Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions.
Rectally administered medications are essential in palliative medicine, particularly in the last days of life. They are underutilized. The pharmacology of rectally administered medications relates not only to the medication but also to the suppository base, additives, drug ionization, p K(a), absorptive surface of the rectum, and rectal health. The pharmacokinetics may differ from those of orally administered medications owing to reduced hepatic first-pass clearance. In this review the pharmacology of rectally administered palliative medications is reviewed and the use of individual drugs is outlined.
Davis
Mellar P
MP
Harry R. Horvitz Center for Palliative Medicine, 9500 Euclid Avenue R35, Cleveland OH 44195, USA. davism6@ccf.org
Walsh
Declan
D
LeGrand
Susan B
SB
Naughton
Michael
M
D000285:Administration, Rectal; D000701:Analgesics, Opioid / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D010166:Palliative Care; D012007:Rectum / Q000098:blood supply / Q000187:drug effects; D013488:Suppositories / Q000627:therapeutic use
D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000932:Antiemetics; D013488:Suppositories