Bartholin’s Gland Cyst
Although Bartholin’s gland abscesses may rupture and drain spontaneously, recurrence is likely, and surgical excision may be necessary. Excision is not an office-based procedure. Cultures for N. gonorrhoeae and C. trachomatis may be obtained. However, Bartholin’s gland abscesses tend to be polymicrobial, and empiric broad-spectrum antibiotic therapy should be used. Excision of the Bartholin’s gland should be considered in patients who do not respond to conservative attempts to create a drainage tract, but the procedure should be performed when there is no active infection. If multiple attempts have been made to drain a cyst or an abscess, adhesions may be present, making excision difficult and resulting in postoperative scarring and chronic pain in the area. Some investigators recommend excision of the Bartholin’s gland to exclude adenocarcinoma when cysts or abscesses occur in patients more than 40 years of age. Even though adenocarcinoma of the Bartholin’s gland is rare, gynecologic oncology referral should be considered for older patients with Bartholin’s duct cysts or gland abscesses.
Major actions appear to be associated primarily with inhibiting the formation of prostaglandins involved in the production of inflammation, pain,and fever.Antiinflammatory action: Inhibits prostaglandin synthesis. As an antiinflammatory agent, aspirin appears to be involved in enhancing antigen removal and in reducing the spread of inflammation in ground substances. These antiinflammatory actions also contribute to analgesic effects. Analgesic action: Principally peripheral with limited action in the CNS, possibly on the hypothalamus; results in relief of mild to moderate pain. Antipyretic action: In addition to inhibiting prostaglandin synthesis, it lowers body temperature in fever by indirectly causing centrally mediated peripheral vasodilation and sweating.
Reduces inflammation, pain,and fever.
To relieve pain of low to moderate intensity. Also for various inflammatory conditions, such as acute rheumatic fever, Systemic Lupus, rheumatoid arthritis, osteoarthritis, bursitis, and calcific tendonitis, and to reduce fever in selected febrile conditions.
Assessment & Drug Effects
- Monitor for loss of tolerance to analgesics. Some individuals develop an acute and specific intolerance to analgesics, although they may have taken it for years without incident. The reaction is nonimmunologic; symptoms usually occur 15 min to 3 h after ingestion: profuse rhinorrhea, erythema, nausea, vomiting, intestinal cramps, diarrhea.
- Monitor for toxicity. In adults, a sensation of fullness in the ears, tinnitus, and decreased or muffled hearing are the most frequent symptoms associated with overdosage.
- Monitor children closely because toxicity is enhanced by the dehydration that frequently accompanies fever or illness. Children tend to manifest toxicity by hyperventilation, agitation, mental confusion, or other behavioral changes, drowsiness, lethargy, sweating, and constipation.
- Monitor the diabetic child carefully for indicated need of insulin adjustment. Children on high doses of aspirin are particularly prone to develop hypoglycemia.
- Note: Potential for toxicity is high in older adults and patients with asthma, nasal polyps, perennial vasomotor rhinitis, hay fever, or chronic urticaria.
It is active against many gram-positive aerobic cocci and much less active against gram-negative bacteria. Effectively treats osteomyelitis, otitis media, streptococcal pharyngitis, prostate and respiratory infections, skin and urinary tract infections, eliminating or reducing infection.
To treat infections caused by susceptible pathogens in respiratory and urinary tracts, middle ear, skin, soft tissue, and bone.
Assessment & Drug Effects
- Determine previous hypersensitivity reactions to antibiotics and other allergens prior to therapy.
- Lab tests: Baseline C&S tests prior to initiation of therapy, start drug pending results; periodic assessments of renal, hepatic, and hematologic functions should be made during prolonged therapy.
- Monitor for S&S of an urticarial rash (usually occurring within a few days after start of drug) suggestive of a hypersensitivity reaction. If it occurs, look for other signs of hypersensitivity (fever, wheezing, generalized itching, dyspnea), and report to physician immediately.
- Report onset of generalized, erythematous, maculopapular rash to physician.
- Closely monitor diarrhea to rule out pseudomembranous colitis.