Sex Therapy Drugs

Question 1

Sex HOrmones

Answer 1

Women: Estrogen and progesterone
Can be used for contraception, replacement therapy, hormone sensitive prostate therapy, dysmenorrhea, abnormal uterine bleeding, gender reassignment therapy
Men: Testosterone
Can be used for: low testosterone levels, delayed puberty in males, gender reassignment therapy

Question 2

Oral contraceptives

Answer 2

Estrogen/progestin:
Prevent ovulation
Various does and types
Progestin only:
suppresses ovulation creates thigh mucous later at cervix preventing sperm from entering uterus
LEss effective than estrogen/progestin
Increased menstrual regularities
Used when estrogen is contraindicated (postpartum, breast cancer Hx)

Question 3

Oral Contraceptives overview

Answer 3

Typically contain 21 day hormone pills followed 7 placebo pills
Important to take at the same time every day
Back up contraception is advised if client misses douses, experiences n/v or diarrhea, or is taking another medications (penicillin)
Women with person of family Hx of breast cancer should seek non-hormonal methods of birth control

Question 4

Oral Contraceptives Advantages/Disadvantages

Answer 4

Ad: predictable cycle, protection from ovarian and ends cancer
Dis: success depends on administration, N/C, breast tenderness, weight gain, breakthrough bleeding, headache
Additional risks: HTN, venous thrombosis (due to estrogen ), increased risk with smoking and if >35, stroke, breast cancer. Other meds can decrease effectiveness

Question 5

Erectile Dysfunction

Answer 5

Caused by: increased age, disease processes (DM, CVA, HTN, atherosclerosis, renal disease), smoking, ETOH, psychogenic causes (depression, fatigue), medications (beta blocker, SSRIs, TCAs, ACE Inhibitors)

Question 6

Sildenafil

Viagra

Answer 6

Thera: erectile dysfunction agent, vaseodilator
Pharm: Phosphodiesterase-5 inhibitor
Indications: Ed, pulmonary arterial hypertension
MOA; inhibiting PDE-5 increases levels of cGMP which produces smooth muscle relaxation and increases blood flow to the corpus cavernosum,
Adverse: headache, dizziness, facial flushing, nasal congestion, hypotension
Contraindicated: concurrent use of nitrates may cause refractory life threatening hypotension
Implications: Viagra: seek medical attention 4 hours or more, does not prevent HIV/STD; Revatio: vital signs, cardiac function, exercise tolerance prior to and during therapy

Question 7

Benign Prostatic Hypertrophy

BPH

Answer 7

Smooth muscle tissue surrounding urethra is regulated by alpha 1 adrenergic receptors
Glandular tissue regulated primarily by testosterone. Enzyme 5-alpha reductase converts testosterone to DHT, its active metabolites
DHT causes proliferation of prostate tissue - if we stop it we can reduce prostate size

Question 8

BHP Drug Classes

Answer 8

5-alpha reductase inhibitors
-finasterides (Proscar), dutasteride (avodart)
Make take 3-6 months to read peak, monitors for sexual dysfunction, do not handle crushed or broken tablets if pregnant

Alpha 1 adrenergic blockers - cause vasodilation
-tamsulosin (Flomax), terazosin (Hytrin)
Monitor for postural hypotension (first does effect), sleep difficulties