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Pharmacology > Drugs and Sex > Flashcards

Drugs and Sex Flashcards

1
Q

General mechanisms for drugs to affect sexuality

A

Libido and performance

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2
Q

Hormones and NT’s that increase libido

A

Testosterone
Dopamine
Estrogen (female), FSH, LH?

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3
Q

Hormones and NT’s that decrease libido

A

Prolactin
Estrogen (male)
Serotonin

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4
Q

Hormonal effects of drugs on sex

A

Increased prolactin secretion

Anti adrenergic

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5
Q

CNS effects of drugs on sex

A

Block dopamine, NE, Ach, enhance 5HT, sedation

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6
Q

Interference with erection mechanism

A

Peripheral anti muscarinic action

Decreased blood flow

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7
Q

Interference with orgasm mechanism

A

Alpha 1 blockade
Anesthetic
Sedation

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8
Q

Antihypertensives that cause sexual problems

A 
Ganglionic blockers
Clonidine Methyldopa
Alpha 1 blockers
Beta Blockers - 5-10%
Spironolactone
Thiazide diuretics
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9
Q

Antihypertensives with few sexual side effects

A

Calcium channel blockers, ACE inhibitors, ARB’s,

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10
Q

Why are psychiatric drug effects on sexuality more complicated?

A

Because the disease itself can have effects on sexuality

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11
Q

Antipsychotics and libido

A

Decrease
DA receptor blockade
Anticholinergic
Sedative

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12
Q

Antipsychotics and erection

A

Decreased due to anticholinergic effects

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13
Q

Antipsychotics and orgasm

A

Decrease due to alpha 1 blockade.

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14
Q

Alcohol and sex - acute effects

A

Small doses - disinhibiting.

Large doses - impotence, delayed, inhibited, and/or less intense orgasm.

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15
Q

Alcohol and sex - chronic effects

A

Neuropathy - impotence

Decreased testosterone - lower libido.

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16
Q

Marijuana and sex - acute effects

A

Low dose - enhanced sensation,

High dose - impotence

17
Q

Marijuana and sex - “Chronic” effects

A

Infertility, decreased testosterone, impotence, menstrual and ovulation problems.

18
Q

Cocaine, amphetamines acute effects

A

Low dose - enhanced libido, delayed orgasm. High dose direct stimulation of erection.

19
Q

Cocaine, amphetamines - chronic effects

A

Loss of libido, depression, ejaculatory failure

20
Q

Treatment of premature ejaculation

A

Local anesthetics, orgasm-delaying agents, The problem is that many of these also inhibit libido.

21
Q

Treatment of low libido

A

Testosterone (low dose in females)

Dopamine agonists

22
Q

Smooth muscle relaxants to treat Erectile Dysfunction

A

Papaverine - multiple adverse effects including penile fibrosis

Phentolamine - can interfere with orgasm

Prostaglandin E
Injectible and Urethral suppository

23
Q

PDE5 inhibitors

A

Sildenafil (Viagra) - works on erection, NOT libido.

New drugs differ only in pharmacokinetics

24
Q

PDE5 inhibitors mechanism

A

Inhibits phosphodiesterase 5, which degrades cGMP in the corpus cavernosum. In the presence of sexual stimulation, which causes a release of NO, this causes vasodilation and erection.

25
Q

When should a patient take silfenidil

A

1 hour prior to expected intercourse. Half life and effective duration about 4 hours.

26
Q

PDE5 inhibitors other indications

A

BPH, pulmonary arterial hypertension.

27
Q

PDE5 inhibitors adverse effects

A

hypotension, headache, flushing, indigestion,

Less common - vusal and hearing problems.

28
Q

Potentially serious adverse effects of PDE5 inhibitors

A

Sudden hearing loss/Vision loss

29
Q

PDE5 DDI’s

A

Potentially dangerous interaction with nitrates

Large decrease in BP - syncope, decreased perfusion, MI

30
Q

Are there any FDA approved treatments for female sexual dysfunction?

A

No.

31
Q

Hormone treatment for female sexual dysfunction

A

Estrogen - menopause
Androgen/Testosterone patches - libido, especially post menopause
Ospemifine - agonist in the vagina for estrogen receptors.

32
Q

Silfenidil in women

A

Andecdotal support, possible utility.

Pharmacology (11 decks)

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