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Women's Health Conditions (1)

Intrauterine device iud propagating a warm moist

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Intrauterine device (IUD) Propagating a warm, moist environment Tight fitting, nonabsorbant clothing or pantyhose VVC Pathophysiology
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Determine severity Categorize: Uncomplicated Infrequent Mild-moderate symptoms Complicated (~5% of women) Severe symptoms Concurrent predisposing medication or illness Recurrent ( 4 documented infections in 1 year) Treatment of VVC
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Exclusions for Self-Treatment Complicated/Recurrent Pregnancy Girls < 12 years Concurrent symptoms of fever or pain in the abdomen,  back or shoulder Medications that predispose to VVC Medical conditions that predispose to VVC Treatment of VVC
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Treatment goals: Relief of symptoms Reestablishment of normal vaginal flora Symptomatic improvement within 2-3 days and complete  resolution within 1 week of treatment Nonpharmacologic treatment: Discontinue possible precipitating factors Treatment of VVC
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Agents: Butoconazole, Clotrimazole, Miconazole, Tioconazole Creams, Suppositories, Tablets 1-day, 3-days, 7-days treatment options MOA:  Alters the membrane permeability of the fungi by  inhibiting CYP450 enzymes in the fungi sterol  ergosterol Imidazoles are equally effective Cure rates of 80-90% Pharmacologic Treatment of  VVC: Vaginal antifungals (imidazoles):
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Topical preparations have minimal systemic  absorption Side effects: Vulvovaginal burning, itching, and irritation Abdominal cramps Penile irritation Allergic reactions Headache Pharmacologic Treatment of VVC
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Nonprescription vaginal preparations for relief of  vaginal itching and irritation: Symptom relief only Do NOT treat the infection Ingredients: Benzocaine and hydrocortisone Example products: Vagisil Yeast-Gard Pharmacologic Treatment of VVC
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Special Populations Pregnancy Butoconazole, clotrimazole, or miconazole Prefer 3 or 7 day treatment Must consult physician Pharmacologic Treatment of VVC
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Vulvovaginal irritation or pruritis caused by 
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