Administering medication rectallyInsertion of an enema nozzle as it breaches the anal sphincter.Glycerin (laxative) suppositories for insertion into the rectum.A rectal "bulb" syringe for introducing a small amount of fluid into the rectum.Enema equipment for introducing a large amount of fluid into the colon via the rectum.
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,[Note 1] and flow into the body's circulatory system, which distributes the drug to the body's organs and bodily systems.[Note 2]
A drug that is administered rectally will in general (depending on the drug) have a faster onset, higher bioavailability, shorter peak, and shorter duration than oral administration.[1][2] Another advantage of administering a drug rectally, is that it tends to produce less nausea compared to the oral route and prevents any amount of the drug from being lost due to emesis (vomiting). In addition, the rectal route bypasses around two-thirds of the first-pass metabolism as the rectum's venous drainage is two-thirds systemic (middle and inferior rectal vein) and one-third hepatic portal system (superior rectal vein). This means the drug will reach the circulatory system with significantly less alteration and in greater concentrations.[Note 3] Finally, rectal administration can allow patients to remain in the home setting when the oral route is compromised. Unlike intravenous lines, which usually need to be placed in an inpatient environment and require special formulation of sterile medications,[3] a specialized rectal catheter can be placed by a clinician, such as a hospice nurse or home health nurse, in the home. Many oral forms of medications can be crushed and suspended in water to be given via a rectal catheter.
The rectal route of administration is useful for patients with any digestive tract motility problem, such as dysphagia, ileus, or bowel obstruction, that would interfere with the progression of the medication through the tract. This often includes patients near the end of life (an estimated 1.65 million people are in hospice care in the US each year).[4] Because using the rectal route enables a rapid, safe, and lower cost alternative to administration of medications,[5] it may also facilitate the care of patients in long-term care or palliative care, or as an alternative to intravenous or subcutaneous medication delivery in other instances.
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^De Boer AG, Moolenaar F, de Leede LG, Breimer DD. (1982) "Rectal drug administration: clinical pharmacokinetic considerations." Clin Pharmacokinetics. 7(4):285–311
^Moolenaar F, Koning B, Huizinga T. (1979) "Biopharmaceutics of rectal administration of drugs in man. Absorption rate and bioavailability of phenobarbital and its sodium salt from rectal dosage forms." International Journal of Pharmacaceutics, 4:99–109
^Plumer AL. 2007. Plumer's Principles and Practices of Intravenous Therapy. Lippincott Williams & Wilkins. 753 pp.
^"National Hospice and Palliative Care Organization's Facts and Figures: Hospice Care in America, 2013 Edition" (PDF) Archived 2014-05-13 at the Wayback Machine
^A Quality Improvement Study: Use of a Rectal Medication Administration Device Intervention to manage end-stage symptoms in hospice patients when the oral route fails. Poster Presentations. 6th Annual Hospice Palliative Nurses Association Clinical Practice Forum, Pittsburgh, PA, September 15-15, 2012
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the belly leading directly to the stomach (PEG tube). Rectaladministration usually involves rectal suppositories.) The mechanism for drug absorption from...
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comfortable and discreet administration of ongoing medications via the rectal route. The catheter was developed to make rectal access more practical and...
for rectaladministration by Ferring Pharmaceuticals from the early 1960s under brand names such as Rektandron and Testosteron. Rectaladministration of...
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administration and between 30 and 60 minutes after intramuscular administration; after rectaladministration, peak plasma levels occur after 10 to 45 minutes. Diazepam...
available for use by oral administration in the form of tablets, orally disintegrating tablets and suspension, and by rectaladministration in the form of suppositories...
of various infections of the upper and lower respiratory tract. Rectaladministration is an off-label use of vancomycin for the treatment of Clostridium...
across the surface. Intravaginal administration Vaginal rings Capsules and tablets Suppositories Rectaladministration (enteral) Suppositories Suspensions...
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medication. Aside from oral administration, benzonatate has also been used by a variety of other routes, including rectaladministration, subcutaneous injection...
Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the...
their causticity and vasoconstrictive effects. Rectaladministration and intravaginal administration are less-popular drug routes in the community with...
gluconate may also be given intramuscularly (IM) or rectally (PR). The main problem with rectaladministration is that the dose can be expelled before it is...
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injection, or rectally. The bioavailability of oral administration of oxycodone averages within a range of 60 to 87%, with rectaladministration yielding the...
for an alcohol enema Boofing, a generalized slang term for the rectaladministration of a drug This disambiguation page lists articles associated with...
lorazepam is absorbed relatively slowly by mouth and is unsuitable for rectaladministration. However, its poor lipid solubility and high degree of protein binding...
in the United States and Europe. It has been studied for use by rectaladministration in the treatment of prostate cancer in men as well. The medication...
users usually take the drug orally; there are a few case reports of rectaladministration and one report of insufflation, which was described as "very painful"...
or inability to swallow, rectaladministration may be given as pre-referral treatment as long as parenteral administration is initiated after transfer...
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