20.14j Medications Affecting Sexual Behavior

libido

For centuries, cultures have searched for medications that would increase (?) and sexual potency.

reverse

The largest category of medications affecting sexual behavior do so as a side effect of their intended purpose.

decrease libido

Many medication classifications (?) in both sexes and inhibit erection and ejaculation in men.

antihypertensives

Examples include (?) (beta blockers, centrally acting alpha antagonists, and diuretics) and antianxiety/antipsychotic medications (benzodiazepines, phenothiazines, MAO inhibitors, and tricyclic antidepressants).

cantharis (Spanish fly)

The most notable of these is (?).

dangerous side effects

Indeed, it can produce some very (?).

Hallucinogens

Hallucinogens such as LSD and marijuana, as well as alcohol, are also commonly believed to heighten sexuality.

decreased inhibitions or anxiety

Any such effect from these agents is likely an indirect result of (?).

unique physiology

These medications have very different effects, depending on each individual’s (?), expectations before use, and surrounding circumstances.

no proven direct physiologic effect

They have (?) on sexual gratification.

Levodopa (L-dopa)

(? ), an anti-Parkinson’s medication, has demonstrated increased libido and improved erectile ability as a side effect of treatment.

temporary

Whether this results directly from increased autonomic stimulation or indirectly from improved self-esteem achieved in therapy, any improvement seems to be only (?).

erectile dysfunction

Several medications that aid in (?) have been developed.

age

Erectile dysfunction becomes more frequent with (?) or with certain diseases such as diabetes or cardiovascular disease.

blood supply to the penis

Medications that aid in erectile dysfunction increase (?).

sildenafil (Viagra)

These include (?), vardenafil (Levitra), and tadalafil (Cialis).

vascular smooth muscle

These medications act by relaxing (?), which increases blood flow to the corpus cavernosum, the spongelike tissue on the sides of the penis responsible for erection.

sexual stimulation

These medications are unique in that they have no effect in the absence of (?).

priapism

Other medications used to treat impotence have caused prolonged and painful erections (?).

nitrates

The chief side effect of sildenafil is seen when it is used in combination with (?).

decreased preload

The combined effect of relaxing vascular smooth muscle can lead to a dangerously decreased (?), which can lower blood pressure and lead to myocardial infarction.

important interaction

Prehospital personnel should be aware of this (?).

nitroglycerin

If you are called on to treat a patient with chest pain who has taken sildenafil, vardenafil, or tadalafil recently, do not give him (?) or any other nitrate.

Table 20-28

Table 20-28 details hormones and related agents.