Suppository

see also: Etymology of Suppository

A suppository is a galenic Forme of Médicament intended to be introduced into the Rectum by the Anus. The suppository melts in the rectum.

One distinguishes three types of suppositories:

most, which manages a substance activates by absorption through the rectal mucous membrane; in France, their regulation is more current than in other countries, in particular for the children, because they can be easier to manage to them than oral forms such as Sirop S or compressed;
those managing a substance locally, in particular for the treatment of the Hémorroïde S;
the Laxatif S buildings release a substance, like Glycérine, having a laxative effect.

The medicamentous suppositories most current include/understand in particular those managing of the analgesics (Paracétamol), of anti-inflammatory drugs, the substances with aiming eupnéisantes (Eucalyptol). A medicamentous suppository must be managed in an empty rectum, under penalty of being likely to be expelled prematurely at the time of the defecation. It is thus recommended that the patient goes to the saddle before the administration. In spite of this precaution it is more difficult to predict the diffusion of the substances in the organization than by oral way. Moreover certain substances can cause rectites.

The composition of the suppositories includes/understands a fatty excipient (at one time, Cocoa butter) which melts at the body temperature; this excipient is expelled with the next saddles, and sometimes at the time of Flatulence S.

Contrary to the suppositories with fatty excipient, the glycerin suppositories are not naturally lubricated. It is possibly indicated to use a Lubrifiant intimates to facilitate their administration.

Errors of use

Two errors affect the use of the suppository specifically: the error of direction of introduction and the Error of way.

Much of people think that it is necessary to introduce the suppository, which generally has the shape of a shell, by the pointed part. However, and against-intuitively, this way of proceeding is false. The suppository must be introduced by the punt end in first and the pointed part towards outside. In this manner, the suppository remains and melts right in top of the anal channel, and it is not pushed by the natural contractions of the Intestin which act in the direction of the increase of the object. That makes it possible the active substance to be directly absorptive in circulation, without passage by the Foie, which would generate a Effet of first passage hepatic which would result in to make the drug inactive.

Another traditional error, called " Error of way " consist in managing the suppository by another natural way, generally the mouth. One in the case of estimates at 15% the number of Erreurs of way the suppository. It is the form of medicamentous administration which is affected by this type of error.

The Erreur of way is much more harmful with the therapeutic effects of the suppository than the error of direction of introduction.

History

The first suppositories are undoubtedly of Egyptian origin, and they were also used by the Greeks, the Hebrews, the Arabs (at the 10th century, the Arab scientist Ibn El Jazzar makes mention of it), then Europeans. At the beginning, they consisted of a solid and neutral support (metal, horn) on which was deposited the active ingredient.

At the 17th century, they are used like purgative to replace the Lavement S, by an especially mechanical action. This substitution for the rectal injection is perhaps at the origin of the word: supponere meaning in Latin “to substitute”.

They then consist of solidified honey (according to Nicolas Lémery), with purgative different components. In 1762 the first suppositories containing cocoa butter appear, which make it possible to encapsulate the active ingredients and thus to better diffuse them. Their use spreads only at the 19th century.

After the Second world war, the cocoa butter is replaced by other excipients.

References

Random links: