Jul
15
The Prostate in Sexual Activity.
July 15, 2009 | Leave a Comment
The Prostate in Sexual Activity
The prostate is part of the male reproductive system and supplies part of the seminal fluid. It is not essential for the man’s sexuality, though, nor even for his ability to reproduce. When a man’s prostate is removed, male sexuality is not normally affected ripped fuel. His sex drive is intact, and his ability to
achieve and maintain an erection is unchanged.
SEMINAL FLUID
In fact most of the fluid you ejaculate isn’t sperm at all. Most of the fluid consists mainly of secretions from a number of glands. The largest of these glands is the prostate.
The various secretions from these glands probably serve the purpose of providing the sperm with a greater motility after they have been ejaculated, which stimulates their activity and enables them to move towards the egg. It is thought by some people that the prostate also has a lot to do with the feeling that an orgasm gives you. When a man
has an orgasm, sperm fluid from the seminal vesicles and the secretions from the prostate all mix together as semen at the top of the urethra, just below the bladder. A man gets an intensely pleasurable sensation when the semen floods down the urethra into the penis . He also gets a pleasurable feeling when the semen squirts out of the penis and into the tight region of a woman’s vagina. The prostate gland can be felt, as a man’s orgasm proceeds, to contract i-liythmically, which some people believe to be very much an integral part of the pleasure he experiences on orgasm.
What prostate fluid contains:
• Water.
• Salts.
• Minerals.
• Proteins.
• Antibodies.
• Enzymes.
• Citric acid.
• Fats buy domain fioricet tramadol .
• Prostaglandins, which are hormone-like chemicals.
PROSTATIC DISEASE
Prostatic disease can have an effect not only on the urinary system, but also on the reproductive system. The male reproductive and urinary systems are, of course, closely linked, if only because they share the same exit route - the penis - or, to be more exact, the urethra which runs through the centre of the penis. The prostate gland is the site at which the male sex hormone testosterone, which is made by the testicles, is broken down. It is here that it then forms another hormone called dihydrotestosterone (DHT). The conversion is controlled by an enzyme called 5-alphareductase. In a study conducted by Imperato-McGinley (Science, 1974), the males in an obscure tribe in the Dominican Republic are deficient in 5-alpha-reductase and are often mistaken for girls until they reach puberty. Until then, they have a very small penis and scrotum, which suddenly enlarge at puberty, along with the development of a deep voice. These males only ever develop a very small prostate gland, they never go bald, and they do not suffer from acne check.
It is this genetic deficiency in 5-alpha-reductase that has enabled researchers to comprehend the role played by dihydrotestosterone in the enlargement of the prostate gland.
Testosterone
As well as prostate enlargement, the male hormone testosterone also has several other effects on the male body.
These include the following:
• The growth of the penis.
• The growth of testes.
• The production of sperm.
• A deeper voice.
• The growth of facial and body hair.
• The male sex drive.
• Bone growth hair loss.
• Strength.
• Acne.
• Baldness.
A MAN’S GREATEST FEARS
One of man’s greatest fears on seeing a urologist and considering the prospect of a prostatectomy is what effect this will have on his sexuality. The idea of having any sexual organ tampered with by a surgeon is very frightening for most men, who worry that it may have a deleterious effect on their sex lives. Many men are so frightened that their prostate problems will affect their sex lives, particularly if they have to have an operation, that they put off going to the doctor gastroparesis caused by prozac . And even when they do eventually go to the doctor, they may be too embarrassed to discuss sexual matters. Sex is something that all too many men find difficult -if not impossible - to talk about with their doctor. But this is foolish. It is only by talking the matter over with their doctor that they will find their fears were groundless and that they can therefore be reassured.
The doctor’s role.
To make matters worse, some doctors and urologists are sometimes insensitive on this subject. It is quite wrong of them to assume that their patients are too old to be interested in sex. Sex can play an important role in the lives of many men until well into old age, and they should treat their fears as real and serious. A man who is due to have a prostatectomy should not just fret about this in secret, he should talk to his doctors about it - his GP, his consultant, his surgeon. Most importantly, the doctor should respect his fears, and him for coming to air them with him. It’s not easy for any man to do this, and if he succeeds in overcoming his reluctance to do so, the doctor should recognise what that has cost him. If the doctor reacts badly, it might have catastrophic effects: it might just send him scuttling back to his burrow, his pride injured, and he might never be able to take the risk again. Only when both doctor and patient can talk about this calmly, sensibly, realistically, will the patient be reassured that it will have no effect on his sexuality - neither on his libido, nor his ability to obtain or maintain an erection, nor on his performance.
Retrograde ejaculation
What it may well do, however, is cause him to be infertile after the operation. Even a man who has no intention of becoming a father again may find the idea of losing his potential to be a father very distressing. A man may find this emasculating, as if it were questioning his manhood. He’s only lost his ability to procreate, not his sexuality, but this can have a devastating effect on him. This is reminiscent of a woman who regrets the loss of her womb after a hysterectomy, even though she is beyond childbearing, and feels she has lost her femininity. A doctor should have the sensitivity to talk to his patient about this. Only with patience and understanding can he help
him come to terms with his feelings of fear and loss. Retrograde ejaculation will not make a man impotent, nor - in most cases - will it prevent him from having orgasms. It will, however, make the sensation of orgasm a different one - and, in all honesty, probably not as good. Some women, too, are disappointed by the new feeling of a ‘dry’ climax in their male partner. These changes in a man’s sexuality should be addressed beforehand. He should be told what to expect. A sensitive doctor will also help a couple come to terms with their new-found sexuality.
Impotence
It is possible, though by no means certain - nor even common -that prostatectomy may cause impotence Some men are frightened that it might have this effect, probably because they have heard tales of the old perineal prostate operation (which is hardly ever done nowadays) or the radical prostatectomy in which the entire prostate, including the capsule in which it is enclosed, is removed (sometimes performed for prostate cancer). In both these operations, the nerves supplying the penis were sometimes cut, which led to a man’s impotentence. The problem of impotence is therefore unlikely but it may arise. If a man is very frightened that the operation may lead to impotence, he may actually experience a kind of psychological impotence afterwards. This underlines how important it is for a man to be reassured before the operation. If a psychological problem does occur, a counsellor or sex therapist should be able to deal with it.
An excuse to avoid sex
In spite of all the evidence that prostate surgery has no effect at all on a man’s sexuality (other than retrograde ejaculation), it does occasionally seem to happen. An obvious explanation for this is that some men may use surgery as an excuse to avoid sex, which they had stopped enjoying ages ago anyway. Occasionally, if a man is not in very good health, a prostate operation - which is, after all, a major operation requiring a long convalescence period - may be enough to push his sexuality over the edge.
Generally, though, most men do not have any problems with their sex lives after the operation. In fact, a man may actually find that his sex life has greatly improved since he had his prostatectomy, if only because he now has full control of his bladder.
Jul
1
Drugs for Cough Treatment
July 1, 2009 | Leave a Comment
Cough
Cough is an explosive exptiation of air from the lungs, and is a protectiv-e–! mechanism to expel excessive exudate or foreign bodies from the respiratory tract,
but other irritant factors may also stimulate the cough reflex. Productive cough
should not be suppressed without good cause, such as when the patient finds
cough exhausting or prevents sleep, but suppression may then have the
undesirable effect of causing retention of sputum. On the other hand, suppression
of the dry, useless or unproductive cough may have corresponding advantages.
Many soothing and demulcent preparations represented by simple linctus have
been used for the symptomatic relief of cough, and another traditional remedy is
steam inhalation, assisted by the addition of Friar’s balsam and menthol.
Expectorant products such as ammonia and ipecacuanha mixture are also used,-,—,–.
even though pharmacological proof of their efficacy may be lacking. Cough
suppressants, represented by codeine, have a central depressant action on the
cough centre, but effective doses may have the disadvantage of causin
Extended use should be avoided because of the possible risk of
habituation. The treatment of severe cough in terminal lung cancer is with more potent cough suppressants such as diamorphine or methadone.
Approved names Brand names
codeine linctus Galcodine
pholcodine linctus
Table 9 Cough suppressants.
Galenophol, Pavocol D, Pholcomed
Jul
1
Drugs for Angina Treatment
July 1, 2009 | Leave a Comment
Angina pectoris
Angina pectoris is a painful cardiac condition that occurs when the work load on the heart and the onsequent oxygen demand of the myocardium exceed the ability of the cardiovascular system to meet that demand. The pain may vary from a relatively mild ache to a crushing chest pain which may radiate to the left shoulder and left arm and other areas. It is often triggered off by exertion, and usually subsides rapidly with rest. It is basically a stress response to factors that increase cardiac demand and output, and is often linked with an atheromatous narrowing of the coronary arteries.
Treatment of angina is with coronary vasodilator drugs that reduce cardiac drive and lower the myocardial oxygen demand (many of which are also used in the treatment of hypertension. They include the time-honoured glyceryl trinitrate (which can be given by several routes), other nitrates, calcium channel blocking agents, beta-adrenergic receptor blocking agents and potassium channel activators. Glyceryl trinitrate is of particular value when a rapid response is required. The following Table gives an indication of the wide range of anti-anginal products currently available.
sublingual tablets 300, 500, 600 mg spray 400 mg/dose spray 400 mg/dose 400 mg/dose
long-acting tablets, 6.4 mg long-acting tablets, I mg, 3 mg, 5 mg long-acting tablets, 2.6 mg, 6.4 mg
patches 5 mg
patches 5 mg, 10 mg, 15 mg
patches 2.5 mg, 5 mg, 10 mg, 15 mg patches 5 mg, 10 mg
ointment 2%
glyceryl trinitrate Coro-Nitro Spray* Glytrin Spray Nitrolingual Spray
Nitro-Continua Suscard
Sustac
Nitrocine injection Nitronal injection
Deponit
Minitran
Nitro-Dur Trasiderm-Nitro
Percutol
Note: Sprays (1 -2 doses) are given under the tongue; the mouth should then be closed.
sorbide Isordil tablets 5mg, 10 mg, 30 mg
idinitrate Sorbichew tablets 5 mg
Sorbitrate tablets 10 mg, 20 mg
long-acting products Cedocard-Retard 20 mg, 40 mg
Isoket Retard 20 mg, 40 mg
Isordif Tembids 40 mg
Sorbid-SA 20 mg, 40 mg
Isoket injection 500 mg
tablets 10, 20, 40 mg tablets 10, 20, 40 mg tablets 20mg
tablets 10, 20mg
tablets 10, 20, 40 mg
long-acting products
capsules 25 mg, 50 mg
capsules 60 mg tablets 40 mg capsules 50 mg tablets 40 mg capsules 40mg
Table 4 Drugs used in angina. Continued over.
isosorbide mononitrate
Elantan
Ismo
Isotrate
Monit Mono-Cedocard
Elantan LA lmdur
Ismo Retard MCR-50
Monit SR Monomax SR
pentaerythritol Mycardol tablets 30 mg tetranitrate
acebutolol Sectral capsules 100mg, 200mg tablets 400 mg
atenolol Tenormin tablets 25, 50, 100mg
bisoprolol Emcor, Monocr tablets 5 mg, 10 mg
metoprolol Betaloc, Lopresor tablets 50 mg, 100 mg
nadolol Corgard tablets 40 mg, 80 mg
oxprenolol Trasicor tablets 20 mg, 40 mg, 80 mg
Slow-Trasicor tablets 160 mg
pindolol Visken tablets 5 mg, 15 mg
propranolol Inderal tablets 10, 40, 80 mg
Inderal-LA tablets 160 mg
amlodipine Istin tablets 5mg, 10 mg
dittiazem Adizem tablets 60 mg
Tildiem tablets 60 mg (long-acting diltiazem products are:
Adizem-XL AAngil SR Calcicard CR, Diazem SR, Diazem XL, Slozem,
Tildiem LA, Tildiem Retard)
felodipine Plendil tablets 5 mg, 10 mg
Anicardipine Cardene tablets 20 mg, 30 mg
nifedipine Adalat capsules 5mg, 10 mg (long-acting nifedipine products are:
Adalat LA, Adalat Retard, Adipine MR, Angiopine MR, Cardilate MR,
Coracten, Hypolar Retard, Nifelease, Nifensar XL, Unipine XL)
(verapamil Cordilox tablets 40, 80, 120, 160 mg
Securon tablets 40 mg, 80 mg, 120 mg:potassium channel activator
nicorandil Ikorel tablets 10mg, 20mg