Drugs and Sex Flashcards Preview

Pharmacology II - Exam 3 > Drugs and Sex > Flashcards

Flashcards in Drugs and Sex Deck (25):
1

What are the two main ways drugs can affect sexuality?

  1. alteration of libido
  2. alteration of performance (erection/lubrication/orgasm)

2

what hormones increase libido in males and females?

testosterone

dopamine

3

which hormone increases libido in females only?

estrogen

4

what hormones decrease libido in males and females?

prolactin

serotonin

norepinephrine (alpha 2)

 

5

what hormone decreases libido in men?

estrogen (feeds back and lowers T levels)

6

what are the parasympathetic nerves involved in penile or clitoral erection/lubrication?

S2-S4

7

what are the sympathetic nerves involved in ejaculation in men and contraction of the uterus, fallopian tubes and vagina in women?

T12-L3

8

what are the somatic nerves that contribute to erection and orgasm?

S2-S4

9

the typical effect of drugs that interferes with erection are what two things?

  • peripheral anti-muscarinic actions 
  • decreased blood flow

10

the typical ways in which drugs act to decrease libido are:  

increasing prolactin secretion

blocking androgenic action (anti-androgenic)

Block Dopamine, NE or ACh (muscarinic) 

enhance 5-HT

sedation

11

the most common ways drugs interfere with orgasm are:

alpha 1 blockade

local anesthetic 

sedatives

12

what are the treatments for premature ejaculation?  What is the most significant side effect?

local anesthetics

drugs that delay orgasm:

clomipramine (TCA)

thioridazine (neuroleptic antipsychotic)

MAOIs

benzodiazepines

***but, these drugs also inhibit libido

13

what are some drugs that enhance libido?

Testosterone (both males and females - lower doses in females)

Dopamine agonists:

L-DOPA

Bromocriptine -used in prolactinemia

Apomorphine - in clinical trials

methlyphenidate (Ritalin)

bupropion (Wellbutrin) 

14

what is a major drug-induced cause of impotence?

alcohol abuse

15

what was commonly used before PDE5 inhibitors to treat ED?

Prostaglandin E1 (alprostadil)

injectable and uretrhal suppository

acts by vasodilating

SE:  hypotension, mild penile pain, occasional priapism

16

what are the differences among the PDE5 inhibitors?

pharmacokinetics and price

17

what is the MOA of PDE5 inhibitors?  

NO acts on a pathway in the endothelial and or neural cells to convert guanylate cyclase and GTP into cGMP, which leads to musclar relaxation of the corpora cavernosa and then erection

the "off" switch for this pathway converts cGMP into GMP using PDE5 the inhibtors block this "off" switch

18

what are the pharmacokinetics of sildenafil (viagra)?

peak plasma concentrations at 1 hour - take 1 hour prior to intercourse

half-life 4 hours (short)

 

 

19

what is the pharmacokinetics of Cialis (tadalafil)?

half-life is 18 hours (effective 36)

 

peak concentration is 1-6 hours 

20

what are the adverse effects of PDE5 inhibitors?

hyptension (average decrease 9/6)

common: headache, flushing, indigestion

less common: visual disturbance, actue hearing loss, nasal congestion, diarrhea, rash

21

How are the PDE5 inhbitors metabolized?

CYP3A4

22

what kind of hearing loss has been reported with PDE5 inhibitors?

unilateral, 1/3 temporary, sometimes with vertigo, tinnitus and dizziness

23

what kind of reports of vision loss have there been with PDE5 inhibitors?

nonaerteritic ischemic optic neuropathy

progressive, usually after continual use

partial vision loss, but permanent

small # cases 15-20

24

what are the potential serious interactions with nitrates for the PDE5 inihibitors?

large decrease in BP, syncope, lower cardiac perfusion, MI

 

don't forget that nitrates includes nitroprusside and recreational drugs like amyl nitrate and butyl nitrate

25