Pharmacology: Suppositories Overview

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Questions and Answers

What is one main characteristic of suppositories?

They must be taken with water.

They are typically used for oral administration.

They are only used for local action.

They melt, soften, or dissolve in the body cavity. (correct)

What is a significant drawback associated with the use of suppositories?

They have a faster absorption rate than oral routes.

They are always preferred over oral medications.

They are only effective for infants.

They can be messy and lead to poor patient compliance. (correct)

Why are suppositories still in use despite some of their drawbacks?

They can be administered without patient consent.

They are preferred for long-term treatment.

They provide a safe and effective alternative to the oral route. (correct)

They are cheaper than all other forms of medication.

Which patient group is most likely to benefit from the use of suppositories?

Patients with swallowing difficulties or severe nausea. Signup and view all the answers

What is a potential advantage of administering drugs rectally?

Ability to administer large doses effectively. Signup and view all the answers

Which of the following describes a reason for the inter-subject variation in suppository absorption?

Differing rectal temperatures among individuals. Signup and view all the answers

What form of medication is specifically mentioned as another related dosage form besides suppositories?

Aerosol foams Signup and view all the answers

One potential disadvantage of using suppositories is:

They can be costly to manufacture on a large scale. Signup and view all the answers

What is one advantage of rectal administration of drugs?

Avoids first-pass metabolism Signup and view all the answers

What shape are rectal suppositories typically formed into?

Conical or cylindrical Signup and view all the answers

What is the typical weight of an adult rectal suppository?

2 g Signup and view all the answers

Which type of suppository is also known as a pessary?

Vaginal suppository Signup and view all the answers

What is a common reason for using rectal administration over the oral route?

The patient is nauseous or vomiting Signup and view all the answers

What is the usual diameter range of urethral suppositories?

3-6 mm Signup and view all the answers

Why might the rectal route be less practical for drug administration?

It may be uncomfortable for the patient Signup and view all the answers

How does the length of urethral suppositories vary?

By gender Signup and view all the answers

What is the typical length range for rectal suppositories?

1-5 inches Signup and view all the answers

Which is NOT a characteristic of urethral suppositories?

They are commonly used for treatment Signup and view all the answers

What characterizes the release rate of water-soluble drugs when using a fatty base for a suppository?

Rapid release rate Signup and view all the answers

What type of suppository base is preferred for rectal administration due to its soothing action?

Fatty bases Signup and view all the answers

Which of the following is a major disadvantage of using cocoa butter as a suppository base?

Polymorphism Signup and view all the answers

Which property of cocoa butter is NOT favorable for the use in suppositories?

Contains high levels of saturated fatty acids Signup and view all the answers

What mechanism allows for pressure to be exerted on a suppository in the rectum?

Motility of rectal wall muscles Signup and view all the answers

Which of the following is NOT a component of semi-synthetic fatty bases?

Water-absorbing agents Signup and view all the answers

Which surfactant is noted for its power in enhancing absorption for peptide-like drugs?

Polyoxyethylene lauryl alcohol ether Signup and view all the answers

What is the typical pH of vaginal fluids during the menstrual cycle?

Between 3.5 and 4.5 Signup and view all the answers

Why is it problematic for ketoconazole to become protonated at acidic pH levels?

It cannot cross cell membranes and becomes trapped. Signup and view all the answers

What major characteristic of the rectal environment influences the absorption of drugs from suppositories?

Pressure from abdominal organs Signup and view all the answers

What is a potential systemic effect of drug absorption from the vaginal route?

Lower local concentration Signup and view all the answers

What physiological structure ensures that the vaginal mucosa is vascularized?

Fibromuscular tube Signup and view all the answers

What happens to the absorption of slightly water-soluble drugs in the rectum?

It can be the slowest step in the absorption process. Signup and view all the answers

What is a characteristic of the vaginal route of drug administration?

Almost always self-administered Signup and view all the answers

How does age and hormonal activity affect the vaginal mucosa?

It alters thickness variably with hormonal activity. Signup and view all the answers

What is a key advantage of vaginal administration over oral routes?

It completely avoids the first pass effect. Signup and view all the answers

Which of the following represents a disadvantage of vaginal administration?

Systemic absorption can be unpredictable. Signup and view all the answers

Vaginal films are primarily used for which purpose?

Delivering localized drugs such as spermicides. Signup and view all the answers

What characteristic of vaginal rings allows them to release medication over an extended period?

They use a reservoir system. Signup and view all the answers

What is a common component of vaginal tablets that assists in their functionality?

Dispersing agents. Signup and view all the answers

Which attribute is crucial for the effectiveness of vaginal products after administration?

The product should retain in place long enough for drug distribution. Signup and view all the answers

Why might some patients be reluctant to use vaginal delivery systems?

The systems can cause leakage or slipping. Signup and view all the answers

In vaginal semisolids, which factor can increase the contact time with the epithelial surface?

Incorporation of bioadhesive or mucoadhesive gels. Signup and view all the answers

What is a typical disadvantage of vaginal suppositories compared to vaginal tablets?

They are not as easy to manufacture. Signup and view all the answers

Which of the following dosage forms is commonly delivered via a plastic applicator for local action?

Vaginal gels. Signup and view all the answers

Study Notes

Suppositories: Dosage Form & Administration

Suppositories are solid dosage forms designed to melt or dissolve at body temperature, releasing medication locally or systemically.
Drawback: A significant issue with suppositories is variability in absorption rates due to factors like individual physiology, rectal contents, and drug properties.
Benefit: Despite drawbacks, suppositories offer advantages for patients who cannot take oral medications or prefer a non-invasive route.
Target Patient Group: Patients with nausea, vomiting, or impaired swallowing benefit significantly from suppositories.
Rectal Advantage: Rectal administration bypasses the first-pass metabolism in the liver, often resulting in higher drug bioavailability.
Inter-Subject Variation: Differences in rectal anatomy, intestinal motility, and individual drug-receptor interactions contribute to varying absorption rates among individuals.
Related Dosage Forms: Besides suppositories, pessaries (vaginal suppositories) are another relevant dosage form.

Suppository Characteristics & Types

Disadvantage: One potential disadvantage of suppositories is that they can cause rectal irritation or discomfort.
Advantage: Rectal administration allows for faster absorption of drugs compared to oral administration.
Shape: Rectal suppositories are typically molded into a torpedo shape for easier insertion.
Weight: Adult rectal suppositories typically weigh around 2 grams.
Pessary: Vaginal suppositories are also known as pessaries.
Reason for Rectal Use: When oral administration is ineffective or contraindicated, rectal administration is often preferred.
Urethral Suppository Diameter: The usual diameter range for urethral suppositories is 0.5 to 1 cm.
Rectal Route Practicality: The rectal route can be less practical for drug administration due to potential discomfort, embarrassment, and the need for patient cooperation.
Urethral Suppository Length: The length of urethral suppositories varies depending on the intended use, with a typical range of 2 to 5 cm.
Rectal Suppository Length: The typical length range for rectal suppositories is 3 to 5 cm.
Urethral Suppository Characteristic: Unlike most suppositories, urethral suppositories are cylindrical in shape.

Suppository Bases & Drug Release

Water-Soluble Drug Release: Water-soluble drugs released from a fatty suppository base often have a slow and erratic release rate.
Preferred Rectal Base: Cocoa butter, with its soothing action, is preferred for rectal administration.
Cocoa Butter Disadvantage: One major disadvantage of using cocoa butter as a suppository base is its sensitivity to temperature fluctuations.
Cocoa Butter Property: The polymorphism of cocoa butter is not favorable for suppository use, as it affects its melting point and solidification properties.
Rectal Pressure: Suppository pressure in the rectum is exerted by the rectal sphincter muscle during insertion.
Semi-Synthetic Fatty Bases: Semi-synthetic fatty bases typically do not contain hydrogenated vegetable oils.
Absorption Enhancement: Sodium lauryl sulfate is a surfactant known for its ability to enhance absorption for peptide-like drugs.

Vaginal Route & Administration

Vaginal pH: The typical pH of vaginal fluids during the menstrual cycle is around 4.5.
Ketoconazole Problem: At acidic pH levels, ketoconazole becomes protonated, which reduces its absorption and effectiveness.
Rectal Absorption Influence: The highly vascularized rectal mucosa is a major factor influencing drug absorption from rectal suppositories.
Vaginal Systemic Effect: Drug absorption from the vaginal route can lead to potential systemic effects.
Vaginal Vascularization: The rich network of blood vessels surrounding the vaginal mucosa ensures its vascularization.
Water-Soluble Drug Absorption: Slightly water-soluble drugs tend to absorb faster in the rectum due to its higher water content.
Vaginal Route Characteristic: Drug delivery via the vaginal route allows for local and systemic drug action.
Vaginal Mucosa Changes: Age and hormonal activity significantly impact the integrity and absorption capacity of the vaginal mucosa.
Vaginal Advantage: Vaginal administration allows for targeted drug delivery to the reproductive system, bypassing the liver and gastrointestinal tract.
Vaginal Administration Disadvantage: One disadvantage of vaginal administration is potential discomfort, leakage, and difficulty with insertion.
Vaginal Film Purpose: Vaginal films are primarily used for estrogen replacement therapy.
Vaginal Ring Release: Vaginal rings are designed with a reservoir that allows for controlled medication release over an extended period.
Vaginal Tablet Component: Vaginal tablets typically contain acid-forming ingredients, which create a favorable environment for drug dissolution and absorption.
Vaginal Product Effectiveness: The dissolution rate and absorption of vaginal products are crucial for their effectiveness after administration.
Patient Reluctance: Some patients might be hesitant to use vaginal delivery systems due to social stigma, discomfort, or personal preference.
Vaginal Semisolid Contact Time: In vaginal semisolids, the viscosity and gel-forming properties can increase contact time with the epithelial surface, promoting drug absorption and effectiveness.
Vaginal Suppository Disadvantage: Compared to vaginal tablets, vaginal suppositories may have a shorter duration of action due to their rapid melting and release.
Plastic Applicator Dosage Form: Vaginal creams and gels are commonly delivered via a plastic applicator to ensure local action within the vagina.

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Description

This quiz explores key characteristics and benefits of suppositories in pharmacology. It covers their advantages, disadvantages, and patient groups that can benefit. Test your knowledge about rectal drug administration and absorption variations.