Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Administration, Intravaginal”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1995

Genital-associated lymphoid tissue in female non-human primates.

We investigated genital-associated lymphoid tissue (GENALT) in non-human primates (macaques), by augmenting vaginal with oral immunization. The vaccine was a recombinant particulate SIV antigen (p27:Ty-VLP), linked to CT-B, and administered into the vagina by a paediatric naso-gastric tube and into the stomach by a gastric tube. Oro-vaginal or vagino-oral sequence of immunization elicited specific CD4+ T cell proliferative responses to p27 antigen in the genital lymph nodes and the spleen but not in unrelated lymph nodes. CD4+ T cells reconstituted with B cells and macrophages from the genital lymph nodes induced specific IgA and to a lesser extent IgG anti-p27 antibodies. However, the corresponding splenic cells induced greater IgG than IgA antibody synthesis. Intramuscular immunization primed splenic but not genital lymph node cells, and induced CD4+ T cell proliferative responses and predominantly B cell IgG antibody synthesis. Finding primed B and T cells in the genital lymph nodes after augmenting vaginal by oral immunization provides experimental evidence for GENALT in non-human primates. This primate model of vaginal immunization suggests 3 levels of specific immunity: (1) secretory IgA (and IgG) in the cervico-vaginal mucosal epithelium; (2) primed CD4+ T cells and B cells in the genital lymph nodes and the spleen; and (3) circulating CD4+ T cells, B cells and IgG and IgA antibodies specific to the immunizing antigen.

Administration, Intravaginal↗
PubMed2000

Trends in antifungal research.

With the increasing use of aggressive immunosuppressive therapies in the management of a variety of patient populations, the continuing presence of the AIDS pandemic and the therapeutic advances employed in critical care settings, an increasing number of serious fungal infections are being encountered by today's practicing clinicians. Traditionally, antifungal drug therapy has been delivered by means of intravenous infusion, oral administration, or topical application. Recently, a number of alternative routes of antifungal drug delivery have been developed and investigated, and the traditional means of antifungal administration have been improved to facilitate the therapeutic use of new and reformulated antifungal agents. Organized based on the route of administration, this chapter reviews these advances in antifungal drug delivery.

Administration, Intranasal↗
PubMed2005

Probiotics to prevent urinary tract infections: the rationale and evidence.

For over 30 years, urologists have recognized in females, that urinary pathogens almost always infect the host through ascension from the rectum, vagina to the urethra and bladder. Likewise, the Lactobacillus organisms that predominate in the vagina of healthy women, spread from the rectum and perineum and form a barrier in the vagina to bladder entry by uropathogens. The concept of artificially boosting the lactobacilli numbers through probiotic instillation has long been conceived, but only in recent years shown to be possible. Not all lactobacilli are effective, and to date clinical efficacy only exists for Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri B-54 and RC-14. These strains are only commercially available in Austria, and therefore for most urologists, while some probiotic organisms may reduce the recurrences of bladder cancer or oxaluria, no probiotics can be recommended widely to prevent UTI at present.

Administration, Intravaginal↗
PubMed2004

Vaginal administration of oral micronized estradiol results in successful twin pregnancy in a functionally agonadal woman.

CASE REPORT: A 31-year-old nulligravid woman seeking fertility treatment with in vitro fertilization and intracytoplasmic sperm injection failed to achieve pregnancy. Supernumerary embryos were cryopreserved for future use. In preparation for the transfer of the frozen embryos, the patient was prescribed hormones, which included pituitary down-regulation with leuprolide acetate, followed by oral micronized estradiol (E2) and vaginal progesterone (P4) suppositories. At the time of embryo transfer (ET) it was noted that the patient had misunderstood her instructions and was administering both her estrogen and progesterone vaginally. Ultrasound examination revealed a well-developed endometrium adequate for ET so the procedure was performed, and at that point she was instructed to use E2 orally as originally prescribed. Two weeks later, her beta-hCG was elevated, and subsequent ultrasound examinations revealed a twin gestation. The pregnancy progressed normally. CONCLUSION: This patient's hormones were adequately replaced despite vaginal placement of oral medication. Although not commonly prescribed, oral E2 tablets may be administered vaginally in functionally agonadal women preparing for ET, and may serve as an alternative route for women who experience difficulties with oral formulations.

Administration, Intravaginal↗
PubMed1998

Lipid effects of an intrauterine levonorgestrel device or oral vs. vaginal natural progesterone in post-menopausal women treated with percutaneous estradiol.

BACKGROUND: The ideal progestin for combined hormone replacement therapy should be free of adverse effects on lipid metabolism. We therefore examined lipid profiles during continuous hormone replacement therapy (HRT) with an estradiol-gel combined with either a levonorgestrel-releasing intrauterine device (LNG-IUD) or oral/vaginal natural progesterone. METHODS: Sixty menopausal women recruited in this open, non-randomised parallel three-group study received percutaneous gel containing 1.5 mg of estradiol daily. Progestin was administered to the women with an LNG-IUD (n = 20), as oral natural progesterone (n = 21) 100 mg daily on the 1-25 calendar days of the month or as vaginal progesterone (n = 19) 100-200 mg daily on the 1-25 calendar days of the month. Serum concentrations for total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and sex hormone binding globulin (SHBG) were measured at 0, 6 and 12 months. The median (and 95% confidence interval) of the serum SHBG, total, LDL-, HDL- cholesterol and triglycerides concentrations at baseline and after 6 and 12 months of the study and the ratio of 6 and 12 months values to baseline values were calculated. RESULTS: Total cholesterol was significantly decreased (8%) in the vaginal progesterone group at the end of the trial. HDL-cholesterol did not change in either of the progesterone groups, while a slight but transient decrease (median 15%) was seen at 6 months in the LNG-IUD group. There were no significant changes in triglycerides or LDL-cholesterol concentrations in any group. SHBG did not change significantly in the LNG-IUD and vaginal progesterone groups, while a slight but transient increase was seen in oral P group at 6 months. CONCLUSIONS: As the only significant harmful effect observed was a transient decrease in HDL-cholesterol in the LNG-IUD group at 6 months, each of these HRT-administration methods can be regarded as being safe in their effects on lipid metabolism.

Administration, Cutaneous↗
PubMed2001

Use of misoprostol for the termination of second trimester pregnancies.

Surgical termination of pregnancy is of high risk for the woman's health and safe medical ways are required. The use of prostaglandins may substantially reduce this risk. The efficacy and safety of misoprostol as a medication for the termination of the second trimester pregnancies were studied. During a 15-month period ninety-eight healthy pregnant women (13-24 weeks) wishing to terminate their pregnancy due to medical reasons participated voluntarily in this study. Misoprostol was administered 400 microg per os and 400 microg vaginally. Dose was repeated every 6 hours until adequate contractions and cervical ripening were achieved. Outcome measures included successful termination rates, mean expulsion time and side effects of the medication. The efficacy of the method was as high as 91.8% (90/98 cases 95%, CI 86-97%). Mean expulsion time was 10.2 h (range 3-23.4 h) for primigravida and 9.2 h (range 2.5-22.2 h) for multigravida. In 9 cases (9.2%) placenta remnants and in 8 (8.2%) placenta retention were found. Most common side effect was shivering in 17.3% of cases, vomiting and nausea (10.2%), headache and dizziness (7.1%), abdominal pain (79.6%), while diarrhea was noticed in 4.1%. The high efficacy and low incidence of side effects make misoprostol a useful alternative method for medical termination of second trimester pregnancies.

Abortifacient Agents, Nonsteroidal↗
PubMed1977

The abortifacient and oxytocic effects of an intravaginal silicone rubber device containing a 0.5% concentration of 15(S)-15-methyl-prostaglandin F2alpha methyl ester.

Abortion was successfully induced by intravaginal insertion of a silicone rubber device impregnated with an 0.5% concentration of 15(S)-15-methyl-prostaglandin F2alpha methyl ester in 20 of 25 patients by prostaglandin alone and in an additional three patients by prostaglandin with a concomitant oxytocin infusion. The mean abortion time for the 23 successful abortions was 15.46 hours. Uterine activity was monitored in six patients and uterine response to the vaginal insertion of the prostaglandin-impregnated device was characterized by a gradual rise in amplitude of contractions and intrauterine baseline tonus accompanied by a rapid increase in the frequency of contractions. Induction of abortion by intravaginal administration of a silicone rubber device impregnated with prostaglandin eliminates the hazards associated with intra-amniotic instillation and offers the advantage of a single administration with the option of reversibility if a patient should be hypersensitive to the drug.

Abortion, Induced↗
PubMed1977

Induction of labor in patients with missed abortion and fetal death in utero with protaglandin E2 suppositories.

Labor was successfully induced in 20 patients with a diagnosis of missed abortion or intrauterine fetal death (IUFD) by intravaginal administration of prostaglandin E2 suppositories. Fifteen patients delivered with the prostaglandin alone while a concomitant oxytocin infusion was employed to augment contractions in the other five patients. The mean induction-delivery time was 9.80 hours; nulliparous patients delivered in a mean time if 7.78 hours, parous patients in a mean time of 12.29 hours. The uterus appeared to be sensitive to the PGE2 stimulation in all patients and all were delivered completely without the need for surgical intervention. Fifty per cent of patients were delivered within 8 hours and 80 per cent by 12 hours. The side effects associated with prostaglandin administration--vomiting, diarrhea, and temperature elevation--were well tolerated and therapy did not have to be terminated in any patient. The administration of PGE2 vaginal suppositories offers an effective and safe technique for the induction of labor in patients with IUFD. Labor can be induced with PGE2 suppositories as soon as the diagnosis of IUFD is confirmed, which eliminates the need for waiting until spontaneous labor occurs.

Abortion, Missed↗
PubMed1988

Patient acceptance of prefilled disposable vaginal applicator.

Patient acceptance of a new, compact, prefilled disposable vaginal applicator was tested in an open study in which 2% butoconazole cream was used for the treatment of vulvovaginal candidiasis. Twenty nonpregnant patients with clinical signs and symptoms of candidiasis and microscopic identification of Candida in wet smear were treated for 3 days and then asked to rate the convenience of and their acceptance of the prefilled vaginal applicator. No adverse events were reported. All of the patients readily accepted the idea of a prefilled applicator and judged the shape and surface of the test applicator to be comfortable and the applicator to be easily inserted. Patients judged this applicator to be the most convenient and least messy when compared with other commercially available, reusable, or prefilled disposable applicators.

Administration, Intravaginal↗
PubMed1990

Myometrial activity after local application of prostaglandin E2 for cervical ripening and term labor induction.

Twelve pregnant women at term with unfavorable cervices (less than or equal to 5 points according to Bishop score) were given prostaglandin E2 for cervical priming and labor induction. Prostaglandin E2 was given in the following manner: 0.5 mg in gel strictly intracervically (n = 4), extraamniotically (n = 4), or prostaglandin E2 (4 mg) in gel vaginally (n = 4). The myometrial activity was registered over a period of 30 minutes before and at least 3 hours after gel application by means of an extraamniotic microtransducer catheter. After both extraamniotic and vaginal gel application, myometrial activity was significantly increased compared with intracervical application. All the women had favorable cervical states 6 hours after treatment and were delivered vaginally within 24 hours. All infants were delivered in good condition with 1-minute Apgar scores greater than 7. From these results we conclude that proper intracervical prostaglandin E2 gel application, in contrast to extraamniotic or vaginal application, induces cervical ripening without significant myometrial activity. Because careful intracervical application appears to avoid or minimize the risks of myometrial hyperstimulation, this technique should be considered particularly in women with unfavorable cervices and delicate fetuses.

Administration, Intravaginal↗
PubMed1995

Initial and steady-state pharmacokinetics of a vaginally administered formulation of progesterone.

OBJECTIVE: The pharmacokinetics of a 100 mg vaginal progesterone suppository was evaluated on days 1 and 7 and a 200 mg suppository on day 14. All the volunteers were given oral 17 beta-estradiol during the study. STUDY DESIGN: Ten postmenopausal women volunteered for this study. Progesterone was given as a vaginal suppository. Peripheral venous samples were obtained at appropriate intervals and analyzed for 17 beta-estradiol and progesterone levels. Area under the curve for progesterone was assessed by the trapezoidal method. Statistical analysis was performed by a one-way analysis of variance. RESULTS: Serum 17 beta-estradiol levels ranged from 22 to 182 pg/ml. Maximal serum progesterone levels ranged from 5.7 to 20.9 ng/ml, with the mean maximal levels 13.97, 16.09, and 12.68 ng/ml (not significantly different) and a mean area under the curve of 168.13, 207.64 and 227.71 ng/ml per hour on days 1, 7, and 14 (not statistically different). CONCLUSIONS: These data indicate that vaginal absorption of progesterone is efficient. The lack of difference in the area under the curve for both doses suggests that the vaginal mucosa or the total surface area of the vagina may limit the absorption of progesterone from the vagina.

Absorption↗
PubMed1995

Misoprostol: an effective agent for cervical ripening and labor induction.

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginal misoprostol versus intracervical prostaglandin E2 gel (dinoprostone) for preinduction cervical ripening and induction of labor. STUDY DESIGN: Two hundred seventy-six patients with indications for induction of labor and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone. Twenty-five micrograms of misoprostol were placed in the posterior vaginal fornix every 3 hours, with a potential maximum of eight doses. Prostaglandin E2 in gel form, 0.5 mg, was placed in the endocervix every 6 hours, with a maximum of three doses. Further medication was withheld with the occurrence of spontaneous rupture of membranes, entry into active phase of labor, or a "prolonged contraction response." RESULTS: Among those evaluated, 138 received misoprostol and 137 received dinoprostone. The average interval from start of induction to vaginal delivery was shorter in the misoprostol group (1323.0 +/- 844.4 minutes) than in the dinoprostone group (1532.4 +/- 706.5 minutes) (p < 0.05). Need for oxytocin augmentation of labor occurred more commonly in the dinoprostone group (72.6%) than in the misoprostol group (45.7%) (p < 0.0001). There were no significant differences in the routes of delivery. Twenty-eight of the misoprostol-treated patients (20.3%) and thirty-eight of the dinoprostone-treated patients (27.7%) required abdominal delivery. Complications such as uterine tachysystole and thick meconium passage occurred with similar frequency in the two treatment groups. CONCLUSIONS: Intravaginal administration of misoprostol appears to be as effective as intracervical dinoprostone for cervical ripening and labor induction. Complications associated with prostaglandin administration were not statistically different between the two treatment groups. The cost of misoprostol ($0.36/100 micrograms) is much less than that of dinoprostone ($75/0.5 mg).

Cervix Uteri↗
PubMed1987

Comparative pharmacokinetics of levonorgestrel and ethinyloestradiol following intravenous, oral and vaginal administration.

The plasma concentrations of levonorgestrel (LNG) and ethinyloestradiol (EE2) have been measured in a random crossover study in five healthy female volunteers given a combination oral contraceptive tablet (250 micrograms LNG and 50 micrograms EE2) by the oral route and per vaginum and also receiving the same dose intravenously. The fractional bioavailability of LNG after oral administration was 1.00 +/- 0.16 (mean +/- S.D.) and after vaginal insertion 0.88 +/- 0.16. The time to peak (tmax) was significantly longer and the peak concentration (Cmax) significantly reduced following vaginal administration. The fractional bioavailability of EE2 after oral dosing was 0.62 +/- 0.11 and after vaginal insertion 0.74 +/- 0.16; tmax was prolonged, hence absorption was slower from the vagina. The reduced rate of absorption was evident in the differences seen in the area under the curve for early time periods for both steroids. However, overall bioavailability is not reduced for either steroid when a single tablet is inserted into the vagina.

Administration, Intravaginal↗
PubMed1993

Methotrexate and misoprostol for early abortion.

Methotrexate is cytotoxic to trophoblast and, in low doses, has minimal side effects. It is used to treat both gestational trophoblastic neoplasia and ectopic pregnancy. The cytotoxic effects of methotrexate on intrauterine trophoblast should be equivalent. To test this hypothesis, ten pregnant women, < 8 weeks' gestation were treated with methotrexate 50 mg/m2 intramuscularly followed 3 days later by misoprostol, a prostaglandin E1 analogue. The first 4 patients received misoprostol 600 micrograms orally; none aborted soon after the misoprostol. Two patients aborted 25 and 26 days after the methotrexate injection and two elected a suction abortion after 14 days (one by choice and one because the pregnancy was still viable). The last 6 patients received misoprostol 800 micrograms vaginally and aborted within 3-8 hours. One patient had an incomplete abortion requiring a suction curettage 34 days after the misoprostol. Vaginal bleeding for these 6 patients lasted an average of 29 +/- 11 days (range, 12-42 days). No methotrexate side effects were observed. Vaginal misoprostol (800 micrograms) was significantly more effective (p = 0.005) than oral misoprostol (600 micrograms) in effecting abortion after intramuscular methotrexate.

Abortion, Induced↗
PubMed1995

Oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration in women in the sixth to twelfth week of gestation.

The effectiveness of oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration was compared in women in the 6th to 12th week of pregnancy. Sixty-four nulliparous women requesting termination of pregnancy between 6th to 12th weeks of gestation were randomized to receive either 400 micrograms misoprostol orally or 1 mg vaginal gemeprost at 12 hr or 3 hr prior to vacuum aspiration, respectively. The cervical dilatation at vacuum aspiration, the ease of the subsequent surgical procedure, and the incidence of complications and side effects were compared between these two methods of cervical priming. The median cervical dilatation at vacuum aspiration in the misoprostol group was significantly greater than that in the gemeprost group (8.0 mm versus 7.0 mm, p < 0.02). Preoperative side effects were significantly less frequent in the misoprostol group (p < 0.01). The ease of dilatation assessed subjectively by the operating surgeons was also improved significantly in the misoprostol group (p < 0.01). However, the duration of operation and blood loss were similar in both groups. Since misoprostol is also much cheaper and more convenient to use, we conclude that oral misoprostol is better than vaginal gemeprost for cervical dilatation prior to vacuum aspiration in first trimester pregnancy.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

Oral methotrexate and vaginal misoprostol for early abortion.

Intramuscular methotrexate followed by vaginal misoprostol has been shown to be effective for abortion at < or = 49 days gestation. Oral dosing of the methotrexate may offer advantages over parenteral dosing. This pilot study was performed to evaluate if oral methotrexate would be effective when combined with vaginal misoprostol to effect abortion at < or = 49 days gestation. Twenty pregnant women were randomized to receive methotrexate 25 mg or 50 mg followed 7 days later by misoprostol 800 micrograms vaginally. The misoprostol dose was repeated the next day if the abortion did not occur. Complete abortion occurred in all subjects in both groups within 20 days after the methotrexate. However, women in the 50 mg group passed the pregnancy within 24 hours of the first or second dose of methotrexate more often than women in the 25 mg group (80% vs. 50%, p = 0.35). Vaginal bleeding lasted 12.1 +/- 3.1 days and 9.4 +/- 4.5 days in immediate success and delayed success patients, respectively. Oral methotrexate may be an effective alternative to intramuscular methotrexate in treatment regimens for nonsurgical abortion.

Abortifacient Agents↗