamol]] suppositories]]

==Urethral suppositories==
[[Alprostadil]] pellets are urethral suppositories used for the treatment of severe [[erectile dysfunction|erectile dysfunction (impotence)]]. They are marketed under the name ''Muse'' in the United States.<ref>{{cite web|title=Muse Suppository - Facts and Comparisons|url=https://www.drugs.com/cdi/muse-suppository.html|publisher=Drugs.com|access-date=4 January 2013}}</ref> Its use has diminished since the development of oral impotence medications.

== See also ==
{{Commons and category|Suppository|Suppositories}}
* [[Artesunate suppositories]]
* [[Enema]]
* [[Pessary]]

==Notes==
{{reflist}}

==References==

* Doyle, D., [https://www.rcpe.ac.uk/sites/default/files/doyle_4.pdf "Per Rectum: A History of Enemata"], ''Journal of the Royal College of Physicians of Edinburgh'', Vol.35, No.4, (December 2005), pp.&nbsp;367–370.
* Payer, L., [https://nyaspubs.onlinelibrary.wiley.com/doi/10.1002/j.2326-1951.1990.tb02238.x "Borderline Cases: How Medical Practice Reflects National Culture"], ''The Sciences'', Vol.30, No.4, (July–August 1990), pp.&nbsp;38–42.

{{Dosage forms|state=expanded}}{{Medical-equipment-stub}}{{Authority control}}

[[Category:Anus]]
[[Category:Constipation]]
[[Category:Dosage forms]]
[[Category:Drug delivery devices]]
[[Category:Drugs acting on the gastrointestinal system and metabolism]]
[[Category:Laxatives]]
[[Category:Rectum]]
[[Category:Routes of administration]]