Skill 62

Rectal Suppository Insertion

Rectal medications exert either local effects on gastrointestinal (GI) mucosa (e.g., promoting defecation) or systemic effects (e.g., relieving nausea or providing analgesia). The rectal route is not as reliable as the oral and parenteral routes in terms of drug absorption and distribution. However, the medications are relatively safe because they rarely cause local irritation or side effects. Rectal medications are contraindicated in patients with recent surgery on the rectum, bowel, or prostate gland; rectal bleeding or prolapse; and very low platelet counts (Lilley et al., 2011).

Rectal suppositories are thinner and more bullet-shaped than vaginal suppositories. The rounded end prevents anal trauma during insertion. When you administer a rectal suppository, placing it past the internal anal sphincter and against the rectal mucosa is important. Improper placement can result in expulsion of the suppository before the medication dissolves and is absorbed into the mucosa. If a patient prefers to self-administer a suppository, give specific instructions so the medication is deposited correctly. Do not cut the suppository into sections to divide the dosage; the active drug may not be distributed evenly within the suppository, and the result may be an inaccurate dose (Lilley et al., 2011).