Just a quick little interesting nerdy nursing information here.
First of all, there is a new medication out just for migraine headaches. It is an oral medication, and yes, I realize that you sufferers often can't take orals because of your nausea/vomiting, however this medication is what I like to call a "fluffy" pill. It basically dissolves almost instantly on your tongue and actually, it doesn't taste bad either. It only works for migraines though, and will not work for your normal run of the mill headache. It's about 20 bucks a pill, but for those of you who suffer real migraines, it's well worth the money. Once you place it on your tongue, it's totally dissolved in 10 seconds, and in less than 5 minutes you will notice your headache is about 50 percent gone, and by 15 minutes, it's totally gone. It also almost totally alleviates that post migraine haze/disorientation phase a lot of migraine sufferers have when the headache is gone too. The drug is fantastically amazing and it is called Maxalt. Your doc will most likely have samples since it's still pretty new and expensive, but worth every cent, and then some.
On a second nerdy thing, someone said that they heard that aspirin came in rectal form. I actually don't know if it does or not, but it doesn't need to. Not all, but most medications can be taken rectally. There are some that are enteric coated, or extended release, or ones that can't be crushed, that are not really suitable to be given/taken rectally. But I give normal everyday PO (oral) meds PR (per rectum) all the time. Depending on the situation and its variables depends on how I give them rectally. For example, my patient is hospice and can't really swallow without choking. In this case I usually just stick the whole pills with a bit of KY on them strait up into their rectum where they dissolve and are absorbed. In another case where I have a patient who is in pretty bad pain, or who maybe being combative, or who has a strong history of pocketing pills or spitting them back out, I can also give them rectally two different ways too. I can crush the meds and put them in these clear and somewhat slightly larger than normal capsules that are made for this exact purpose. So I crush all the meds together then fill however many of the capsules I need to fit all the meds in, then I mix them in some KY and I put them in one by one until they are all done. The third method I use, and I use this method usually on my patients who are in a lot of pain, or who are really out of control and being a danger to themselves and to my staff. But I again crush the meds really pretty fine and I get the water as hot as I can get it, then add just enough very hot water to dissolve the medications completely. Then I stir them up real well, make sure they are completely dissolved, then I suck them up into, depending on the amount, either a 10 cc syringe, or a 60 cc syringe, and no, it never takes 60 cc's, but some medications take longer to dissolve, or they might have little beads in them which makes them next to impossible to dissolve and a 60cc tube feed syringe has a very nice 1 inch tapered end with a hole that is pretty close to the size of a q-tip, which in turn ensures all the meds get into the rectum without clogging the syringe. And sometimes when you have someone who's being a real big pain in the tush, the last thing you want to have happen, need to happen, and making an already difficult issue more so, is to have the tip clog and you have to stop, unclog it, which is putting your staff, you, and often your patient in even more danger because the longer it takes you to get medications in an already agitated and abusive patient, the more agitated and abusive they get, trust me, it's happened more than once. Also when my patient is in pain, and it's the pain medications that I am administering back there, they are absorbed quicker rectally than orally, which makes my patients feeling better much better much faster. And same goes for your abusive patient, a lot of medications, most actually are metabolized about 50 percent faster when given rectally, and some even faster than that. Another example, and I am edging pretty close to an ethical line here, but only because of the reason I am giving them rectally to this one patient, but I have a patient who will scream at the top of her lungs for hours on end. When you go to her room to make sure she's okay, she plays possum, and on the off chance you can get her to talk to you when she's in one of "those' moods she says something like "I wasn't yelling sweetheart, I was just laying here (insert an obvious over the top compliment she pulls out of the top of her 105 year old mind), thinking to myself how pretty you are both inside and out, and that you take such good care of me." I would then politely say thank you and ask her to please make sure she kept those thoughts to herself and not yell them out for everyone to hear. Then again she will say she wasn't saying a word, just thinkin' to herself. Then as soon as you walk out of her room she starts yelling again, but then it's usually actually words like, (her name is Jane for example), so she yells out "Jane, shut-up. Jane all you do is talk like a crazy old loone. Someone get in here and beat me till I shut my mouth, that will teach me, yes indeedy, that's right, you beat good and hard too." I hate it when she does that because no one would ever do that, at least not in my facility. So the point I was making here about me probably walking slightly close to the "ethical line" is that she would probably take her ambien by mouth pretty easily, but then again, there is that chance she wouldn't, so I don't give her the option. I dissolve her ambien in hot water, draw it up in a 5 cc syringe, let it cool down a few minutes, I roll her over and up and in they go. And instead of 30 to 45 minutes of having to continuously listen to more of her yelling and screaming, giving them rectally means that the rest of my 37 patients, staff, and I will only have to listen to her yelling for another 5-10 minutes tops. And I can assure you, her voice is somewhat like nails on a chalkboard, so even cutting that time to 5-10 minute seems like 5-10 hours, but it sure as heck beats the alternative, trust me, lol.
But please remember a few words of caution here, not all meds can, will, or should be/can be given per rectum do to various reasons such as being a time relaeased medication, some, no matter how well you think they are disolved still rely heavily on the acidity in your stomach to properly break down the molecules correctly so that the body can absorb and utilize them to their metabolism them thus causing them to be of the most value to your body as they were intended to be. Another point I have to say, that you do not, especially don't if you are giving them to yourself or another, is that In order for me to be able to give medicatsion per rectum, I have to have a doctors order for administering any and all medications rectally, unless the medication ordered only comes rectally.
And finally last but not least, if one of my patients is nauseated and or vomiting and they don't already have a order for an antiemitic (medication for nausea or vomiting), then I will call and ask them for something to alleviate these symptoms. Sometimes they will start rattling off a pill and I have to stop them and remind them why I am calling them in the first place for, remind them that they can't keep anything down and a medication that can be given both ways, or all three ways. Phenergan and Zofran (my personal favorite because it works the best on nausea caused by kidney issues, and has little to no side effects like phenergan does, which it's biggie is severe lethargy), can be given orally, (PO), rectally (PR), or IM (intramuscullarly, which consequently enough works even faster than rectally and 100 times faster than when given by mouth.) It just doesn't make a lick of sense if you or your patient is puking their guts out to give them a pill that has to sit in an already agitated stomach trying to get broken down enough to be able to be processed before the stomach decides it time for yet another purge. Then also makes no sense that if your patient or yourself is vomiting constantly, that eliminates the pill, or they are also having diarrhea along with vomiting, that would rule out both forms of usually a pill by mouth, or a rectal suppository per rectum, well, common sense would just tell you to write the order for all three routes, so as the patients symptoms improve, their needs also lesson for the most drastic form of that medication there is, and they then go back in reverse order, IM, to rectally, to PO, then to needing nothing. If my patients are really sick, I like to get the first few doses in them IM even if I think they definitely could tolerate it rectally, but might not orally because given IM, their body really don't have much of a choice but to use it because once it's in, it's in and stays in which allows it to start working, and working faster than the other two routes. Then after the first few IM doses, they start feeling better pretty quickly and then usually can start using the PO version. It's a win/win situation I think anyway.
Anyway, I hope something I said made sense and might be helpful to someone along the way at some point in time.
Mashie