Didactic 06_Suppositories - Spring 2021 - Parts A &...

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4/7/20211Monica Chuong, Ph.D. Module 6: Rectal, Vaginal and Urethral Suppositories1ObjectivesTolearnthecalculation,suppositorybases,compoundingmethod,compatibility,stability,BUD,patientconsultationthroughthepreparations of:Rx 061 Bismuth Subgallate Rectal SuppositoriesRX 062 Boric Acid Vaginal SuppositoriesRx 063 Oxybutynin UrethralSuppository for Overactive Bladder(for practicing skill only)2
4/7/20212Unconscious, vomit, seizure, obstruction in upper GI.Drugs with extensive metabolized by the first pass effect.Drugs degraded in stomach or small intestine.Local applications hemorrhoids, itching, and infection.Systemic applications -antinauseants, antiasthmatics, analgesics and hormones.Uses of Suppositories34lucy.stanford.edu/img/ImageCA_517.jpgTheinferior and middle rectal veinsbring the bloodto the systemic circulation (inferior vena cava), thusbypassing the primary liver passage.
4/7/20213Thesuperiorrectalveindrainsdirectlyonthemesenteric vein (portal vein,vena portae), and thus to theliver.Becausethethreevenoussystemsareinterconnectedby anastomoses, wecannotcount on completebypassingtheliverof a drug absorbedby the lower section of therectum.5Rectalcylindrical or conical and are tapered orpointed at one end.Weigh about 2 g.Children rectalhalf of adult size (~ 1 g).Vaginalovoid, globular or other shapes. Weighabout 35 g each.UrethralFor female 5 mm (D),70 mm (L), 2 g (W)For male5 mm (D), 140 mm (L), 4 g (W)6
4/7/202147Suppositories are abbreviated as “supp”.cap (capsule), crm (cream), tab (tablet)Sol (solution) syr (syrup) susp (suspension)oint, ung (ointment0Suppository Bases(I)Oleaginous (fatty) bases Example cocoa butter difficult to compound.mp 30 to 35oC (Soften in warm weather, Lose effectiveness if over heat).Five polymorphs due to growing climate (beta form is used, most stable).(II) Hydrogenated vegetable oil basesCombined oils (palm kernel oil, coconut oil) Wecobee, Witepsol (synthetic triglycerides)Mixtures of fatty acid (MBK, FattiBase)(III) Water soluble or water miscibles bases: PEG8
4/7/20215Hand molding, fusion, and compressionHand molding requires considerable skill butmay avoidusing heat.Some bases (such as cocoa butter) are easilymanipulated, shaped and handled at roomtemperature.Methods of Suppository Preparation9Wearplasticgloves.Gratethecocoabutter(theobroma oil). Weigh the amount of drug andbase.Using geometric dilution, mix the drug and thecocoa butter(or another base with low meltingtemperature) in a mortar.Collect the mixture in the mortar and knead themass into a ball in hand on clean disposablegloves and form a cylindrical pipe.Hand Molding Method10
4/7/20216Put the pipe on an ointment slab.Rollthemassintoasmoothcylindrical pipe, keeping both endsas square as possible.

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