Pharmaceuticals: Suppositories Overview
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Questions and Answers

What is a key advantage of the rectal administration of drugs?

  • It generally avoids first pass metabolism. (correct)
  • It is the preferred method of administration in most cases.
  • It provides inconsistent systemic drug absorption.
  • It avoids all forms of drug metabolism.
  • What factors make rectal administration preferable over oral administration?

  • Patient has nausea or vomiting. (correct)
  • Patient's ability to swallow medication.
  • Patient's need for quick action and conscious state.
  • Patient consumes a high-fiber diet.
  • What is a primary characteristic of suppositories?

  • They are always made from liquid bases.
  • They must dissolve in the mouth.
  • They can be used for both local and systemic action. (correct)
  • They are only effective in the vagina.
  • What is the typical length of a rectal suppository?

    <p>1 to 5 inches</p> Signup and view all the answers

    What historical materials were used to create suppositories?

    <p>Various materials including cloth and plants.</p> Signup and view all the answers

    What shapes are prevalent in vaginal suppositories?

    <p>Globular and cone-shaped</p> Signup and view all the answers

    Which of the following is a disadvantage of using suppositories?

    <p>They can require high-quality manufacturing.</p> Signup and view all the answers

    What is the weight range typically for adult rectal suppositories?

    <p>2 to 4 g</p> Signup and view all the answers

    Why might suppositories be preferred over oral medication?

    <p>They can allow for sustained drug delivery.</p> Signup and view all the answers

    What is the diameter of urethral suppositories?

    <p>3-6 mm</p> Signup and view all the answers

    Which patient group is particularly suitable for suppository administration?

    <p>Patients who are severely nauseated or vomiting.</p> Signup and view all the answers

    Which of the following routes is generally preferred for drug administration?

    <p>Oral</p> Signup and view all the answers

    What are retention enemas primarily used for?

    <p>To deliver medications for systemic action.</p> Signup and view all the answers

    In infants and children, how does the size of rectal suppositories compare to those for adults?

    <p>They are roughly half the weight and size.</p> Signup and view all the answers

    How do suppositories impact first-pass metabolism?

    <p>They can help avoid first-pass metabolism.</p> Signup and view all the answers

    What percentage of the large intestine is comprised by the rectum?

    <p>15-20 cm</p> Signup and view all the answers

    What is often a reason for poor patient acceptance of suppositories?

    <p>They may leak and be messy.</p> Signup and view all the answers

    How are urethral suppositories commonly referred to?

    <p>Bougies</p> Signup and view all the answers

    Which of the following dosage forms is NOT typically classified under rectal or vaginal preparations?

    <p>Intravenous injections.</p> Signup and view all the answers

    What is a significant advantage of vaginal administration compared to oral administration?

    <p>There is no first pass effect.</p> Signup and view all the answers

    What disadvantage might occur with vaginal administration related to patient experience?

    <p>Patients may experience leakage.</p> Signup and view all the answers

    Which dosage form is specifically intended to dissolve or melt within the vagina?

    <p>Suppositories</p> Signup and view all the answers

    What characteristic is NOT true about vaginal tablets?

    <p>They are more difficult to manufacture than suppositories.</p> Signup and view all the answers

    Which attribute should be optimized for vaginal products to ensure effective drug delivery?

    <p>Low product pH for stability.</p> Signup and view all the answers

    What is a main purpose of mucoadhesives in vaginal films?

    <p>To allow for prolonged local action.</p> Signup and view all the answers

    What is a key feature of vaginal rings that differentiates them from other dosage forms?

    <p>They provide a predetermined drug release rate.</p> Signup and view all the answers

    Which of the following statements about vaginal semisolids is correct?

    <p>They can be uncomfortable and tend to leak.</p> Signup and view all the answers

    What is a possible benefit of using vaginal films in medication delivery?

    <p>They create a high localized concentration of the drug.</p> Signup and view all the answers

    What common component is found in the formulation of vaginal tablets?

    <p>Starch as a disintegrating agent</p> Signup and view all the answers

    What is the primary reason fatty bases are preferred for rectal suppositories?

    <p>They are less irritating to rectal tissues.</p> Signup and view all the answers

    Which of the following statements about cocoa butter is accurate?

    <p>It can trap fat-soluble drugs within its structure.</p> Signup and view all the answers

    What characteristic contributes to cocoa butter's unique properties when compared to semi-synthetic fatty bases?

    <p>It has considerable unsaturated oleic acid content.</p> Signup and view all the answers

    What is a limitation of using cocoa butter in suppository formulations?

    <p>It has a tendency to leak from the body orifice.</p> Signup and view all the answers

    Why is it important for drugs to partition out of the suppository base and dissolve in the body?

    <p>To ensure proper drug absorption can occur.</p> Signup and view all the answers

    What factor significantly affects the release rate of oil-soluble drugs in suppositories using fatty bases?

    <p>The presence of surfactants in the formulation.</p> Signup and view all the answers

    Which veins drain the inferior and middle rectum directly into systemic circulation?

    <p>Inferior and middle hemorrhoidal veins</p> Signup and view all the answers

    What is the primary mechanism of drug absorption from the rectum?

    <p>Passive diffusion</p> Signup and view all the answers

    If a drug is placed too high in the rectum, what metabolic process may it undergo?

    <p>First pass metabolism</p> Signup and view all the answers

    What factor can influence drug absorption from rectal fluids?

    <p>pH of rectal fluids</p> Signup and view all the answers

    How does osmotic effect impact the process of drug dissolution in the rectum?

    <p>Draws water from rectal fluids</p> Signup and view all the answers

    What is the rectal pH in adults roughly around?

    <p>7.2</p> Signup and view all the answers

    What happens to drugs after a suppository dissolves in the rectum?

    <p>They are absorbed through passive diffusion</p> Signup and view all the answers

    Which factor does NOT affect drug absorption variability in the rectum?

    <p>Body temperature</p> Signup and view all the answers

    What is a significant characteristic of the rectal epithelium compared to the upper gastrointestinal tract epithelium?

    <p>Absence of villi</p> Signup and view all the answers

    What might result from placing a suppository delivery system too high in the rectum?

    <p>First pass hepatic metabolism</p> Signup and view all the answers

    The pre-blended suppository base, MBK is similar to what other base?

    <p>Cocoa butter</p> Signup and view all the answers

    True or false. MBK exhibits polymorphism.

    <p>False</p> Signup and view all the answers

    What are the MWs of PEG (a water soluble base) as a liquid?

    <p>PEG 300, 400, 600</p> Signup and view all the answers

    Glycinerated gelatin suppositories contain what components?

    <p>20% gelatin, 70% glycerin, 10% solution or suspension of drug</p> Signup and view all the answers

    Glycinerated gelatin suppositories are used to make what types of suppositories?

    <p>Vaginal or urethral</p> Signup and view all the answers

    A low fat/oil solubility means what water solubility and choice of base?

    <p>High water solubility and fatty base</p> Signup and view all the answers

    A high fat/oil solubility means what water solubility and choice of base?

    <p>Low water solubility and aqueous base</p> Signup and view all the answers

    A low fat/oil solubility means was water solubility and choice of base?

    <p>Low water solubility and base is indeterminate</p> Signup and view all the answers

    What is the purpose of determining the density factor (DF) in the formulation process?

    <p>To estimate the amount of active ingredient needed</p> Signup and view all the answers

    In the preparation of suppositories, why are certain bases preferred over others?

    <p>For their efficient release of the active ingredient</p> Signup and view all the answers

    What is the molar ratio of atropine to atropine sulfate used in the formulation?

    <p>2:1</p> Signup and view all the answers

    How is the active ingredient amount for morphine hydrochloride calculated in the given formulation?

    <p>By calculating based on its molar mass and desired dosage</p> Signup and view all the answers

    What is the significance of using extra suppositories in the total calculation?

    <p>To account for loss during preparation and handling</p> Signup and view all the answers

    What is the blank suppository weight for fatty base in the atropine formulation?

    <p>1.3 g</p> Signup and view all the answers

    What would be a key consideration when selecting the active ingredient for a formulation?

    <p>The interaction with other ingredients</p> Signup and view all the answers

    How does the molecular weight of an active ingredient affect its dosage calculation?

    <p>Lower molecular weight requires a higher dosage</p> Signup and view all the answers

    In the formulation of a suppository, what role does the balance with a low weight quantity (LWQ) play?

    <p>It ensures precise measurements of small quantities</p> Signup and view all the answers

    Which factor is least likely to affect the stability of the active ingredients in suppositories?

    <p>The shape of the suppository</p> Signup and view all the answers

    What is a primary characteristic of the double-casting method for preparing suppositories?

    <p>It does not require density factor calculations.</p> Signup and view all the answers

    Which technique is crucial for ensuring accurate dosage when preparing suppositories?

    <p>Density factor calculations.</p> Signup and view all the answers

    What is a significant advantage of using density factors when formulating suppositories?

    <p>They ensure consistent homogeneity in the final product.</p> Signup and view all the answers

    Which of the following statements about pharmaceutical stability in suppository formulation is true?

    <p>Factors like temperature and humidity affect the shelf life of suppositories.</p> Signup and view all the answers

    When formulating a suppository with multiple active ingredients, which consideration is essential?

    <p>Interactions between active ingredients must be assessed.</p> Signup and view all the answers

    Which of the following might hinder the absorption of active ingredients in suppository bases?

    <p>Choosing high-density suppository bases that are difficult to dissolve.</p> Signup and view all the answers

    Which factor can impact the active ingredient release rate in fatty suppositories?

    <p>The molar ratio of active ingredients used.</p> Signup and view all the answers

    What role does the density factor play in the preparation of suppositories?

    <p>It helps determine the amount of active ingredient needed.</p> Signup and view all the answers

    Which statement about the importance of active ingredient selection in suppository formulation is accurate?

    <p>The compatibility of the active ingredient with the base must be checked.</p> Signup and view all the answers

    What is the density factor for acetaminophen in a PEG base if the blank suppository weight is 2.72 g and the final weight is 2.76 g?

    <p>1.4</p> Signup and view all the answers

    Which statement is accurate regarding the preparation of suppositories using the double-casting method?

    <p>It involves mixing the drug with melted base before casting.</p> Signup and view all the answers

    If a pharmacist determined the final individual suppository weight to be 1.95 g with a blank weight of 2 g, what is the calculated density factor for zinc oxide in the glycerin base?

    <p>0.67</p> Signup and view all the answers

    What impact does overheating cocoa butter have on its stability when preparing suppositories?

    <p>Leads to potential degradation and altered properties.</p> Signup and view all the answers

    Which method can be employed to minimize the oxidation of fatty suppository bases?

    <p>Incorporating synthetic antioxidants.</p> Signup and view all the answers

    Which statement about the use of salt forms versus non-salt forms of drugs in cocoa butter suppositories is correct?

    <p>Salt forms improve solubility and absorption.</p> Signup and view all the answers

    Which characteristic is false regarding suppositories?

    <p>They are often water-soluble for faster absorption.</p> Signup and view all the answers

    When calculating the density factor, which element is essential to determine?

    <p>Weight of the active ingredient used.</p> Signup and view all the answers

    What is the primary concern when preparing suppositories if a drug's melting point is significantly lower than that of the base?

    <p>The drug may degrade during the casting process.</p> Signup and view all the answers

    Which statement regarding the double-casting method for preparing suppositories is correct?

    <p>Only a portion of the base is used in the first casting.</p> Signup and view all the answers

    What is the primary purpose of density factor calculations in suppository formulation?

    <p>To establish the dosage of the active ingredient.</p> Signup and view all the answers

    What factor can negatively impact the physical stability of cocoa butter when preparing suppositories?

    <p>Overheating during the melting process.</p> Signup and view all the answers

    In the context of rectal administration, what is a significant advantage of avoiding first pass metabolism?

    <p>Increased bioavailability of the drug.</p> Signup and view all the answers

    When preparing suppositories using the molding/fusion method, which statement is true?

    <p>It can be used for heat-sensitive drugs.</p> Signup and view all the answers

    If the individual suppository weight was 2 g and the final weight was 1.95 g, what does this indicate about the density factor for the active ingredient?

    <p>It is less than 1.</p> Signup and view all the answers

    Which ingredient is often included in base formulations to enhance disintegration of suppositories?

    <p>Polysorbate 80.</p> Signup and view all the answers

    Which of the following describes a typical characteristic of pharmaceutically elegant suppositories?

    <p>They possess a smooth surface and uniform size.</p> Signup and view all the answers

    What is the main concern when using non-salt forms of a drug in cocoa butter suppositories?

    <p>They are less soluble in oil-based formulations.</p> Signup and view all the answers

    Study Notes

    Suppositories

    • Solid dosage form for rectal, vaginal, or urethral use
    • Contains active ingredient and a base that melts, softens, or dissolves in the body
    • Provides local or regional action by distributing medication to tissues
    • Can offer systemic action through absorption via rectal or vaginal mucous membranes

    History of Suppositories

    • Historically, suppositories were made using cloth, plants, wood, or other materials
    • These materials were used plain or soaked in medication solutions

    Drawbacks of Suppositories

    • Strong feelings of aversion towards their use in some countries, notably the US and UK
    • Significant inter- and intra-subject variation in absorption
    • Challenges with large-scale manufacturing, including creating products with a long shelf life
    • Not typically the first choice for drug administration

    Advantages of Suppositories

    • Safe and effective alternative for oral routes
    • Enables sustained systemic and local drug delivery
    • Allows for interruption of therapy by removal
    • Novel polymers enable controlled drug release
    • Convenient, non-messy, and non-staining

    Enemas

    • Liquid preparations administered rectally
    • Retention enemas: retain medication
    • Evacuation enemas: remove feces, used for constipation, impaction, and preparation for lower GI exams
    • Inserted into the rectum or vagina for local or systemic action
    • Examples: ointments, creams, aerosol foams, vaginal films

    Uses of Suppositories

    • Administration of drugs to infants, small children, debilitated patients, nauseated or vomiting patients, those unable or unwilling to take oral medication, and those unsuitable for parenteral routes.

    Suppository Advantages and Disadvantages

    Advantages

    • Effective for drugs that degrade in the gastrointestinal tract (GIT)
    • Minimizes first-pass metabolism
    • Allows administration of large drug doses
    • Offers some control over the duration of action

    Disadvantages

    • Poor patient acceptance and compliance
    • Potential for messiness and leakage
    • Slower absorption compared to intravenous or oral administration
    • Upward migration from the site of administration can increase first-pass metabolism

    Various Sizes and Shapes

    Rectal Suppositories

    • Conical or cylindrical
    • Tapered or pointed on one end (bullet or torpedo shaped)
    • Length: 1 to 5 inches
    • Weight: 1 to 4 g, typically 2 g
    • Smaller sizes and weights are used for infants and children

    Vaginal Suppositories

    • Also known as pessaries
    • Globular, ovi-form, or cone-shaped
    • Often use the same molds as rectal suppositories

    Urethral Suppositories

    • Also known as bougies
    • Less common
    • Slender, pencil-shaped, typically 3-6 mm in diameter
    • Vary in length by gender: females 25-70 mm, males 50-125 mm
    • Compounded using thin, long molds or oral dosing syringes

    Rectal Route

    • Preferred route is oral, but rectal administration is used when oral administration is impractical or infeasible.
    • This might occur when a patient has nausea or vomiting, altered consciousness, is uncooperative, has restricted oral intake, or oral administration is not feasible.

    Rectal Route Physiology

    • The rectum is 15-20 cm long
    • Contains the anal canal (4-5 cm).
    • Highly vascularized rectal epithelium resembles upper GIT epithelium but lacks villi.
    • Lower Rectum: Inferior and middle hemorrhoidal veins drain directly into systemic circulation.
    • Upper Rectum: Superior hemorrhoidal vein drains directly into portal circulation.

    Drug Absorption from Rectum

    • Drugs absorbed from the lower rectum avoid first-pass hepatic metabolism due to lower and middle rectal vein drainage into systemic circulation.
    • Drugs absorbed from the upper rectum are carried directly to the liver, undergoing first-pass metabolism, if placed too high.
    • Patients should be instructed not to place the delivery system too high in the rectum unless directed by their physician.

    Main Mechanism of Drug Absorption

    • Passive diffusion
    • Absorption is influenced by:
      • Molecular weight of the drug
      • Lipid solubility
      • Degree of ionization
    • Rectal fluid pH influences drug absorption

    Rectal Fluid pH

    • Adult rectal pH is roughly 7.2, but varies based on rectal contents.
      • Independent of sex and age after puberty.
      • Limited buffer capacity.
      • Significantly lower than in children (9.6±0.9).

    Factors Affecting Drug Absorption

    • Diarrhea
    • Disease States
    • Large inter- and intra-subject variability in absorption

    Drug Release from a Suppository

    • Suppository dissolves or melts onto the mucous layer.
    • Drug diffuses outward towards the rectal membranes.
    • Drug absorption occurs through passive diffusion.

    How Drugs Dissolve

    • Small volume of rectal fluid (~3 mL) results in incomplete dissolution and requires additional water.
    • Osmotic effect draws water out of rectal tissues, which can be uncomfortable for patients.
    • Suspended drugs may lead to undesirable systemic side effects.

    Vaginal Administration

    Advantages

    • Local or systemic drug administration
    • Absorption is not affected by gastrointestinal, or GI disturbances.
    • Venous drainage bypasses the hepatic portal vein, avoiding the first-pass effect.
    • Convenience of self-administration, potentially releasing drug for weeks.
    • Ease of self-administration.
    • Painless application.
    • Discreet use.
    • Can effectively deliver lower doses of hormones.

    Disadvantages

    • Erratic and unpredictable systemic drug absorption, due to variations in vaginal epithelium thickness and pH.
    • Leakage or slipping out may occur, soiling undergarments or clothing.
    • Some patients are hesitant to use vaginal delivery systems.

    Dosage Forms for Vaginal Administration

    • Solids: tablets, suppositories (also known as pessaries, ovules, and inserts), films, inserts (rings).
    • Semisolids: foams, ointments, creams, gels.
    • solutions.

    Vaginal Tablets

    • Stable and less messy than ointments or creams.
    • Intended to disintegrate in the vagina, releasing their contents.
    • Commonly contain:
      • Lactose as a filler
      • Disintegrating agent (e.g., starch)
      • Dispersing agent (e.g., polyvinylpyrrolidone)
      • Tablet lubricant (e.g., magnesium stearate).
    • Easy to manufacture and insert.

    Vaginal Suppositories

    • Stable and less messy than ointments or creams.
    • Intended to dissolve or melt in the vagina, releasing their contents.
    • Not as easy to manufacture as tablets, but easy to compound and insert.

    Vaginal Films

    • Paper-thin translucent films that dissolve quickly.
    • Primarily provide local action.
    • Most contain spermicides or other drugs like antibacterial agents.
    • Mucoadhesives may improve retention time.

    Vaginal Rings

    • Flexible, circular polymeric delivery systems.
    • Approximately 5.5 cm in diameter.
    • Made of non-irritating materials like ethylene acetate copolymers, silicone, or poly(dimethylsiloxane).
    • Non-messy to use.
    • Release pre-determined amounts of drug per day over extended periods.
      • Polymer is non-biodegradable.
      • Reservoir system: drug is located in the center core, released via diffusion through the polymeric membrane coat.
      • Release rate can be modified by modifying the thickness of the membrane coat or the diameter of the core.

    Vaginal Semisolids

    • Used for local vaginal action.
    • Deliver spermicides, antibacterial drugs, hormones, and drugs for cervical ripening.
    • Usually delivered with a plastic applicator.
    • Result in high local drug concentrations for short durations.
    • More viscous products remain in place longer.
    • Bioadhesive or mucoadhesive gel formulations can extend contact time with epithelial surfaces.

    Vaginal Semisolids - Disadvantages

    • Messy to use.
    • Can be uncomfortable for patients.
    • Prone to leakage rather than remaining in place.

    Vaginal Foams

    • Similar advantages and disadvantages to other semisolids.
    • Contain propellants to aid drug delivery.
    • Pressure exerted by the propellant ensures the formulation fills the applicator space.

    Dosage Form Design Considerations for Vaginal Products

    • Product pH: Some products are formulated to match vaginal pH, which is crucial for drug solubility and stability.
    • Microbial presence: Products should be free from microorganisms, yeast, and molds.
    • Product attributes after administration:
      • Retention: Products should be retained long enough for drug distribution.
      • Liquefaction: Products should disintegrate, dissolve, or melt within a reasonable timeframe.
      • Distribution: Products should spread well throughout the vaginal cavity (e.g., high-density particles).
    • The base should not bind to or interfere with drug release and absorption.

    Suppository Bases

    • Classes of base:
      • Fatty bases
      • Water-soluble bases
    • Choosing a base: Requires practical experience and cannot be solely guided by scientific data.
    • General guidelines:
      • Fatty bases are preferred for rectal suppositories, providing soothing and emollient action, and are less irritating to rectal tissues.
      • Water-soluble bases are used for vaginal and urethral suppositories, as oily material is less desirable in these scenarios due to the lack of sphincter muscles to prevent leakage.
    • Desired release rate:
      • Oil-soluble drugs: slow release with fatty bases, moderate release with water-soluble bases.
      • Water-soluble drugs: rapid release with fatty bases, moderate release with water-soluble bases.

    Fatty or Oleaginous Bases

    • Soothing and emollient action.
    • Most used bases today are semi- or fully synthetic.
    • Preferred for rectal suppositories due to less rectal tissue irritation.
    • Less commonly used for vaginal and urethral suppositories, as oily material is less desirable.
    • Release drugs after melting in the rectum.
      • The drug must partition out of the base and dissolve in sufficient aqueous media at the site of action.
      • Absorption occurs after the drug is in solution.

    Cocoa Butter (Theobroma Oil)

    • Mixture of liquid triglycerides entrapped in a network of crystalline, solid triglycerides.
    • Soothing and emollient action.
    • Melts quickly at body temperature.
    • Softens at 30°C and melts at 34°C.
    • Must be stored in a refrigerator to avoid melting.
    • Exhibits polymorphism, with the β form being the most stable.
    • Should not be heated above 34°C.

    Cocoa Butter - Disadvantages

    • Fat-soluble drugs are trapped in the base and do not mix with body fluids, leading to potential trapping.
    • Water-soluble drugs are quickly released, often leading to rapid absorption.
    • Leakage from the body orifice, as it is immiscible with body fluids.
    • Some drugs lower the melting point (e.g., chloral hydrate, phenol).
    • Potential for polymorphism.
    • Poor contraction on cooling, making removal from molds challenging, particularly in industrial settings.
    • Low softening point.
    • Chemical instability.
    • Poor water-absorption power.
    • Higher cost.

    Semi-Synthetic Fatty Bases

    • Also known as adeps solidus.
    • Hard fats consisting of a mixture of triglycerides, diglycerides, and monoglycerides.
    • Obtained from natural fatty acid esterification with glycerol or by natural fats transesterification.
    • Characteristics:
      • Melting point
      • Hydroxyl value
      • Saponification value
    • Contain no additives.

    Semi-Synthetic Fatty Bases - Comparison to Cocoa Butter

    • Semi-synthetic: Most acids are saturated.
    • Cocoa Butter: Contains considerable unsaturated oleic acid (primarily responsible for unique properties).
    Base Melting Range Acid Number (AN) Hydroxyl Number (HN) Iodine Number (IN)
    Cocoa Butter 31-34 °C
    Semi-Synthetic

    Suppository Preparation and Advantages

    • Advantages of Suppositories: Provide potential advantages over oral dosage forms (e.g., capsules and tablets) due to bypassing the first-pass metabolism, circumventing the gastrointestinal tract, and avoiding potential inactivation by digestive enzymes.
    • Rectal Administration Advantages: Rectal administration can offer increased bioavailability and consistent systemic drug absorption.
    • Suppository Disintegration: Polysorbate 80, a surfactant, can facilitate the disintegration of suppositories after administration.

    Molding and Fusion Method

    • Molding/Fusion: Typically results in pharmaceutically elegant suppositories. Molding requires heat, which may not be suitable for heat-sensitive drugs.
    • Double-Casting Method: This method enables the preparation of suppositories with a uniform drug distribution and eliminates the need for additional calculations.
    • Density Factor: The density factor is essential for calculating the amount of active ingredient and base needed to prepare suppositories accurately.
    • Double-Casting Steps: The first step involves blending the drug with a portion of the melted base and pouring it into the bottom portion of the molds. The second step involves pouring the remaining melted base into the molds after the initially poured mixture has solidified.
    • Calculating Density Factor: The density factor is calculated by dividing the difference between the final weight and the blank suppository weight by the blank suppository weight. For example, if the blank suppository weight is 2.72 g and the individual suppository weight is 2.76 g, the density factor is 0.0148 (2.76 g - 2.72 g) / 2.72 g. This density factor is then applied to the final weight to determine the amount of drug required.

    Suppository Base Considerations

    • Cocoa Butter: Overheating cocoa butter can lead to a change in its polymorphic form, resulting in a less stable and less desirable product.
    • Fatty Base Oxidation: The addition of antioxidants, such as ascorbyl palmitate, can help minimize the oxidation of fatty suppository bases.

    Suppository Formulation and Dosage

    • Suppository Flexibility: Suppositories provide a degree of dosing flexibility but are limited by the unit-dose and size limitations.
    • Salt Form: The salt form of a drug is often preferred when preparing cocoa butter suppositories because it generally exhibits increased solubility and better physical stability compared to the non-salt form.

    Example Prescription Calculations

    • Atropine and Atropine Sulfate: For a prescription with a 1.75 mg/supp dosage, a total of 56 mg of atropine is needed.
    • Morphine Hydrochloride and Theobroma Oil: For a prescription with a 125 mg/25 supp dosage, a total of 135 mg of morphine is needed.

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    Description

    Explore the world of suppositories, a unique dosage form for rectal, vaginal, or urethral use. This quiz delves into their history, advantages, drawbacks, and the challenges faced in manufacturing. Test your knowledge on how suppositories provide both local and systemic action.

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