level: level 2
Questions and Answers List
Medication sticks
level questions: level 2
| Question | Answer |
|---|---|
| RANGE FROM 5 TO 25 g cylindrical in shape generally packed in an applicator tube for topical administration, and the applicator can be adjusted to continually expose new, fresh sticks from inside the tube | Medication Sticks |
| Advantages of Rectal Administration | 1. Avoidance of first-pass effect 2. Drug stability- avoiding breakdown of drugs that are susceptible to gastric degradation 3. Large dose drugs: Ability to administer somewhat large dose of drugs than oral administration 4. Irritating drugs: ability to administer drugs that have an irritating effect on the oral or GI mucosa 5. Unpleasant tasting and smelling drugs 6. Rectal route is especially useful for children 7. Patient experiencing nausea and vomiting, unconscious 8. Presence of dx of the upper GI tract that interferes drug absorptions 9. Objectional taste or odor of a drug ( impt. in children) 10. Achievement of rapid drug effect systemically (alternate to injection) |
| Disadvantages of Rectal Administration | 1. A perceived lack of flexibility regarding dosage of commercially available suppositories in underuse and a lack of availability 2. If made on demand, may be EXPENSIVE 3. Exhibit VARIABLE EFFECTIVENESS 4. Formulations with NARROW THERAPEUTIC MARGIN, cannot be interchanged w/o risk of toxicity 5. Bullet shaped suppository after insertion can leave the anorectal site and ascend to rectostigmoid and descending colon, should not be used at bedtime 6. Defecation may interrupt the absorption process of drug, occur if drug is irritating 7. The absorbing SA of the rectum is much smaller than that of the small intestine 8. Fluid content of the rectum is much less than that of the SI, which may affect dissolution rate 9. Possibility of degradation of some drugs by the microflora present in the rectum 10. Dose of drug may be greater or less than the dose of the oral drug 11. Factors that affect rectal absorption of a drug administered in the form of suppository: a. anatomic and physiologic factors b. physicochemical factors of the drug and the base |
| Used to relieve constipation, as laxative | RECTAL SUPPOSITORIES FOR LOCAL EFFECT/ ACTION Ex. Dulcolax (Bisacodyl) suppositories Glycerin suppositories |
| promote laxation by local irritation of the mucous membranes, due to the dehydrating effect of the glycerin on those membranes | Glycerin suppositories |
| Used to relieve pain, irritation, itching, and inflammation associated with hemorrhoids and other anorectal conditions example suppositories | RECTAL SUPPOSITORIES FOR LOCAL EFFECT/ ACTION ex. Hydrocortisone suppositories Mesalamine suppositories |
| Frequently contain a number of components, including : Local anesthetics, vasoconstrictors, astringents, analgesics, soothing emollients, and protective agents. | Antihemorrhoidal suppositories |
| 1 Employed mainly as contraceptives, antiseptics in feminine hygiene, and as specific agents to combat an invading pathogen. 2 Most commonly, the drug used for contraception, trichomonacides to combat vaginitis caused by Trichomonas vaginalis, antifungals to treat Candida (Monilia) albicans, and anti-infectives/antibiotics directed at other microorganisms. 3 Urethral suppositories may be __ preparative for a urethral examination. | 1 VAGINAL SUPPOSITORIES OR INSERTS FOR LOCAL EFFECT 2) nonoxynol-9 3 antibacterial or a local anesthetic |
| are commonly used for local effect and include hydration/emmolient, antibacterial, sunscreen, antipruritc | Sticks |
| 1 __ permit the absorption of many soluble drugs. 2 site for the systemic absorption of drugs 3 not as frequently used | 1 Mucous membranes of the rectum and vagina 2 Rectum 3 Vagina |
| 1 Physiologic factors affecting the absorption of drugs from rectal suppositories 2 Physicochemical factors | 1 Colonic content (Emptier, the more absorption), Circulation route (Avoids first pass effect), pH and lack of buffering capacity of the rectal fluids 2 Lipid-water solubility, Particle Size, Nature of the base Mnemonic: CCP, LPN |
| FACTORS 1 A drug will have greater opportunity to make contact with the absorbing surface of the rectum and colon in an empty rectum. 2 Lower hemorrhoidal veins surrounding the colon receive the absorbed drug and initiate circulation bypassing liver | 1 Colonic contents 2 Circulation route |
| 1 For systemic effect, absorption is greater in a rectum that is __ 2 They slow down rectal drug absorption | 1 void or empty 2 Diarrhea, Fecal matter, Tumor growth, Tissue dehydration Mnemonics: DFTT |
| 1 rectal fluids are essentially neutral in pH (7.2 to 7.4) and have __, the form in which the drug is administered will not generally be chemically changed by the environment. | 1 no effective buffer capacity |
| PHYSICOCHEMICAL FACTORS OF THE DRUG AND SUPPOSITORY BASE | The relative solubility of the drug in lipid and in water . The particle size of a dispersed drug. Physicochemical factors of the base include its ability to melt, soften, or dissolve at body temperature, its ability to release the drug substance, and its hydrophilic or hydrophobic character |
| 1 an important consideration in the selection of the suppository base and in anticipating drug release from that base. 2 A lipophilic drug that is distributed in a fatty suppository base in low concentration has less tendency to escape to the surrounding aqueous fluids than a hydrophilic substance in a fatty base. TRUE OR FALSE | 1 lipid–water partition coefficient 2 TRUE |
| 1 the more drug a base contains, the more drug will be available for absorption. TRUE OR FALSE 2 if the concentration of a drug in the intestinal lumen is above a particular amount, which varies with the drug, the rate of absorption is __ | 1 TRUE 2 NOT CHANGED; still the same |
| 1 In particle Size, avoid __ because of high incidence of the viscosity of melted excipient, possible difficulies in flow during production. | 1 too fine particle size |