Vaginal preparation

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1-powder                                        
2-douche
3-cream
4-suppository and tablets

1-powder

General notes :
- vaginal media is low acidic in normal cases but high acidity of vaginal discharge cause itching & burning.
-vaginal discharges have unpleasant odour.
-vaginal powders generally used for antiseptic action &odour .
- vaginal powders dissolved in worm water and used as vaginal douche using syringe or vaginal douche once daily for treatment for  two weaks & twice weakly for personal hygiene .
-Alkaline wash found also as preparation in pharmacy.
- Alkaline wash also used as nasal wash to dissolve mucus & as mouth wash
in inflammations of throat associated with dental problems and aphthous ulcers . 
.

Questions???

2-Douche

-used as vaginal powders for antiseptic action &cleansing uses.

 
General notes :
 some douches like .*Betadine have antimicrobial,antimycotic action &antiprotozoal action  so it have broad spectrum activity against most of vaginal pathogens accompanied with vaginitis .(simple infection)
-*Malva douche have small tube for deep vaginal wash .
-douches use :2 table spoonful diluted by 1 liter of worm water using syringe or vaginal douche apparatus  once daily for treatment for 2  successful weeks & twice weakly for personal hygiene .

3-vaginal creams

-most of vaginal creams is mainly antifungal with anti microbial activity e.g *candistan vaginal cream .
-vaginal creams specified for intra vaginal application not to be applied on skin .
-skin creams can be used for topical vaginal inflammations like *kenacomb or infection like *Acyclovir skin cream  in case of vaginal herbes simplex.
-most of vaginal cream supplied with applicator to ensure effective  intra vaginal application & correct dose .
-applicator must be cleansed after use with water &soap to avoid recurrence of infection .
-*Gynotrosyd v.cream over come this problem as each tube supplieded with three applicators for one use .

4-vaginal suppository,ovules&tablets

-most of them like v.creams are antifungal with anti microbial activity.
e.g: Miconaz v.tablet
       Povidone iodine ovules
      Amrizole vaginal tablet

• some vaginal suppository contain combination of antiprotozoal & anti fungal drugs which result in broader spectrum  action e.g *amrizole-N
• -also combination of anti fungal &anti inflammatory & antibiotic e.g :*Monicure NH v.suppository .
• -combinations used in treatment of mixed infection .
• General notes :
• -general dose for simple &medium infection is one supp for 3days & for sever infection one supp/6days .
• -giving  systemic antifungal e.g flucoral capsule is essential in case of sever fungal infection.
• giving  systemic antifungal &antibiotic is essential in case of sever mixed infection .
• advise patient to take vaginal supp or tablet at night before sleeping to avoid drop down of vaginal tablets.
• Glycerin Icthyol v. supp isonly for vaginitis have not anti fungal activity .
• - some times patient husband should take systemic antifungal .
• it is preferable to use applicator for insertion of vaginal tablet .              -

-mention the advantages & disadvantages of applicators ?