The document provides a comprehensive overview of vaginal medication administration, discussing its advantages such as prolonged release and minimal systemic side effects, while also noting disadvantages like patient incompliance and limited drug options. It outlines various forms of vaginal medication, general instructions for administration, and detailed procedural steps for both administration and aftercare. The document emphasizes the importance of aseptic technique and patient education throughout the process.

1. Prepared by-
Aashish Parihar
m.sc. nursing

2. Introduction
Advantages
Disadvantages
Forms of medication
General instructions
Articles required
Procedure

3. Introduction
Vagina is route for administration for
contraceptives, antifungal and anti microbial.
It is used for the achievement of local and
systemic absorption.
Vaginal medications include suppositories,
creams, gels, and ointments.
Suppositories melt when they contact the
vaginal mucosa, and their medication diffuses
topically (as effectively as creams, gels, and
ointments).
Vaginal medications usually come with a
disposable applicator that enables placement of
medication in the anterior and posterior fornices.

4. Advantages
Prolonged release.
Minimal systemic side effects.
An increase in bioavailability.
Use of less total drug than an oral dose.
First-pass metabolism can be avoided.
Self medication is possible.

5. Disadvantages
Patient incompliance.
Only a few drugs are administered by this route.
Variability in drug absorption related with
menstrual cycle, menopause and pregnancy, can
also limit vaginal drug delivery route usage.
Influence with sexual intercourse.
Gender specificity.

6. Forms of vaginal medication
Many different types of formulations have been applied
vaginally as-
 Tablets
 Vaginal suppositories or pessaries (globular, oviform
or cone-shaped, and weighing about 5 g each. )
 Douches (aqueous solutions that are administered into
the vagina for cleansing purpose. )
 Foams
 Sprays
 Gels
 Creams
 Vaginal rings
(Creams, gels, sprays and foams are used as vehicles for
drugs such as anti-infective or contraceptive agents.)

7. General instructions
To prevent damage, suppositories must be stored
in refrigerator.
Foams, jellies, and cream are administered with
an inserter or applicator.
Perineal pads may be used to collect excess
drainage after inserting a suppository.
Good aseptic technique must be followed.
Good perineal hygiene must be maintained.
The patient should be encouraged to empty her
bladder as she has to lie down for 20 minutes
The patient can either lie supine with knees up or
lateral with knees up
Always lubricate the pessary or applicator before
inserting

8. Articles required
A clean tray containing-
 Medication administration record (MAR)
 Nonsterile gloves
 Mackintosh
 Prescribed vaginal suppository or any other form of
vaginal medication
 Perineal pads
 Water-soluble lubricant
 Disposable applicator
 Tissue paper/ cotton balls
 Paper bag
 Kidney tray
And
 Side screen

9. Procedure
Preliminary assessment-
 Review the physician’s order, patient’s name, name and form
of vaginal medication, dosage and time.
 Explain procedure to patient. If client plans to self-administer,
be very specific with instructions.
 Gather necessary equipment.
 Follow the rights of medication administration.
 Ask the client to void.
 Provide for privacy.
 Wash hands
 Don Nonsterile gloves.
 Position the client in a dorsal recumbent position with knees
flexed and hips rotated laterally or in a Sims’ position.
 Assess perineal area, inspect vaginal orifice, note any odor or
discharge from the vagina, and inquire about any problems
such as itching or discomfort.

10. Procedure
 If secretion or discharge is present, cleanse the
perineal area with soap and water.
 Remove suppository from the foil wrapper and, if
applicable, insert into applicator tip.
 Apply a small amount of lubricant to rounded tip of
suppository.
 If not using an applicator, apply a small amount of
lubricant to gloved index finger.
 With non dominant hand, spread labial folds. Insert
the suppository into the vaginal canal at least 2 inches
(5 cm) along the posterior wall of the vagina or as far
as it will go
 If using an applicator, insert as described above and
depress plunger to release suppository.

11. Procedure
After care-
 Wipe the perineum with clean, dry tissue.
 Instruct the client to remain in bed for 15 minutes.
 Wash applicator under cool running water to clean and
return to appropriate storage in the client’s room.
 Remove gloves, turning them inside out, dispose them.
 Wash hands.
 Record on the MAR the drug’s name dosage, route, and
date and time of administration; document any evidence
of discharge or odor from the vagina.
 Check with the client in 15 minutes to ensure that the
suppository did not slip out and to allow the client to
verbalize any problems or concerns.
 Observe for effectiveness of the medication; inspect the
condition of the vaginal canal and external genitalia
between applications.