A rectal suppository is a solid, typically cone-shaped dosage form designed for insertion into the rectum. This medication is encased in a base, often made of substances like cocoa butter or gelatin, which melts or dissolves at body temperature to release the active drug. Rectal delivery is used when a person cannot take medication orally. It can also provide systemic drug delivery by absorption into the bloodstream or act locally on the rectal tissue.
The Specific Insertion Depth for Adults
For an adult, the suppository must be inserted beyond the internal anal sphincter, which is a ring of muscle that controls the opening. The standard insertion depth is typically between 1 to 1.5 inches (2.5 to 4 centimeters) past the anal opening, though some sources suggest up to 2 or 3 inches. This depth ensures the suppository is placed in the rectal vault, where the medication can dissolve and be absorbed effectively. Proper placement beyond this muscular barrier is the primary factor in achieving both retention and therapeutic effect.
Essential Steps Before Administration
Preparation is necessary to ensure a smooth and hygienic procedure before inserting the medication. Begin with thorough hand washing, considering a disposable glove or finger cot for cleanliness. If the suppository feels too soft, chill it in the refrigerator or under cool water to firm it up. Lubrication is highly recommended to minimize discomfort during insertion; coat the tip with a water-soluble lubricating jelly, avoiding petroleum-based products. The preferred patient position is the Sims position, lying on the left side with the right knee bent toward the chest.
Procedural Adjustments for Children
Administering a suppository to a child or infant requires adjustments due to anatomical differences. The required insertion depth is much shallower, typically between 0.5 to 1 inch (1.25 to 2.5 centimeters) into the rectum. For infants, a depth of about a half-inch is often sufficient. Inserting the suppository too deeply can increase the risk of immediate expulsion. After insertion, gently hold the child’s buttocks together for a few seconds to help prevent the suppository from being expelled.
Maintaining Retention Post-Administration
Once the suppository is placed, maintaining its position is crucial for the medication to dissolve and be absorbed. The patient should remain lying down or in a resting, still position for a specific period. This retention time is typically advised to be between 15 to 20 minutes, or up to 30 minutes, allowing the suppository’s base to melt completely. Deep breathing can help the patient relax the anal sphincter muscles, which may reduce the urge to expel the medication. Unless the suppository is a laxative, the patient should try to avoid defecating for at least an hour after administration to ensure maximum drug absorption.