Introduction to Suppositories
📌 Suppositories are a type of solid dosage form inserted into body orifices, primarily the rectum, vagina, and urethra.
💧 Upon insertion, they can melt or dissolve to exert local or systemic effects depending on the drug and formulation design.
📏 Common shapes include bullet-like for rectal use and wider/flatter forms for vaginal application.

History of Suppositories
📜 Early uses were focused on local treatment of the rectal mucosa, often to ease bowel movements, documented as far back as the Egyptian Ebers Papyrus.
🌰 The use of Oleum Cacao (cocoa butter) as a suppository base was introduced in 1707 by Flammer.
🏛️ The modern era of suppositories is generally considered to have begun in the 1800s, leading to expanded applications beyond laxatives, including anti-inflammatory and anthelmintic uses.

Modern Applications and Administration Routes
💊 Suppositories account for a small fraction of drug formulations, estimated at about 5% maximum.
🔬 Urethral suppositories (using the MUSE system for erectile dysfunction) and vaginal suppositories (often for fungal infections like Nystatin) are specialized uses.
🔄 Rectal suppositories have the widest use for both local and systemic effects, used for analgesics, antiemetics, and treating conditions like hemorrhoids.

Advantages and Rationale for Use
🚫 Suppositories serve as a crucial alternative route when oral administration (swallowing) or parenteral routes (injection) are impossible or undesirable for the patient.
👶 They are often preferred for children, adults, and the elderly who cannot take tablets or capsules.
💨 Suppositories can provide a faster onset of action compared to oral tablets and avoid the discomfort of injections.

Rectal Anatomy for Absorption
📏 The rectal wall offers a sufficient surface area for drug absorption, approximately 200 to 400 cm².
❤️ Absorption via the rectum helps to minimize first-pass metabolism in the liver because some of the venous drainage bypasses the hepatic portal system.

Key Points & Insights
➡️ Suppositories remain essential as they provide a viable route for medication delivery when oral or parenteral routes fail or are unsuitable.
➡️ The initial focus on suppositories was local relief (e.g., constipation), but the modern use encompasses broader systemic therapeutic effects.
➡️ Rectal administration offers the advantage of bypassing significant hepatic metabolism due to the vascular drainage structure of the rectum.

📸 Video summarized with SummaryTube.com on Dec 14, 2025, 21:38 UTC