Question

what are the positive and negative anatomical and physiological factors to consider in attaining effective drug tissue concentrations in the vagina ?

Answer 1

Answer: Attainment of effective drug delivery to the va***a is important for treating many diseases. Drug concentration is important for drug effectiveness. Different hormones and antimicrobial medications are delivered via the va***a. Microbicides are delivered to the va***al environment to inhibit infection by HIV and other pathogens. The drugs are delivered in the form of gels or intrava***al rings. Many studies have shown that va***a is a highly effective site for drug delivery. If a drug is administered through va***al route, gastrointestinal disturbances do not affect the drug absorption by the site of treatment. However, before delivering a drug through the va***a, there should be proper knowledge of the physiology, anatomy, histology and immunology of the va***a with the consent of the patients.

Drug administration through va***al route avoids hepatic first-pass effect. This enables lower dosing of drugs. The va***a is not straight, rather is curved at 130 ⁰ with a portion that is in a horizontal plane when the woman is standing. The posterior length of the va***a is about 8 to 12 cm. It is a collapsed organ with the contact between the anterior and posterior walls. The va***a in the reproductive age of the woman has many folds allowing higher surface area. There are vascular supplies. All these anatomical features make us understand that the drug could be successfully delivered through the va***a. The physiology of va***a changes with age, hormonal status and pregnancy. So, the decision should be proper at the time of specific drug delivery.    

One negative aspect of this form of drug delivery is that the administration could not be regular, but is possible through oral delivery of a prescribed drug. Poor knowledge of va***al anatomy and physiology for drug delivery can cause complications.