Suppositories have advantages EXCEPT which statement?

• A. Partial avoidance of first pass effect which increases the blood level of drugs which are subject to first pass effect.
• B. Prevent breakdown of certain drugs that are susceptible to gastric degradation.
• C. Ability to administer drugs which may cause oral or gastric irritation.
• D. Generally convenient to use.

Answer: (D)

Suppositories provide certain clear advantages: they can partially bypass the liver’s first-pass metabolism when absorbed through the lower rectum, helping to raise blood levels for drugs that are subject to first-pass effect; they protect drugs that would be degraded by gastric acid or enzymes in the stomach; and they allow administration of medicines that would irritate the oral or gastric mucosa. However, they are not generally convenient to use, since insertion can be uncomfortable, retention must be maintained, and there can be leakage or variability in absorption. So the statement about convenience is not an advantage of suppositories.