Contraceptives and erectyle dysfunction Flashcards
therapeutic benefits of taking oestrogen and progesterone combinations
contraception
menstrual cycle regulation
acne management
feminising hormone therapy (transwomen)
menopause management
reduce risk of osteoporosis, Alzheimer’s, CADs
combined oral contraceptives (COC) MoA
inhibit ovulation
alter cervical mucus secretion to create sperm barrier
alter endometrial lining to prevent implantation
COCs contains 21 _______ and 7 _________ per strip
active and placebo
progesterone-only preparations (POP) MoA
alter cervical mucus secretion to create sperm barrier
inhibit ovulation (60%)
alter endometrial lining to prevent implantation
contraceptive failure causes
missed doses - human error, vomiting or diarrhoea
medication interactions with rifampicin (Abx) or other meds that reduce absorption
Long acting reversible contraceptives (progesterone only) adm and disavantages compared to PO contraceptives
adm via injection, implantation and intra uterine device
- invasive
- costly
- very uncomfortable
- not available in community pharmacies
emergency contraceptive pill (ECP) MoA (Levonorgestrel)
1.5mg stat
delays ovulation
impairs sperm motility
thickens cervical mucus
prevents implantation
98% effective if taken stat but no later than 72 hours
adverse effects of oestrogen/progesterone
adverse effects will likely happen from higher doses especially oestrogen
may cause acne and hirsutism (unwanted male-pattern hair growth in women’s face, chest and back)
breast tenderness, headaches, fluid retention
weight gain, glucose intolerance, dylipidaemia
breakthrough bleeding
nausea and GI disturbance (liver impairment)
increased risk of HTN, thromboembolism stroke, breast cancer and dementia
biggest sexual organ in the body
brain
erectile dysfunction treatments
Phosodiesterase-5 inhibitors - sildenafil (viagra) tadafanil (cialis) - relaxes blood vessels in the penis to increase blood flow
Prostaglandin E1 - alprostadil
PDE type 5 inhibitors (Sildenafil) pharmacodynamics
increases nitric oxide which is responsible in secreting guanylate cyclase > increasing cGMP (cGMP is converted to PDE type 5 - enzyme found in the walls of blood vessels) > sildenafil inhibits PDE type 5 to enhance the effects of cGMP > decreased smooth muscle tone and vasodilation of penile arteries therefore prolonged erection and increased sexual satisfaction
adverse effects of sildenafil
headache, flushing, cyanopsia (blue vision), priaprism (prolonged penile erection - which can cause gangrene if blood won’t leave the penis for a while)
cautions with sildenafil
DONT USE WITH nitrates - double vasodilators > increased risk of sever and profound hypotension
takes an hour to work and benefits last for 24-48 hours
prostaglandin e1 pharmacodynamics
direct application to penis (SC)
takes 10 mins to see benefits lasting 30-60 mins
prostaglandin e1 adverse effects
pain, minor bleeding, fibrous tissue formation and priaprism (prolonged painful erection)
