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Induction Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Dinoprostone gel (Prepidil) is packaged as a 0.5-mg dose in a 2.5-mL syringe. A shielded catheter is added to the syringe end to facilitate safe injection, usually intracervically. Under direct visualization using a speculum, the syringe contents should be injected into the endocervical canal using sterile technique. The patient should remain supine for 30 minutes to minimize leakage from the canal. An alternative method for administering the gel is to inject it into the posterior fornix or intravaginal administration. Until achieving a favorable cervix, dinoprostone 0.5 mg may be repeated every 6 hours up to a maximum dose of 1.5 mg in a 24-hour period. Once the cervix is favorable, oxytocin may be initiated for induction 6 hours after the last dose.
Impact of Probiotics on Animal Health
Published in Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani, Lactic Acid Bacteria, 2020
Sabrina da Silva Sabo, Elías Figueroa Villalobos, Anna Carolina Meireles Piazentin, André Moreni Lopes, Ricardo Pinheiro de Souza Oliveira
For dairy cattle, the use of probiotics is related to the milk productivity and nutritional quality (Krehbiel et al. 2002, Xu et al. 2017). In addition to these targets, probiotics have been used to reduce the prevalence of metritis (Genís et al. 2018). Metritis is an inflammation of the uterus occurring due to bacterial infection during the first 21 days after calving (LeBlanc et al. 2008). Metritis affects up to 40% of dairy cows and it is usually treated with antibiotics (Genís et al. 2018). In spite of their effectiveness, there is an increasing concern about excessive use of antibiotics due to the aforementioned drawbacks. In this sense, researchers have been successfully using probiotics via intravaginal administration to prevent postpartum uterine infections and inflammation (Deng et al. 2015, 2016, Genís et al. 2016, 2017a,b, 2018). Another important and prevalent disease of dairy cattle is mastitis, defined as the inflammation of the mammary glands where the tissue of the udder is severely affected (Pellegrino et al. 2018). To avoid using antibiotics to control mastitis, researches have been evaluating the effect of probiotics and their bioproducts (bacteriocin, as example) to prevent and/or for treatment of this disease (Twomey et al. 2000, Bouchard et al. 2015, Pellegrino et al. 2018). For such approach, studies are purposing intramammary infusion of live probiotics cultures, associating the positive results with stimulation of the host intramammary immune system (Crispie et al. 2008, Klostermann et al. 2008, Pellegrino et al. 2018).
Metronidazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Intravaginal administration may be used for the treatment of bacterial vaginosis, wherein the recommended regimen is usually one full applicator of the gel (0.75% metronidazole—equivalent to approximately 37.5 mg of metronidazole) once a day for 5 days (Workowski and Bolan 2015).
In vitro and in silico computational methods for assessing vaginal permeability
Published in Drug Development and Industrial Pharmacy, 2023
Eleni Tsanaktsidou, Marios Krestenitis, Christina Karavasili, Constantinos K. Zacharis, Dimitrios G. Fatouros, Catherine K. Markopoulou
Both the amount and composition of the vaginal fluid interfere to the dissolution of the drug prior to its transport. Certainly, while excessive fluid content promotes a “flushing” effect that reduces drug retention, the presence of cervical mucus could increase bio-adhesion [28]. Correspondingly, vaginal pH affects the degree of ionization of drugs, and therefore their absorption properties [29]. In adult women, vaginal pH ranges between 3.8 and 5.0 (depending on the specific stage of the menstrual cycle), while during pregnancy it ranges between 3.8 and 4.4. In postmenopausal state or after oophorectomy, the pH increases to 7.0 − 7.4 due to a decrease in cellular glycogen content. The vaginal fluid simulator proposed in this research is intended to model the properties of drugs in fluids originating from the vagina of a specific group of women. So, the pH of VFS used was adjusted to 4.5 which is a typical value of the vaginal fluid of healthy, non-menstruating, premenopausal women. In order to generate comparable Papp results, all the experiments were carried out under the same conditions. The compounds were formulated using Tween 80 and PEG 200 as excipients. Both are compatible with intravaginal administration and suitable for dissolving hydrophobic molecules. Equal concentrations for each compound were placed in the donor’s compartment and verified by HPLC-DAD or LC-(ESI)/MS (Supplementary File).
The development of a silicone vaginal ring with a prostaglandin analogue for potential use in the treatment of canine reproductive disorders
Published in Pharmaceutical Development and Technology, 2019
Veronika Nováková Tkadlečková, Jakub Vysloužil, Kateřina Kubová, Jan Elbl, Darja Bučková, Jan Muselík, David Vetchý, Robert Novotný, Pavel Proks, Josef Jančář, Petr Poláček
To our knowledge within veterinary medicine, the VR technology has not yet been used. However, there are some diseases or statuses of the reproductive system of female dogs which could be a suitable possibility for their usage, such as pyometra (Fieni et al. 2014), interruption of pregnancy (Hoffmann and Schuler 2000), pseudopregnancy (Arbeiter et al. 1988; Gobello et al. 2001), induction and synchronisation of oestrus (Kutzler 2007) or lactation cessation (Bastan et al. 1998). Drug intervention for these conditions includes an administration of prostaglandins (prostaglandin F2α) (Nelson et al. 1982; Gilbert et al. 1989; Arnold et al. 2006), dopamine agonists (bromocryptine, cabergoline), gonadotropin-releasing hormone agonists and gonadotropins (Kutzler 2005) for extended time periods. These drugs are usually administered parenterally in repeated doses, although dopamine agonists are also administered orally (Zöldág et al. 2001). Unfortunately, systemic administration of many of these substances is associated with harmful side effects such as abdominal pain, vomiting, dizziness, distress, defaecation, tachycardia, hypersalivation, dyspnoea and panting (Fransson and Ragle 2003; Smith 2006; Verstegen et al. 2008). On the other hand, a significant reduction of these adverse effects is observed after intravaginal administration due to more local action and bypassing the systemic route (Gábor et al. 1999).
Probiotic and cranberry supplementation for preventing recurrent uncomplicated urinary tract infections in premenopausal women: a controlled pilot study
Published in Expert Review of Anti-infective Therapy, 2019
Parshottam Koradia, Shital Kapadia, Yamini Trivedi, Gajendrasinh Chanchu, Ashton Harper
The findings with BKPro-Cyan are notable when compared with the literature since they are the first to suggest clinical benefit of an oral preparation in premenopausal women suffering with recurrent UTIs. In the aforementioned Cochrane systematic review involving 9 studies and 735 participants, no significant clinical benefit for probiotics administered orally or intravaginally (pessary) for different periods to women or girls with recurrent UTIs was observed in the group overall [22]. Interestingly, one study which also used a Lactobacillus-based probiotic (but administered intravaginally), noted robust and prolonged re-colonization with Lactobacillus crispatus in women with recurrent UTI [29]. This was associated with a trend toward a reduction in the incidence of UTIs [the rate of culture-confirmed UTI was 15% in the probiotic group, as compared with 27% for placebo (relative risk, 0.5; 95% CI, 0.2–1.2)]. Whilst these findings align with the results of our pilot study, they are not as substantial, and intravaginal administration also suffered from the drawback of a high incidence of AEs (56%) such as vaginal discharge/itching, and abdominal discomfort.