The Biochemistry of Contraception
A. S. Curry, J. V. Hewitt in Biochemistry of Women: Clinical Concepts, 1974
Intravaginal administration has similar effects to those seen after intravenous administration. Effective uterine stimulation has been associated with frequent generalized side effects, indicating absorption into the systemic circulation. Vaginal suppositories are available containing PGF2α, and PGE2. The results are consistent and encouraging, but the incidence of side effects in terms of vomiting and diarrhea or fever remain high. Karim115 used intravaginal prostaglandin E2 and F2α, in 12 women who had passed their expected date of menstruation. Menstrual-like bleeding and eventual abortion was induced in 11 women. Bygdeman et al.108 treated eight pregnant women with vaginal administration of PGF2α,. Despite the fact that menstrual-like bleeding was induced, only three women aborted. All patients suffered side effects during treatment.
Induction Of Labor
Vincenzo Berghella in 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
Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani in Lactic Acid Bacteria, 2020
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).
Development of an intravaginal ring delivering simultaneously anastrozole and levonorgestrel: a pharmacokinetic perspective
Published in Drug Delivery, 2019
We considered intravaginal administration, which has been shown as a feasible route for systemic delivery for various pharmaceutically active agents, such as steroids (Chien, 1992; Mishell et al., 1970; Hussain and Ahsan, 2005; Brache and Faundes, 2010). This route of administration can be advantageous as drugs absorbed from the vagina do not undergo first-pass metabolism due to blood from the vagina reaching systemic circulation via the internal iliac veins (Chien, 1992; Richardson et al., 1992; Hussain and Ahsan, 2005). This route is also used to provide sustained and controlled drug release, most often for contraceptive steroid hormones and hormone replacement therapy (Ballagh, 2001; Brache and Faundes, 2010). The first contraceptive trials using vaginal rings were conducted in the 1980s (Kerns and Darney, 2011). Nowadays, commercial intravaginal rings (IVRs) are available for contraceptive use including the NuvaRing® that releases etonogestrel and ethinyl estradiol (Timmer and Mulders, 2000; Mulders and Dieben, 2001; van Laarhoven et al., 2002; Trussell, 2011). IVRs delivering LNG are not currently commercially available.
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.
Related Knowledge Centers
- Adverse Effect
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- Pharmacology
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- Vaginal Ring
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