self care II Vaginal and Vulvovaginal disorder

STUDY
PLAY

Terms in this set (...)

vagninal anatomy
8 -10 cm tube--> vulva to uterus
between bladder and rectum

upper end closed except for cervical os--> opening to cervix

bartholinin's glands are at lower end- secretins in respnse to sexual stimulation
vaginal defenses
lined by stratifed squamous epithelium

contains glycogen

lactobacillus; act on glycogen to form lactic acid

acidic pH= 4-4.5
acidic pH and hydrogen peroxide production by bacteria=protection from infection with other bacteria
2 factors provide protection
acidic pH and Hydrogen peroxide
secretions
clean and lubricate vaginal tract
leukorrhea
normal vaginal discharge
odorless, clear/white, viscous/sticky
increased vaginal secretions
ovulation,
pregnacy,
following menses
sexual excitement
emotional flares

may change w/ vaginal irritants, contraceptives, tampons
flora
lactobacillus species 90-95%
5-10 other species present
glycogen conc
vaginal pH
Bacterial vaginosis
off white discolored, thin, foamy, elevated pH
"fishy odor" increases w/ sexual intercourse

TTX: Rx only
trichonomas
Yellow-green
malodorus, frothy

Pruitis, vaginal irritation, dysuria, initially no sx in 50% women, and most men asymptomatic

TTX: Rx
Vulvovaginal Candidiasis
thick white, cottage cheese like;
NO ODOR
NORMAL pH

erythema, itching, vulvar edema

OTC antifungals
Vulvovaginal Candidiasis
yeast infections

2nd most common vaginal infection (BV is 1st)
Causative organism of vulvovaginal candidiasis
candida albicans
increasing incidence: C. glabrata and c. tropicals, saccharomyces cerevisiae

NO PRECIPATING CAUSES in MOST CASES
VVC ttx nonpharmacologic
decrease consumption sucrose and refined carbs

yogurt containing live cultures

DC drugs known to increase susceptibility
complementary therapy
Lactobacillus prep

sodium bicarbonate sitz bath for vulvar irritation
tea tree oil vaginal suppository q6h x 6 nights
gentian violet soaled tampons BID x 5 days
boric acid 600mg capsule inserted vaginally 1-2x daily for 14 days
VVC clicnal presentation
NORMAL VAGINAL PH

THICK, WHITE, Cottage cheese discharge

NO ODOR

erythema, edema, itching, burning, soreness, painful urination or intercourse
VVC vaginal pH
NORMAL
Vaginal pH >4.5
bacterial or trichomonal infection
testing devices for vaginal pH
Vagisil screening kit for vaginal infections ( swab) uses color test to determine vaginal pH

Limitations: 72 hours after vaginal prep
48 hours after intercourse
5 days after menstration
self treatment for VVC
greater 12 y/o
current symptoms consistient w/ s/s VVC
no severe symptoms (fever, pain in abdomen, back, shoulders)

vaginal pH 4.5 or lower

No abnormal host factors (DM, pregnancy, immunocompromised)

vaginal symptoms not recurrent
Recurrent >= 4/ year or vaginal infection in last 2 months

1 preveiously diagnosed episode ==>responsive to therapy
VVC TTX-
NON-PRESCRIPTIN IMIDAZOLE
-butoconazole, clotrimazole, miconazole tioconzole

CREAMS< OINTMENT<TABLETS< SUPPOSITORIES

1-7 days

No agent is supeirior
Imidazoles MOA
alters fungal membrane permeability, disrupts metabolic fn =fungal death

TOPICAL VAGINAL IMIDAZOLE PREP NOT SIGNAFICANTLY ABSORBED

SE= minimal
vulvuovaginal burning, itching, irritation; allergic rxn, abdominal cramps, headachie

CI = allergy to imidazole
Drug interaction with imidazole for ttx of VVC
Warfarin
non rx vaginal preps
vagisil anti-itch cream (benzocaine and resorcinol)
vagisil anti-itch wipes (pramoxine hydrochloride)

local anesthetic/analgesic
-relief itching/pain
patient counseling
Go to MD: symptoms persist beyond 1 wk after ttx
new/worsening symptoms

symptoms recur w/in 2 months
vaginal symptoms occur more than 3x in 12 monts

review product labeling
adherance to full course of therapy

symptomatic relief 1-2 days, complete resolution 1week.

SE uncommon, may have burning, irritation

refrain from sexual intercourse during ttx.
YOU MIGHT ALSO LIKE...