Medications taken rectallly

Many of us have the need to take NSAIDS for the relief of inflammation. Unfortunately, most of these medications can cause considerable irritation to the stomach lining.

My question is: Can tablets (i.e. allieve) be ground up and mixed with water and then injected into the rectum using a small syringe? Will the large intestine absorb the key ingredients and provide relief without irritatation to the Upper GI tract. Maybe someone like SwitcheableSusie with a med background could satisfactorily answer this question. Thanks

joymkr

Not sure about the other drugs, but Tylenol suppositories are widely available and although it doesn't do much for me,

the rectal path for Tylenol seems to work as well as oral.

From what I know, I believe that most NSAIDS can be absorbed through your lower GI tract. Widly available here is of course Tylenol suppositories, and in Canada they have Naproxin rectal suppositories too. So that makes me believe that most of them can be absorbed via that route.

However, because of the nature of the beast, taking them orally or rectally can produce basically the same neg results, just different ends, just not as severe when taken rectally.

A rule of thumb that I use in nursing for some of my patients is that most all meds can be, and are usually as effective, some even more etfective, at least faster acting, when given rectally. They don't have to be processed they can just be absorbed. You can't do that with medications that are enteric coated, time released, or some of the other "serious" meds that need the above process to work properly. But if my patient is in serious enough condition that I am giving their meds rectally to them, usually all the serious meds are D/C'd and only comfort meds are being given anyway.

Just a side note, Advil is coated, so when I give it rectally I disolve it first, if not, it just sort of sits there and takes forever to work. Hope this helps?

Mashie

Joymkr: NSAIDS are irritating to the stomach lining, but it is NOT by their contact with the lining. NSAIDS work to releive inflammation by blocking prostaglandins, which transmit pain impulses to the brain. One of the positive things that prostaglandins do is to maintain a bicarbonate layer of mucous at the stomach lining, so that the body's HCL acid will not begin to digest the stomach lining. High doses of NSAIDS for long periods of time will surpress prostaglandins to the point that ulcers develop in the stomach. If you give NSAIDS rectally, they still cause chemical changes in the stomach and you can still get ulcers. If you gave them by I.V. injection, they would still cause the stomach to be at risk. The NSAID chemical does not cause damage to the lining by coming into contact with it; it does so by altering total body prostaglandins. So oral or rectal would make no difference.

Analgesic suppositories are usually given to patients who are unconscious, have damage to their swallowing mechanism, are small children, or for some other reason can't take their meds. orally. BTW, Tylenol is NOT an NSAID and has no effect on prostaglandins and thus, no effect on the stomach.

In my experience, Europeans, especially Germans, are receptive to rectal medications. Many meds are available in a rectal dosage form in Europe.

Jimmy44, you are exactly correct. Good show, good show.

Mashie

20 years ago when I started chemotherapy to treat my MS, the first dose I got following the loading dose, sent me whaco. I had diahrrea and vomiting the day after the chemo. The vomiting got so bad that I called the doctor to so if anything could be done about it. He prescribed a rectal suppository to be use about evey 4 to 6 hours as needed to "pull the contentes of the stomach back down toward the intestines" The suppo's did the trick as within 6 hours I was over the effects of the chemo.

Kept the suppositoris as I had another chemo treatment every 8 weeks for two years to suppress the MS.

Thanks jimmyt44 for your clarification regarding NSAIDS and stomach irritation....very informative. I have found, however, that if I take Naprosin Sodiuim with some food, the nauseous feeling is considerably less.

joymkr

I have heard that people that cant take pills for some reason can crush them up ot get liquid and put it in a small enema and hold for about 30 minutes and the meds will absorb into your system.. does anyone know if that is true

That is a very poor method of getting medication. Absorption rates, onset and completeness varies tremendously. Not everything that comes in a tablet or capsule is absorbed well rectally.

Teachme, that depends on the medication. Not all medications can be used rectally, either whole or crushed because of the way in which they are absorbed/processed in the body. With my patients who are dying and can't take meds by mouth, we always give them their meds per rectum.

I sometimes tell my patients who are being difficult about taking their medications, you can either take them this way, (as I point to my mouth), or I can give them to you this way, (as I point to my tushy). That gets me one of two reactions, either they laugh and then take them orally, or they try to call my bluff. But then when I tell them "okay, I'm going to go and crush these up, be back in 5 minutes. Then I start to turn and walk out, suddenly they change their minds and decide to take them orally. I have yet to have to make good on my threats, lol.

Mashie

Thank you switch and mashie...

Hey Mashie...do you think one might be successful in getting a little extra TLC down below if a naughty patient were to call your bluff? I was just wondering...hypothetically and rhetorically of course!

Hey folks, if you want more meds via suppository, go to Germany for health care.

Be EXTREMELY careful!

Some meds have totally different absorption and metabolization rates that way. If you don't know EXACTLY what you are doing, you could be the next Darwin Award.

MASHIE: "or they try to call my bluff. But then when I tell them "okay, I'm going to go and crush these up, be back in 5 minutes. Then I start to turn and walk out, suddenly they change their minds and decide to take them orally. I have yet to have to make good on my threats, lol."

Well ! Threaten away, Nurse Mashie, their is nothing I would like better than to call that "BLUFF"

DaddyMe, lol. Well if you are ever in my facility then we will call it a date.

Mashie