subdermal implants
DESCRIPTION
First and Second Generation Subdermal ImplantsModule: Family Planning and ContraceptivesTutor: Dr. BarberoTRANSCRIPT
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Subdermal ImplantsDonJayricDepalobos
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Subdermal Implants
•Made of polydimetylsiloxane (Silastic)•Norplant – contains lenonorgestrel•Long-acting, reversible, effective•Trials were initiated on 1975•FDA approval on 1990•Started to be marketed on 1991
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Norplant
•The rate of delivery is proportional to the surface area of the capsule.
•Duration of action is dependent on the amount of steroid within the capsule.
• Effective blood level• 6 capsule filled with
crystalline levonorgestrel
• Each capsule contains 36mg of crystalline levonorgestrel
• 215 mg in each capsule set
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Norplant
•Insertion (Out-patient Setting)1. Infiltration of skin with local anesthesia.2. Incision of 3mm.
Usually upper arm but other areas are used like lower arm, inguinal, scapular, and gluteal.
3. Radial pattern in a 10- to 12-guage trocar.4. Incision is closed.
Sutures are not necessary. Removed after 5 years.
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Norplant
•Removal▫Clinic Area▫Local Anesthesia▫Small Incision▫Remove fibrous tissue if present▫Implants are implanted superficially
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Norplant II• Next Generation Implant
▫Homologous mixture of Silastic and crystalline levonorgestrel extruded as solid rod and covered with Silastic tubing to limit diffusion of steroid.
▫Higher blood levels of levonorgestrel are achieved with a smaller total surface area.
• Two 4cm covered rods achieve same release rate for levonorgestrel (about 50mcg/day) as six 3cm capsules.
• 3 years duration• 2-rod system “Jadelle”
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