Constituents:

Some suppositories are made from a greasy base, such as cocoa butter, in which the active ingredient and other excipients are dissolved; this grease will melt at body temperature (this may be a source of discomfort for the patient, as the melted grease may pass through theanus during flatulences). Other suppositories are made from a water soluble base, such as polyethylene glycol. Suppositories made frompolyethylene glycol are commonly used in vaginal and urethral suppositories. Glycerin suppositories are made of glycerol and gelatin.

Indications:

Suppositories may be used for patients in the event it may be easier to administer than tablets or syrups.

Suppositories may also be used when a patient has a vomiting tendency, as oral medication can be vomited out.

Drugs which often cause stomach upset, for example diclofenac sodium (Voltaren) are better tolerated in suppository form.

Artesunate suppositories:

Artesunate suppositories are used for the treatment of malaria. Artesunate is an antimalarial water-soluble derivative of dihydroartemisinin.Artemisinins are sesquiterpene lactones isolated from Artemisia annua, a Chinese traditional medicine.

The risk of death from severe malaria is largely dependent on the time lag between the onset of symptoms and treatment. Rapid access to effective treatment is therefore essential. For many patients, readily available oral drugs cannot be taken because of their symptoms (e.g., vomiting, convulsions, coma), and hospitals providing alternative, non-oral treatment are often inaccessible. The drug artesunate, given insuppository form, provides a potential solution to this problem: it can be made available in remote areas and thus can be given at the onset of symptoms.

Artesunate is one of a number of artemisinin derivatives discovered and developed by Chinese scientists and registered in China in the 1980s. Since the 1990s, UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) supported studies to assess the properties of the drug. There were already indications that artesunate, given rectally, was effective in severe malaria. Significant work with artemisinin suppositories in severe malaria was conducted in Viet Nam in the early 1990s,^[1][2][3] and clinical trials of rectal artesunate followed by mefloquine treatment in moderately severe malaria were conducted in Thailand.^[4][5]

A major placebo-controlled clinical trial published in 2009 found that "if patients with severe malaria cannot be treated orally and access to injections will take several hours, a single inexpensive artesunate suppository at the time of referral substantially reduces the risk of death or permanent disability.

Enema :

An enema (pronounced /ˈɛnəmə/; plural enemata or enemas) is the procedure of introducing liquids into therectum and colon via the anus. The increasing volume of the liquid causes rapid expansion of the lower intestinal tract, often resulting in very uncomfortable bloating, cramping, powerful peristalsis, a feeling of extreme urgency and complete evacuation of the lower intestinal tract. An enema has the advantage over any laxative in its speed and certainty of action, and some people prefer it for this reason.

Enemas can be carried out as treatment for medical conditions, such as constipation and encopresis, and as part of some alternative health therapies. They are also used to administer certain medical or recreationaldrugs. Enemas have been used for rehydration therapy (proctoclysis) in patients for whom intravenous therapyis not applicable.