Rectal administration (colloquially known as boofing or plugging) uses the rectum as a route of administration for medication and other fluids, which are absorbed by the rectum's blood vessels, and flow into the body's circulatory system, which distributes the drug to the body's organs and bodily systems.
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⭐ Core Definition: Rectal administration
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👉 Rectal administration in the context of Drug delivery
Drug delivery involves various methods and technologies designed to transport pharmaceutical compounds to their target sites helping therapeutic effect. It involves principles related to drug preparation, route of administration, site-specific targeting, metabolism, and toxicity all aimed to optimize efficacy and safety, while improving patient convenience and compliance. A key goal of drug delivery is to modify a drug's pharmacokinetics and specificity by combining it with different excipients, drug carriers, and medical devices designed to control its distribution and activity in the body. Enhancing bioavailability and prolonging duration of action are essential strategies for improving therapeutic outcomes, particularly in chronic disease management. Additionally, some research emphasizes on improving safety for the individuals administering the medication. For example, microneedle patches have been developed for vaccines and drug delivery to minimize the risk of needlestick injuries.
Drug delivery is closely linked with dosage form and route of administration, the latter of which is sometimes considered to be part of the definition. Although the terms are often used interchangeably, they represent distinct concepts. The route of administration refers specifically to the path by which a drug enters the body, such as oral, parenteral, or transdermal. In contrast, the dosage form refers to the physical form in which the drug is manufactured and delivered, such as tablets, capsules, patches, inhalers or injectable solutions. These are various dosage forms and technologies which include but not limited to nanoparticles, liposomes, microneedles, and hydrogels that can be used to enhance therapeutic efficacy and safety. The same route can accommodate multiple dosage forms; for example, the oral route may involve tablet, capsule, or liquid suspension. While the transdermal route may use a patch, gel, or cream. Drug delivery incorporates both of these concepts while encompassing a broader scope, including the design and engineering of systems that operate within or across these routes. Common routes of administration include oral, parenteral (injected), sublingual, topical, transdermal, nasal, ocular, rectal, and vaginal. However, modern drug delivery continue to expand the possibilities of these routes through novel and hybrid approaches.
In this Dossier
Rectal administration in the context of Enema
An enema, also known as a clyster, is the rectal administration of a fluid by injection into the lower bowel via the anus. The word enema can also refer to the liquid injected, as well as to a device for administering such an injection.
In standard medicine, the most frequent uses of enemas are to relieve constipation and for bowel cleansing before a medical examination or procedure; also, they are employed as a lower gastrointestinal series (also called a barium enema), to treat traveler's diarrhea, as a vehicle for the administration of food, water or medicine, as a stimulant to the general system, as a local application and, more rarely, as a means of reducing body temperature, as treatment for encopresis, and as a form of rehydration therapy (proctoclysis) in patients for whom intravenous therapy is not applicable.
Rectal administration in the context of Misoprostol
Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. It is taken by mouth when used to prevent gastric ulcers in people taking nonsteroidal anti-inflammatory drugs (NSAID). For abortions it is typically used in conjunction with mifepristone or methotrexate, but can be used alone. By itself, effectiveness for abortion is between 82% and 100%. Its efficacy with mifepristone is higher, but varies based on gestational age. The misoprostol-only abortion regimen is typically recommended only when mifepristone is not available. For labor induction or abortion, it is taken by mouth, dissolved in the mouth, or placed in the vagina. For postpartum bleeding it may also be used rectally.
Common side effects include diarrhea and abdominal pain. It is in pregnancy category X, meaning that it is known to result in negative outcomes for the fetus if taken during pregnancy. In rare cases, uterine rupture may occur. It is a prostaglandin analogue—specifically, a synthetic prostaglandin E1 (PGE1).
Rectal administration in the context of Morphine
Morphine, formerly known as morphium, is an opiate found naturally in opium, a dark brown resin produced by drying the latex of opium poppies (Papaver somniferum). It is mainly used as an analgesic (pain medication). There are multiple methods used to administer morphine: oral; sublingual; via inhalation; injection into a muscle, injection under the skin, or injection into the spinal cord area; transdermal; intravenously; or via rectal suppository. It acts directly on the central nervous system (CNS) to induce analgesia and alter perception and emotional response to pain. Physical and psychological dependence and tolerance may develop with repeated administration. It can be taken for both acute pain and chronic pain and is frequently used for pain from myocardial infarction, kidney stones, and during labor. Its maximum effect is reached after about 20 minutes when administered intravenously and 60 minutes when administered by mouth, while the duration of its effect is 3–7 hours. Long-acting formulations of morphine are sold under the brand names MS Contin and Kadian, among others. Generic long-acting formulations are also available.
Common side effects of morphine include drowsiness, euphoria, nausea, dizziness, sweating, and constipation. Potentially serious side effects of morphine include decreased respiratory effort, vomiting, and low blood pressure. Morphine is highly addictive and prone to abuse. If one's dose is reduced after long-term use, opioid withdrawal symptoms may occur. Caution is advised for the use of morphine during pregnancy or breastfeeding, as it may affect the health of the baby.
Rectal administration in the context of Suppository
A suppository is a dosage form used to deliver medications by insertion into a body orifice (any opening in the body), where it dissolves or melts to exert local or systemic effects. There are three types of suppositories, each to insert into a different sections: rectal suppositories into the rectum, vaginal suppositories into the vagina, and urethral suppositories into the urethra of a male.
Suppositories are ideal for infants, elderly individuals and post-operative patients, who are unable to swallow oral medications, and for individuals experiencing severe nausea and/or vomiting. Suppositories are administered through rectal route to reduce onset time of reaction.