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Advanced Drug Delivery > Vaginal Drug Delivery > Flashcards

Vaginal Drug Delivery Flashcards

1
Q

Mucosal surface areas of different administration sites

A

GI tract - 350,000
Skin - 20,000
Oral - 200
Vaginal - 90

Units in cm squared
Vaginal is lowest among these 4

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2
Q

Describe the cell type in the vaginal mucosa epithelium

A

Stratified squamous epithelial cells
Non-keratinised

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3
Q

Describe the structure of the laminate propria

A

Loose
Highly vascularised
Connective tissue

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4
Q

What period of the menstrual cycle shows significant change in number of vaginal epithelial cells

A

Days 19 - 24

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5
Q

What are the two sections of the cervix

A

Endocervix
Ectocervix

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6
Q

What type of cells make up the endocervix

A

Columnar epithelial

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7
Q

What type of cells make up the ectocervix

A

Squamous epithelial

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8
Q

How does hormonal influence compare between cervical and vaginal epithelial

A

Cervical epithelia are less sensitive to hormonal influence than vaginal epithelia

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9
Q

What arteries are involved in vaginal blood supply

A

Common iliac artery > hypogastric artery > vaginal arteries

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10
Q

What veins are involved in vaginal drug drainage

A

Vaginal venous plexus > vaginal veins > internal iliac veins

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11
Q

Do vaginally administered drugs undergo hepatic first pass metabolism

A

No
The internal iliac vein does not transport blood to the liver

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12
Q

Describe the uterine first pass effect

A

Vaginally administered drugs are directly transported to the uterus
Drugs move from vaginal vein to uterine artery
Extent of uterine first pass effect is depends of location of administration in the vagina

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13
Q

How does vaginal fluid affect drug delivery

A

Influences :
1. drug solubility
2. dissolution
3. ionisation
4. distribution

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14
Q

What is healthy vaginal pH levels

A

pH 3.5 - 5

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15
Q

How is vaginal pH maintained

A

Maintained by bacteria by L acidophilus
Converts glycogen to lactic acid

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16
Q

What 2 purposes does acidic environment of vagina serve

A

Protection from infection
Promote growth of lactobacilli

17
Q

How does vaginal pH change during the menstrual cycle

A

Increases during mentruation
Falls during ovulation

18
Q

How does cervical pH change during menstrual cycle

A

Stays relatively constant

19
Q

Advantages of vaginal drug delivery

A

Accessible and non-invasive
Good blood supply
Local and systemic effects
High permeability
Avoids first pass metabolism

20
Q

Disadvantages of vaginal drug delivery

A

Hygiene issues
Poor retention of delivery device
Permeability is influenced by oestrogen levels
Local irritation
Semi-solid preparations can be messy
Poor patient compliance

21
Q

What are the indications for vaginal drug delivery

A
  1. Women’s healthcare e.g. vaginal infection, cervicovanginal cancers
  2. Reproductive issues
  3. Oestrogen replacement therapy
  4. Contraception e.g. spermicidal, steroidal
22
Q

What is the active drug, formulation and indication for the product Vagifem

A

Estradiol
Tablet
Vaginal atrophy

23
Q

What is the active drug, formulation and indication for the product Canestan

A

Clotrimazole
Cream
Vaginal/Vulval candidiasis

24
Q

What is the active drug, formulation and indication for the product NuvaRing

A

Ethinylestradiol
Ring
Hormonal contraception

25
Q

Describe a vaginal ring delivery system

A

Diffusion controlled
Controls the release of drug over a long period of time
Provides local or systemic effect

26
Q

What are the two main indications for vaginal rings

A
  1. Oestrogen replacement therapy (Estring)
  2. Contraception (NuvaRing)
27
Q

Name the two types of vaginal rings

A
  1. Matrix type vaginal ring
  2. Reservoir type vaginal ring
28
Q

Describe a matrix type vaginal ring

A

Drug is dispersed through entire ring volume
Made by one step injection moulding

29
Q

Describe a reservoir type vaginal ring

A

Drug is only dispersed through central core
Made via multi step injection moulding

30
Q

Describe the composition of a vaginal gel

A

Water
Gelling agent e.g. carbomer
Preservative
Active drug agent

31
Q

Describe a thin polymer film drug delivery system

A

Water soluble polymer film
Dissolves rapidly in vagina with minimal fluid present
Provides rapid drug release

32
Q

What are thin polymer films used for

A

Vaginal contraceptive
Vaginal cleansing

33
Q

What is a vaginal pessary

A

Small plug of medication
Designed to dissolve at body temperature
Used in the rectum or vagina

Advanced Drug Delivery (18 decks)

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