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PubMedDate not supplied

Studies on nonoxynol-9. IV. Biochemical and morphological effects in the liver, kidneys and lungs of rats following intravaginal and intraperitoneal administration.

The content of DNA and collagen was significantly increased in the liver of young adult rats injected intraperitoneally for five consecutive days with Nonoxynol-9 (N-9; 5 mg/100 g). No changes were observed in the lung. A single dose of N-9 increased the activity of SGOT, reaching a maximum 4 to 8 hours after injection. In transmission electron microscopy the hepatocytes showed a dramatic increase of the rough endoplasmic reticulum. Rats injected intravaginally 5 mg/100 g of N-9 daily demonstrated after 15 injections a significant increase of collagen in the liver and kidney. After 15 days, DNA was significantly increased in the kidney. SGOT increased after 5 applications of N-9. Light and electron microscopy of the liver showed signs of nonspecific inflammation. We conclude that N-9 administered to young adult rats intravaginally or intraperitoneally induces biochemical and morphological changes in organs involved in the excretion of this detergent.

Animals↗
PubMed1999

[Evidence-based medicine: labor induction with prostaglandins].

OBJECTIVE: Because 10-15% of all births in Germany are induced with prostaglandins (PG), a survey of the scientific evidence for the efficacy of PG in promoting cervical ripening was undertaken. PATIENTS AND METHODS: Randomized controlled trials and meta-analyses of the efficacy of the local (intravaginal and intracervical) administration of PGE2 and PGE1 compared to the effects of conservative management (no specific therapy), placebo, and intravenous oxytocin were evaluated. RESULTS: PGE2 was found to be more effective than conservative management and placebo, and to reduce significantly the incidences of cesarean section and instrumental vaginal delivery, without having any impact on measures of fetal outcome. PGE2 was also found to be more effective than oxytocin, especially when the cervix is unripe (Bishop score < or = 5): unsuccessful induction was less frequent and the induction-delivery intervals were shorter, although fetal outcome and the incidences of cesarean section and instrumental vaginal delivery were unaffected. Initial experience also indicates that PGE1 given at a dosage of 25 micrograms every three hours is more effective than intravenous oxytocin or local PGE2, but this advantage appears to be accompanied by an increase in the incidence of uterine hyperstimulation and associated fetal heart rate changes. CONCLUSIONS: It is surprising that, even today, there is little hard scientific data concerning the efficacy of PG in the induction of cervical ripening. This fact should be discussed with the parturient. Further randomized controlled trials using well-defined, standardized measures are needed to clarify the situation.

Administration, Intravaginal↗
PubMed1992

Delivery of hormones: some new concepts.

Some new concepts in the delivery of hormones are described. Transmucosal or transdermal penetration of hormones can be facilitated, often by the use of absorption enhancers. Studies of nasal insulin delivery are described. Recently developed iontophoretic delivery devices can be useful for pulsatile transdermal administration of peptide hormones. A self-regulating delivery system releasing insulin in response to glucose levels is described. A vaginal ring releasing ethinylestradiol and 3-ketodesogestrel is a new concept in long-acting contraception. A nasal estradiol formulation, containing the absorption enhancer dimethyl-beta-cyclodextrin, is an interesting alternative to oral and transdermal delivery of female sex hormones.

Administration, Cutaneous↗
PubMed2005

[Induction of labor with misoprostol--vaginal administration].

The authors induct the labor of 88 pregnant women by Misoprostol /Cytotec/ tablette 50 mcgr accepted every four hour per vaginam. The results are the same as/or better/ than the results per os. Our results are in agreement with experimental one of R.-U. Khan et al,. 2004, fig. 1.

Administration, Intravaginal↗
PubMed1998

Suppression of recurrent genital herpes simplex virus type 2 infection by Rhus javanica in guinea pigs.

Rhus javanica has been shown to exhibit anti-herpes simplex virus (HSV) activity and potentiate the anti-HSV activity of acyclovir in vitro and in vivo. This extract was examined for its suppressive efficacy on recurrent genital infection in guinea pigs. Guinea pigs were primarily infected intravaginally with HSV type 2 (HSV-2). Prophylactic oral administration, at the dose corresponding to human use, of R. javanica significantly reduced the incidence, severity and/or frequency of spontaneous and severe skin lesions as compared with latently infected guinea pigs administered with water. This prophylactic efficacy was confirmed by the crossover administration, for more than 2 months, of R. javanica and water to the infected guinea pigs. Toxicity, such as weight loss, from R. javanica administration was not observed in the guinea pigs. When recurrent HSV-2 disease was induced by ultraviolet irradiation 3 months after primary infection, the prophylaxis with R. javanica was also significantly effective in reducing the severity of ultraviolet-induced skin lesions. Thus, prophylaxis of recurrent genital HSV-2 infection with R. javanica may preserve the efficacy of acyclovir by reducing both the use of acyclovir and the appearance of acyclovir-resistant viruses.

Administration, Intravaginal↗
PubMed2006

Dose response to vaginal administration of 1,25-dihydroxyvitamin D3 to cows.

It was previously reported that intravaginal (IVAG) administration of 1,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) might be protective against bovine hypocalcaemia. In the present study, various doses of exogenous 1,25(OH)(2)D(3) were administered IVAG to ovariectomised cows, and the subsequent changes in the biochemical parameters of the blood were measured to assess the characteristics of vaginal absorption. Five cows received 1,25(OH)(2)D(3) IVAG at a dose of 0.125, 0.25, 0.5, or 1.0microg/kg of body weight (BW) or intravenously at a dose of 1.0microg/kg BW. Dosing was at intervals of at least two weeks in a 5x5 Latin square design. Vaginally administered 1,25(OH)(2)D(3) was absorbed in a dose-dependent manner. There was no correlation between the IVAG dose of 1,25(OH)(2)D(3) and subsequent changes in plasma calcium concentrations. The bioavailability of 1,25(OH)(2)D(3) administered IVAG at 1.0microg/kg BW was approximately 93%.

Absorption↗
PubMed1988

Transplacental and mammary passage of radioactivity in rats treated vaginally and orally with [14C]propranolol.

The milk transfer, maternal-fetal distribution, and disposition of the antihypertensive/spermicidal agent propranolol were studied in pregnant and lactating rats. Single doses (10 mg/kg) of an aqueous solution of [14C]propranolol were administered either orally (po) or intravaginally (ivg) on gestational d 15, or on postpartum d 7-10. Upon ivg administration, [14C]propranolol was quickly transferred to systemic circulation and the mean blood [14C] concentrations were significantly greater during the first 0.25-2 h than in po dosed counterparts. About 98% of the ivg applied dose was absorbed after 6 h in gravid rats, and the combined 6-h excretions of radioactivity in the urine (ivg = 24.6%; po = 22.9%) and feces (ivg = 16.8%; po = 14.6%) were equivalent in both groups. At the end of 6 h, the levels of [14C] in the urinary bladder, adrenal, uterus, ovary, spleen, skeletal muscle, brain, heart, lung and fat were significantly higher in ivg treated rats than po dosed animals. Compared with the maternal plasma (ivg = 0.76; po = 0.88 microgram/ml), the mean concentrations of [14C] in the placentas were similar in both groups, while the amounts of [14C] were three to five times lower in the amniotic fluids and the fetuses of both po and ivg treated dams. In lactating rats, over 99% of the administered radioactivity was absorbed from the vagina within 6 h. The blood concentrations of [14C] were significantly elevated at 0.5 and 1 h in the per vaginam treated animals, and afterward the disappearance rate of [14C] followed a similar course in both groups. Following ivg application, the milk radioactivity peaked at 0.5 h and declined rapidly. However, the appearance of [14C] in milk was rather slow after oral dosing: the milk [14C] peaked between 2 and 3 h posttreatment and remained steady thereafter. The milk to blood (M/B) [14C] concentration ratios were markedly greater during 0.5 to 1 h in the ivg group than in their po dosed counterparts. At 6 h, the [14C] levels in the whole blood, plasma, milk, and mammary gland were virtually equivalent in the ivg and po treated females. Comparison of the areas under the milk [14C] concentration-time curves (AUCs) indicated that the milk availability of [14C] was about 31% more in dams dosed vaginally. These data suggest that route of administration alters the disposition and milk excretion of [14C]propranolol-derived radioactivity in pregnant and lactating rats.

Absorption↗
PubMed2001

Adjunctive intravaginal metronidazole for the prevention of postcesarean endometritis: a randomized controlled trial.

OBJECTIVE: To estimate the efficacy of preoperative administration of intravaginal metronidazole for the prevention of postcesarean endometritis. METHODS: This double-masked, placebo-controlled randomized trial included patients of at least 24 weeks' gestation undergoing cesarean deliveries for various indications. Patients were randomized to receive either 5 g of metronidazole gel intravaginally or matching placebo before the initiation of the cesarean. All patients underwent surgical cleansing of the abdomen, and most received prophylactic antibiotics after cord clamping. Patients with chorioamnionitis and/or suspected allergy to metronidazole were excluded. For a two-sided alpha of 0.05 and beta of 0.20 (80% power), 120 subjects were required in each group. The main outcome variable was the incidence of postcesarean endometritis. Secondary outcome variables included presence of febrile morbidity, wound infection, days on antibiotics, and length of postpartum hospitalization. Neonatal outcomes included birth weight, Apgar scores less than 7 at 5 minutes, umbilical arterial pH less than 7.16, admission and length of stay in the neonatal intensive care unit, and length of hospital stay. RESULTS: Of 112 patients receiving metronidazole, eight (7%) developed postcesarean endometritis, compared with 19 of 112 (17%) of those receiving placebo gel (relative risk 0.42, 95% confidence interval 0.19, 0.92). No significant differences were noted between treatment groups with respect to the other outcome variables. CONCLUSION: The preoperative administration of 5 g of intravaginal metronidazole gel appears to reduce the incidence of postcesarean endometritis.

Administration, Intravaginal↗
PubMed2003

A comparison between intravaginal and oral misoprostol for labor induction: a randomized controlled trial.

AIM: To compare the effectiveness and safety between intravaginal and oral misoprostol for labor induction. METHODS: One hundred and six pregnant women at term with unfavorable cervix (Bishop score < or = 4) and no contraindication to prostaglandin therapy were randomized to receive either intravaginal misoprostol 50 microg every 4 h or oral misoprostol 50 microg every 4 h for prospective randomized controlled trial study. Treatment interval from induction to vaginal delivery, maternal and neonatal complications were the main outcome measures. RESULTS: There were no statistical differences of baseline characteristics and Bishop score prior to intervention between both groups. Time interval from induction to vaginal delivery in the oral group was slightly, but significantly, longer than that of the intravaginal group (886.1 +/- 443.5 min vs 637.0 +/- 373.3 min, respectively.) Additionally, the number of doses required was significantly higher in the oral group. Nonetheless, there was no significant difference between both groups with regard to failure of induction and maternal-neonatal complications. CONCLUSION: The effectiveness in terms of failed induction and safety were comparable between intravaginal and oral misoprostol, but intravaginal route was better with respect to treatment interval and number of required doses. Both routes of administration can alternatively be used for labor induction.

Administration, Intravaginal↗
PubMed1990

Treatment of vaginal candidiasis: orally or vaginally?

Vaginal candidiasis continues to be the most common cause of vaginal discharge. A large variety of topical drugs and a selection of orally active antifungals are currently available. The choice between the use of oral drugs or intravaginal agents will depend on the therapeutic results obtained with the different agents, side effects, pregnancy status, and patient preference. The results obtained in the Maria Hospital, Tilburg, The Netherlands, and a review of foreign data suggest the following: (1) For acute infection oral and topical agents produce equivalent results. (2) For chronic infections oral medication is preferred. (3) Oral therapy should not be given to pregnant patients or to patients not using reliable contraceptive measures. (4) Half the patients prefer oral medication; only 5% prefer intravaginal therapy, and the others had no clear preference.

Administration, Intravaginal↗
PubMed2000

Vaginal misoprostol administered 1, 2, or 3 days after mifepristone for early medical abortion: A randomized trial.

CONTEXT: The conventional timing of misoprostol administration after mifepristone for medical abortion is 2 days, but more flexible intervals, which may make the regimen more convenient, have not been studied. OBJECTIVE: To determine whether vaginal misoprostol administered 1, 2, or 3 days after mifepristone influences safety or effectiveness for abortion at up to 56 days' gestation. DESIGN: Prospective, randomized, open-label trial conducted from March 1998 to June 1999. SETTING: Sixteen US primary care and referral abortion facilities. PATIENTS: A total of 2295 healthy patients aged 18 years or older who were 56 or fewer days pregnant. Forty (1.7%) were lost to follow-up. INTERVENTIONS: Patients received 200 mg of oral mifepristone and were randomly assigned to self-administer 800 microg of vaginal misoprostol at home 1 (n = 745), 2 (n = 778), or 3 (n = 772) days later. Women returned to the clinic up to 8 days after mifepristone for ultrasonographic evaluation. A second dose of misoprostol was administered if the abortion was not complete. Patients with continuing pregnancy, excessive bleeding, or retained pregnancy tissue 5 weeks later received an aspiration curettage. MAIN OUTCOME MEASURES: Effectiveness of the procedure (ie, a complete medical abortion without surgical intervention), adverse effects, acceptability of the procedure based on patient questionnaires, reasons for surgical intervention, and adverse outcomes, compared among the study groups. RESULTS: Of the 2255 women completing follow-up, complete medical abortion rates were 98% (95% confidence interval [CI], 97%-99%) among those using misoprostol after 1 day, 98% (95% CI, 97%-99%) for those using misoprostol after 2 days, and 96% (95% CI, 95%-97%) among those using misoprostol after 3 days. Fifty-five subjects aborted before taking misoprostol, 9 had early surgery, and 103 did not take misoprostol on their assigned day. No blood transfusions were required. Cramping and nausea were the most common adverse effects reported, with similar percentages of patients in all 3 groups reporting such effects. Thirteen unexpected or serious adverse events occurred: 6 in those using misoprostol after 1 day; 4 in those using it after 2 days; and 3 in those using it after 3 days. Nearly all women (>90%) found the procedure to be acceptable. CONCLUSIONS: Our results suggest that vaginal misoprostol, 800 microg, can be used from 1 to 3 days after mifepristone, 200 mg, for early medical abortion, and need not be administered strictly 48 hours after mifepristone. JAMA. 2000;284:1948-1953.

Abortifacient Agents↗
PubMed1995

Low-dose 17 beta-oestradiol during maintenance therapy--a pharmacokinetic and pharmacodynamic study.

The vaginal absorption of oestradiol was studied during maintenance therapy with low-dose oestradiol. Six women with severe vaginal atrophy due to oestrogen deficiency were treated with a vaginal tablet containing 25 micrograms 17 beta-oestradiol. Initially, a daily dose was given for 2 weeks, followed by maintenance therapy with twice weekly treatment for another 10 weeks. The plasma concentrations of unconjugated oestrone and oestradiol were measured before oestrogen treatment was started at the beginning of the study. After 3 months of treatment frequent plasma sampling over a period of 24 h was performed. Gonadotrophins, vaginal and urethral cytology, clinical findings and subjective symptoms were assessed at the beginning and end of the study. Plasma concentrations of unconjugated oestradiol were at all times within the limits of postmenopausal values, but showed a slight but not statistically significant elevation after 3 months compared to pretreatment values. Plasma concentrations of unconjugated oestrone were in the low postmenopausal range throughout the study. LH levels were unaffected during the study, while FSH was somewhat lowered, but still well within the postmenopausal range. Vaginal and urethral cytology showed maturation with almost complete disappearance of parabasal cells. Clinical and subjective improvement was statistically significant during the treatment period.

Administration, Intravaginal↗
PubMed2005

Medical abortion at 9-13 weeks' gestation: a review of 1076 consecutive cases.

OBJECTIVE: The aim of the study was to assess the use, efficacy and factors influencing the outcome of medical abortion at 9-13 weeks' gestation. METHODS: Retrospective chart review of consecutive women undergoing medical abortion at 9-13 weeks' gestation was done. RESULTS: A total of 1927 abortions were carried out at 9-13 weeks' gestation, of which 1076 (55.8%) were undertaken medically. Efficacy decreased with increasing gestation (p=.02). Surgical evacuation was carried out in 45 (4.2%) women including 10 (2.7%) at 64-70 days, 11 (3.3%) at 71-77 days, 10 (5.1%) at 78-84 days and 14 (8.0%) at 85-91 days of gestation (p=.02). Indications for surgery included continuing pregnancy [16 (1.5%) women], retained sac [5 (0.5%)], incomplete abortion [20 (1.9%)] and emergency curettage for bleeding [4 (0.4%)]. The number of misoprostol doses used and the induction-to-abortion interval both significantly increased with gestation (p<.001), while analgesia requirements did not vary with increasing gestation (p=.18). CONCLUSIONS: Medical abortion at 9-13 weeks' gestation is an effective alternative to surgery. Medical methods should be offered routinely at these gestations, thus increasing women's choice.

Abortifacient Agents, Nonsteroidal↗