Suppositories

Question 1

suppositories

Answer 1

medicated, solid bodies of various weights/shapes intended for insertion into body cavities (rectal, vaginal, urethral)
- melt/soften/dissolve at body temp
- may be used for local/systemic effect

Question 2

when should you compound suppositories

Answer 2

as a last resort due to difficulty compounding and unpredictable absorption

Question 3

avoid suppositories with a ______

Answer 3

narrow therapeutic window

Question 4

who are suppositories best for?

Answer 4

patients who are NPO and avoiding IV access

Question 5

ideal properties of suppository base

Answer 5

• stable
• nonreactive with drugs/auxilary agents
• aesthetically pleasing
• melt/dissolve in body cavity
• nontoxic/nonirritating
• nonbinding with drugs
• viscous enough for drug suspension — thin enough to pour into mold
• shrinks on cooling to easily release from molds

Question 6

2 Types of Suppository Bases

Answer 6

1. oleaginous (fatty) bases — cocoa butter, fattibase
2. water soluble/miscible bases — polyethylene glycol (PEG)

Question 7

Oily bases _____ while water miscible bases _____

Answer 7

oil bases MELT while water miscible bases DISSOLVE

Question 8

If the drug is OIL SOLUBLE in an OILY BASE —> drug abs will be ___

Answer 8

SLOW

Question 9

If the drug is WATER SOLUBLE in an OILY BASE —> drug abs will be ___

Answer 9

RAPID

Question 10

If the drug is OIL SOLUBLE in an WATER MISCIBLE BASE —> drug abs will be ___

Answer 10

MODERATE

Question 11

If the drug is WATER SOLUBLE in an WATER MISCIBLE BASE —> drug abs will be ___

Answer 11

MODERATE

Question 12

3 Methods of Suppository Preparation:

Answer 12

1. hand rolling - rarely used needs lot of experience
2. compression molding - not often used
3. fusion molding - base is melted and drug is dissolved in melted base –> poured into mold –> remove when cooled

Question 13

Mold calibration

Answer 13

average mass of one pure base suppository cast in the mold
mold specific, base specific, —- NOT drug specific

Question 14

density factor

Answer 14

ration of a unit mass of drug powder to the amount of suppository base displaced by powder
NOT mold specific — base and drug specific

Question 15

what is the density factor used for

Answer 15

used to determine how much base will be displaced by drug

Question 16

when is the density factor needed

Answer 16

a. when drug has quantity dose and is being used for systemic effect
b. quantity of drug is a relatively significant portion of dosage form
c. density differences exist between base and drug

Question 17

when using a mold lubricating/release agent….

Answer 17

agent should NOT be miscible with suppository base
- green soap for cocoa butter and Fattibase
- mineral oil or PEG/glycerin

Question 18

Avoid using _____ in supository compounding because ____

Answer 18

avoid using WATER
b/c:
- supports bacterial growth
- incr drug degredation
- accelerates fatty oxidation
- contributes to brittleness

Question 19

BUD for suppository

Answer 19

180 days (6 months)

Question 20

Patient counseling points for suppositories

Answer 20

1. instruct on proper admin technique
2. remove foil/plastic wrap
3. store properly