The use of suppositories is probably one of the clearest examples of cross-cultural differences in the approach to pharmaceuticals. A surgeon on a famous ocean liner has commented that: 'Part of the problem of stocking one's pharmacy is that one needs three times as many drugs as when working on land: tablets for the Brits, shots (injectables) for the Yanks, and suppositories for the French!' However, the route of administration is eminently logical, e.g. for the acute treatment of migraine, where drugs are often vomited.
In the UK and USA, peri-operative antibiotics (especially metronidazole), theophylline for pediat-ric nocturnal asthma, and topical treatments for proctitis and inflammatory bowel disease are the most commonly used rectally-administered drugs.
Paraldehyde remains an effective way to abort seizure in pediatric patients in the emergency room, without the need to find a vein. Use a glass syringe. In the USA, diazepam can be administered by the same route, for the same purpose.
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