Enemas bottles

When administering an enema, it is almost impossible to transfer all liquid to the rectum. A small amount will always remain in the bottle or giving tube. Small enema bottles are therefore filled with an excess of liquid. The required excess depends on the model of the micro-enema bottle and on the physical properties of the micro-enema liquid, in particular the viscosity. The residual volume, and thus the required excess, can be determined by weighing a bottle, filling it and emptying it by squeezing, after which it is reweighed. 

When emptying the micro enema bottle some liquid remains in the bottle. Independent of the fill volume this loss is approximately 1.5 mL of aqueous solutions. When filling the bottle an excess volume is therefore required. When using a more viscous solution the loss in the single dose enema bottle will be greater. 

Table 24.8 Filling volume, delivered volume and dose in enema bottle 10 mL, for Chloral hydrate enema 50 mg/mL and 150 mg/mL FNA (see Table 11.15)...

The 100 mL enema bottle (Fig. 24.10) consists of a bottle and a cannula of low density polyethylene (LDPE). 

The nominal content is 100 mL, the maximal fill volume 130 mL. Graduation indicates 50 mL, 75 mL and 1(X) mL. The closure consists of 4 parts a strong screw cap, a flexible cannula, a rubber one-way check valve in the screw cap and a cap. The cannula is usually lubricated with vaseline. The length of the cannula is 52 mm and the top is rounded. Due to the bellows design of the shoulder the bottle can bend which makes administration easier. Water loss by evaporation is relatively small in relation to the fill volume. After administration a small volume (<2 mL with a 100 mL enema) remains in the bottle. The enema bottle provides little protection against the influence of light, so the bottle should be wrapped in aluminium foil or packaged in a secOTidary container if necessary. 

Administration of liquid rectal preparations requires a squeezable bottle (see Sect. 24.4.4.1), a bag (Sect. 24.4.13.2) or a syringe (see Sect. 24.4.16), with a rectal cannula (see Fig. 24.10). This cannula is preferably of flexible material to prevent damage to the rectal mucosa. This is less important with short cannulas than with long ones. An enema bag has a long flexible tube cannula. This cannula should be lubricated or should be made of slippery material to ease insertion. The cannula should have a rubber one-way check valve when respiration is possible (with enema bottles, not with enema bags). 

Treatment of constipation PO Initially, 5 mg/day. Rectal, enema One 1.25-oz bottle in a single daily dose. Rectal, suppository 5-10 mg/day. 

Rectal 40 mg/bottle retention enema Olsalazine (Dipentum)... 

Constipation 15 5 ml p.o. once daily at bedtime, maximum 45 ml or enema - 1 bottle (133 ml) into rectum once. 

The microenema bottle (see Fig. 24.9) is meant for single-dose enemas with a volume of 3-10 mL. The bottle has a bellows design and is made from low-density polyethylene. 

In addition to being packaged in bottles, enemas can also be packaged in enema bags. Enema bags can contain a volume... 

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