SA Pharmaceutical Journal - Volume 74, Issue 1, 2007
Volume 74, Issue 1, 2007
Author Franco GuidozziSource: SA Pharmaceutical Journal 74, pp 10 –16 (2007)More Less
In the age group 15 - 24 years, women are 2.5 times more likely to be HIV infected.
Treatment principles for managing vulvovaginal candidiasis in HIV-positive women should be identical to those used in HIV-negative women.
Approximately 50% of genital ulcers in HIV-infected women will be idiopathic and are called aphthous ulcers, while the rest are most commonly due to herpes simplex virus, mixed bacteria, syphilis, Haemophilus ducrei, mycobacteria or cytomegalovirus infections.
Acyclovir-resistant HSV may be encountered in 11 - 17% of HIV-infected women and valacyclovir, famciclovir, foscarnet or cidofovir may need to be considered.
HIV-positive women with PID have higher temperatures, lower WB Ccounts, more syphilis, more bacterial vaginosis, less chlamydia, less abdominal tenderness and twice as much tubo-ovarian abscess formation compared with HIV-negative women.
Severe immunosuppression and high viral load significantly increase the likelihood of HPV infections, abnormal smears and SIL, and overall, HIV-infected women have a 5-6-fold increase of developing SIL.
Colposcopic examination is warranted after a single pap smear shows cytological atypia, ascus, low-grade or high grade SIL or AGUS in an HIV-positive woman.
Even though ablative or excisional procedures are the treatment of choice for CIN 2 or 3, the need for second or third therapeutic procedures is often required. Hysterectomy is not advocated as there is a 50% rate of recurrence at the vaginal vault.
Menstrual disorders in HIV-infected women may not be directly due to the HIV, but to various factors that are not directly related to the disease.
Condoms are the mainstay of contraception and should be encouraged either as the sole contraceptive or in addition to any other form of contraceptive method used.
''Gimme a break...!'' A prescription for handling employee absences from the workplace : pharmaceutical practitionerAuthor Gerald JacobsSource: SA Pharmaceutical Journal 74, pp 17 –19 (2007)More Less
Source: SA Pharmaceutical Journal 74, pp 20 –24 (2007)More Less
COCs are safe and effective when used correctly and consistently.
COCs have non-contraceptive benefits, e.g. antiandrogen.
If the woman has significant cardiovascular risk factors, alternative methods should be considered.
The risk of venous thromboembolism is lower with COC use than with pregnancy.
Dual protection is recommended if there is risk of transmission of sexually transmitted infections including HIV.
If a woman is taking medication which lowers the efficacy of the low-dose COC (< 35 µg EE) an alternative or additional method is recommended.
For missed pills, apply the two for twenty and three for thirty rule.
Author Chantal StewartSource: SA Pharmaceutical Journal 74, pp 34 –37 (2007)More Less
Nicotine and carbon monoxide are the substances in cigarette smoke that are responsible for most of the adverse effects in pregnancy.
Smoking in pregnancy is associated with an increase in miscarriage, low birth weight babies, abruption placentae, placenta praevia and perinatal mortality.
Women who smoke have an earlier onset of menopause when compared with non-smoking women.
Smoking impairs fertility in both men and women via its effect on gametes and ovarian function.
Smoking is an important co-factor in the development of cervical cancer.
A wide range of cognitive and behavioural problems such as attention deficit hyperactivity disorder (ADHD) have been identified in children of mothers who smoke during pregnancy.
There is an association between smoking in pregnancy and an increase in childhood cancers, such as leukaemia and lymphoma.
The development of good manufacturing practice : part one : safety of medicine; harmonisation of regulatory requirements : industry in-siteAuthor M. De BeerSource: SA Pharmaceutical Journal 74, pp 38 –39 (2007)More Less