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Macy catheter
The Macy Catheter is a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route. The catheter was developed to make rectal access more practical and provide a way to deliver and retain liquid formulations in the distal rectum so that health practitioners can leverage the established benefits of rectal administration. Patients often need medication when the oral route is compromised, and the Macy Catheter provides an alternative for those medications that can be prescribed per rectum. The Macy Catheter is of particular relevance during the end of life, when it can help patients to remain comfortable in their home.〔() Fancher L. "Hospice nurse invention to help alleviate discomfort of taking medication." ''Contra Costa Times.'' July 16, 2014.〕
==Key features and functions==
The Macy Catheter is a disposable device approved by the U.S. Food and Drug Administration (FDA), consisting of a dual-port dual-lumen ballooned tube that is inserted by a clinician into the rectum just past the rectal sphincter. Once inserted into the rectum, a soft balloon is inflated with water via a balloon inflation valve to hold the device in place. This small, flexible "semi-retention" balloon exerts very little pressure on the rectal wall, and is designed for safety and comfort, while also allowing the catheter to be easily expelled when the patient needs to defecate. The catheter utilizes a small flexible silicone shaft, allowing the device to be placed safely and remain comfortably in the rectum for repeated administration of medications or liquids.
Once in place, the medication delivery port of the Macy Catheter rests on the patient's leg or abdomen, where it is easily accessible for repeated administration of liquid medications in solution or suspension form. The device stays in place until the patient has a bowel movement and expels the retention balloon, or until manually removed after first deflating the balloon.
The Macy Catheter medication port has a specialized valve to prevent leakage and is designed to be non-clogging and compatible only with the connectors on oral/enteral syringes (not luer syringes) for safety. The device is FDA-approved to remain in the rectum for up to 28 days. The catheter has a small lumen, allowing for small flush volumes to get medication to the rectum. Small volumes of medications (under 15ml) improve comfort by not stimulating the defecation response of the rectum, and can increase the overall absorption of a given dose by decreasing pooling of medication and migration of medication into more proximal areas of the rectum where absorption can be less effective.〔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〕
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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