Suppository

Suppositories are pharmaceutical dosage forms intended for administration of medicine via the rectum, vagina, or urethra that melt, soften, or dissolve in the body cavity. Rectal and vaginal suppositories are most common but urethral suppositories are sometimes used. Suppositories are indicated for administering drugs to infants and small children, severely debilitated patients, those who cannot take medications orally, and those for whom the parenteral route might be unsuitable. Suppositories are used to administer drugs for either systemic or local application. Local applications include the 

For most purposes, it is convenient to classify suppository bases according to their physical characteristics into two main categories and a third miscellaneous group (i) fatty or oleaginous bases (ii) water-soluble or water-miscible bases, and (iii) miscellaneous bases, general combinations of lipophilic and hydrophilic substances (43). Appendix V presents a survey of commercial pharmaceutical suppositories and the respective suppository bases. 

Cocoa butter NF is defined as the fat obtained from the seed of Theobroma Cacao Linne (Family Sterculiaceae) (44). Cocoa butter softens at 30°C and melts at 34°C. It contains four different forms alpha, beta, beta prime, and gamma with melting points of 22°C, 34°C to 35°C, 28°C and 18°C, respectively. The beta form is the most stable and is desired for suppositories. The biggest challenge with the polymorphism of cocoa butter is the impact of the manufacturing process on the characteristics of the suppository itself. When cocoa butter is hastily melted at a temperature greatly exceeding the minimum required temperature and then quickly chilled, the result is metastable crystalline form (a crystals), which may not even 

Witepsol bases (Sasol North America Inc., Westlake, Louisiana, U.S.A.) solidify rapidly in the mold, and lubrication is not necessary because the suppositories 

Processing condition Compounded at 47° C Compounded at 42° C Compounded at 47° C, tempered and seeded with fresh base at 42° C 

Suppositories should be evaluated for appearance, color, assay, degradation products, particle size, softening range, appearance, dissolution (at 37°C), and microbial limits. 

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Cosmetics and Pharmaceuticals. The main use of hexadecanol (cetyl alcohol) is in cosmetics (qv) and pharmaceuticals (qv), where it and octadecanol (stearyl alcohol) are used extensively as emoUient additives and as bases for creams, Hpsticks, ointments, and suppositories. Octadecenol (oleyl alcohol) is also widely used (47), as are the nonlinear alcohols. The compatibiHty of heavy cut alcohols and other cosmetic materials or active dmg agents, their mildness, skin feel, and low toxicity have made them the preferred materials for these appHcations. Higher alcohols and their derivatives are used in conditioning shampoos, in other personal care products, and in ingested materials such as vitamins (qv) and sustained release tablets (see Controlled RELEASE technology). 

ASA appears to be the active component of sulfasalazine without the sulfa component, and is free of the serious side effects seen with sulfasalazine. It is used orally, in a delay-release formulation, as a retention enema, and as a suppository. It is well tolerated in most patients. 

Progesterone. Progesterone (1) is not orally active. Although seldom used clinically, it can be adrninistered as an intramuscular injection, pessaries, or suppositories in the treatment of menstmal disorders and habitual abortion (121). Progesterone can be recrystaUized from dilute alcohol and exists in two crystalline forms (122). It is soluble in chloroform and ethanol sparingly soluble in acetone, dioxane, ether, and fixed oils and practically insoluble in water (121). Two syntheses of progesterone (1) are described in Figure 3. 

I = injection T = tablet C = cream Tr = transdermal, continuous delivery, P = parenteral VC = vaginal cream VS = vaginal suppositories Ca = capsule. 

Sorbitan sesquioleate emulsions of petrolatum and wax are used as ointment vehicles in skin treatment. In topical appHcations, the inclusion of both sorbitan fatty esters and their poly(oxyethylene) derivatives modifies the rate of release and promotes the absorption of antibiotics, antiseptics, local anesthetics, vasoconstrictors, and other medications from suppositories, ointments, and lotions. Poly(oxyethylene(20)) sorbitan monooleate, also known as Polysorbate 80 (USP 23), has been used to promote absorption of ingested fats from the intestine (245). 

Bismuth subgaHate [12552-60-2] (basic bismuth gaHate), Dermatol, is a bright yellow powder that can be prepared by the interaction of bismuth nitrate and gaUic acid in an acetic acid medium. It has been employed as a dusting powder in some skin disorders and as an ingredient of suppositories for the treatment of hemorrhoids (183,185). It has been taken orally for many years by colostomy patients in order to control fecal odors, but the dmg may cause serious neurological problems (186). 

In the last several decades, physical properties of vaginal contraceptive formulations have been improved to deUver spermicide more effectively and enhance consumer compliance. The formulation that deUvers the spermicide can affect the efficacy of vaginal contraceptives (86,87). Formulations currentiy available include jeUies, creams, suppositories, aerosol foams, and foaming tablets. Each consists of a relative inert base material that serves as a carrier for the chemically active spermicide and blocks to some extent the passage of sperm. 

Rectum. Local treatment of conditions and diseases of the rectum, including hemorrhoids and local inflammation, usually involves dmg-containing suppositories or enemas. 

Setz-fehler, m. compositor s error, -kasten, m. settling tank type case, -phiole, /. (flat bottomed) vial, -fiieb, n. jig(ging) screen, jig(ging) sieve, -zapfcn, m. suppository. Seuche, /. contagious or infectious disease, pestilence, epidemic. 

Solids (eg, suppositories) or jellies inserted into the urethra... 

IMBALANCED BODY TEMPERATURE If the patient is receiving the analgesic for reduction of elevated body temperature the nurse checks the temperature immediately before and 45 to 60 minutes after administration of the drug. If a suppository fonn of the drug is used, it is important to check the patient after 30 minutes for retention of the suppository. If the drug fails to lower an elevated temperature, the nurse notifies the primary health care provider because other means of temperature control, such as a cooling blanket, may be necessary. 

Promoting an Optimal Response to Therapy If the patient is unable to retain the oral form of the drug, the nurse may give it parenterally or as a rectal suppository (if the prescribed drag is available in these forms). If only the oral form has been ordered and the patient is unable to retain the drag, the nurse contacts the primary health care provider regarding an order for a parenteral or suppository form of this or another antiemetic drag. 

If theophylline or anotiier xanthine derivative is given as a rectal suppository, the nurse checks die patient every 15 to 30 minutes to be sure die suppository has been retained. If the patient is unable to retain die suppository, die nurse contacts the primary health care provider because anodier route of administration may be necessary. 

Suppositories insert 1 high in the rectum and retain 15 min rectal liquid insert all the liquid into rectum toward the navel 10-60 mL7d PO... 

Mesalamine—Swallow tablets whole do not chew them. For the suppository, remove foil wrapper and immediately insert tiie pointed end into the rectum without using force. For tiie suspension form, instructions are included with the product. Shake well, remove the protective sheath from the applicator tip, and gently insert the tip into the rectum. Partially intact tablets may be found in the stool if this occurs, notify the primary health care provider. 

Glycerin is used in many skin creams and medicines, such as eye and ear drops, poison ivy creams, suppositories, and contraceptive jellies. It is also used as an emollient (skin softener) in soaps. 

Suppositories and pessaries— These are preparations intended for either rectal or vaginal administration of drugs. They are formulated with a suitable base that melts at body temperature. 

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