Female barrier methods
Suzanne Everett in Handbook of Contraception and Sexual Health, 2020
This chapter discusses female barrier contraception and includes how to use the method, its efficacy, UKMEC category, advantages and disadvantages of methods, and includes detailed instructions on how to fit and teach a woman to use a diaphragm. Contraception not only gives women not only protection against pregnancy but also gives women power over their bodies. The diaphragm gives women the opportunity to understand and get to know their bodies. With careful and consistent use, the diaphragm is 92–96% effective when used with a spermicide in preventing pregnancy in the first year. There are two main types of diaphragm: omniflex coil spring diaphragm and arcing spring diaphragm. Oil-based preparations should not be used with latex-containing diaphragms as they damage the latex rubber; these include lipstick, body oils, massage oils, baby oils butter, ice cream and Vaseline. Vaginal and topical preparation should not be used with latex as they may cause damage; these include econazole, miconazole, isoconazole, fenticonazole and clotrimazole.
Hair and groin problems
Manu Shah, Ariyaratne de Silva in The Male Genitalia, 2018
A number of inflammatory dermatoses and infective conditions commonly affect the groin areas, as well as the hair-bearing areas and peri-anal region. These problems may present to the sexual health clinic or may be seen in the general practice setting or the dermatology department. Intertrigo is a common condition, affecting all races, and is particularly found in old people and young children. The usual presenting symptoms are of chronic irritation of the skin folds with itching and burning being prominent symptoms. Candidosis (infection due to the yeast candida albicans) is the commonest cause of intertrigo. Clinical examination reveals red plaques in the skin folds, often with small erosions. The diagnosis of intertrigo can be made clinically but a cause must be sought. Wood's (ultraviolet) light examination of the groin area will exclude erythrasma. For infective problems antimycotic agents (e.g. topical clotrimazole, itraconazole) and anti-infective agents (antiseptics, topical antibiotics for short-term use) may prove useful.
Therapy For Skin, Hair and Nail Fungal Infections
Raimo E Suhonen, Rodney P R Dawber, David H Ellis in Fungal Infections of the Skin, Hair and Nails, 2020
Most of the fungi that affect the skin, hair and nails only proliferate under the ideal conditions of warmth, moisture and humidity. Topical therapy may be sufficient for dermatophytosis other than nail and scalp infections-for example, terbinafine topical formulations, tolnaftate, imidazole, amorolfine, cyclopiroxolamine, clotrimazole, miconazole, econazole, ketoconazole, bifonazole and tioconazole. It has been available for over 30 years and is still valuable for dermatophytic skin infection, in particular tinea capitis. Oral therapy using griseofulvin has been used extensively for the treatment of dermatophytosis. The duration of therapy varies from patient to patient and on the site and severity of the infection, with up to 12 weeks being required for skin and hair infections and approximately 12 months for nails. Oral ketoconazole has a high affinity for keratin and it has been used for dermatophytes, although the risk of hepatitis, albeit rare, makes this a secondary choice for therapy, especially now newer agents such as fluconazole, itraconazole and terbinafine are available.
Development and evaluation of N-naphthyl-N,O-succinyl chitosan micelles containing clotrimazole for oral candidiasis treatment
Published in Pharmaceutical Development and Technology, 2017
Prasopchai Tonglairoum, Thisirak Woraphatphadung, Tanasait Ngawhirunpat, Theerasak Rojanarata, Prasert Akkaramongkolporn, Warayuth Sajomsang, Praneet Opanasopit
Clotrimazole (CZ)-loaded N-naphthyl-N,O-succinyl chitosan (NSCS) micelles have been developed as an alternative for oral candidiasis treatment. NSCS was synthesized by reductive N-amination and N,O-succinylation. CZ was incorporated into the micelles using various methods, including the dropping method, the dialysis method, and the O/W emulsion method. The size and morphology of the CZ-loaded micelles were characterized using dynamic light scattering measurements (DLS) and a transmission electron microscope (TEM), respectively. The drug entrapment efficiency, loading capacity, release characteristics, and antifungal activity against Candida albicans were also evaluated. The CZ-loaded micelles prepared using different methods differed in the size of micelles. The micelles ranged in size from 120 nm to 173 nm. The micelles prepared via the O/W emulsion method offered the highest percentage entrapment efficiency and loading capacity. The CZ released from the CZ-loaded micelles at much faster rate compared to CZ powder. The CZ-loaded NSCS micelles can significantly hinder the growth of Candida cells after contact. These CZ-loaded NSCS micelles offer great antifungal activity and might be further developed to be a promising candidate for oral candidiasis treatment.
Sugars as solid dispersion carrier to improve solubility and dissolution of the BCS class II drug: clotrimazole
Published in Drug Development and Industrial Pharmacy, 2016
Ashwini Madgulkar, Mithun Bandivadekar, Tanaji Shid, Shivani Rao
Solid dispersion of poorly soluble BCS class II drug, clotrimazole, was prepared with the aim of enhancing its dissolution profile. Solid dispersions were prepared using various sugars as carriers at different weight ratio to drug-like d-mannitol, d-fructose, d-dextrose and d-maltose by fusion method. The solubility of plain clotrimazole in different percent of sugar solutions was measured. Also, its solubility in solid dispersion and their physical mixture were assessed. The dissolution of all the prepared SD tablets, direct compressed clotrimazole tablet and plain drug were tested using the U.S. Pharmacopeia convention (USP) apparatus II. The dissolution profiles were characterized by parameters like area under curve (AUC), mean residence time (MRT), mean dissolution time (MDT) and percent dissolution efficiency (% DE). The release kinetics study was performed using DD Solver TM software. The selected solid dispersions (SDs) were evaluated for antifungal activity. A 100% solution of mannitol showed 806-fold increases in solubility as compared with plain clotrimazole in water. It was observed that the dissolution profile of clotrimazole was improved by mannitol SD at drug to sugar ration of 1:3. The percent DE value for mannitol SD tablet was found to be 77.3516% as against plain drug and directly compressed tablet of clotrimazole at 50.9439% and 31.33%, respectively. Also the antifungal activity indicated by inhibition zone was found to be 54 mm indicating enhance activity against Candida albicans as compared with plain CTZ at 6.6 mm. Thus, it can be concluded that the sugar alcohol, that is, mannitol is a more promising hydrophilic carrier for solid dispersion preparation to improve the solubility and dissolution of poorly soluble drugs.
Comparative efficacy of topical 1% butenafine and 1% clotrimazole in tinea cruris and tinea corporis: A randomized, double‐blind trial
Published in Journal of Dermatological Treatment, 2005
Archana Singal, Deepika Pandhi, Subhav Agrawal, Shukla Das
Localized tinea cruris and tinea corporis can be treated by topical imidazoles (clotrimazole) or newer topical agents like butenafine, a benzylamine derivative with fungicidal activity. The therapeutic efficacy of these two agents was compared in this study. Eighty patients, diagnosed clinically to have tinea cruris or localized tinea corporis and confirmed on KOH examination, were randomly assigned to one of the two treatment groups in a double‐blind manner; butenafine once daily for 2 weeks or clotrimazole twice daily for 4 weeks. Follow‐up was done at 1, 2, 4 and 8 weeks. Clinical assessment score and KOH examination were performed at each visit. Butenafine recipients exhibited higher clinical cure as compared with clotrimazole recipients at the end of 1 week (26.5% vs 2.9%) as well as higher mycological cure (61.7% vs 17.6%). However, this difference was not statistically significant at 4 and 8 weeks of treatment.
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