DRUGS FOR THE TREATMENT OF IMPOTENCE

Penile erection is a complex neurovascular event that represents a bal ance between corporal smooth muscle relaxation and contraction. This b alance is determined by the interaction between proerectile and antier ectile neurotransmitters. It is believed that nitric oxide is the prim ary erectogenic neurotransmitter and that noradrenaline (norepinephrin e) is the primary erectolytic neurotransmitter. There are a number of pharmacological approaches to the management of erectile dysfunction a nd manipulation of the neurotransmitter systems. These involve direct delivery of drugs into the erectile chambers (intracavernosal injectio n therapy), administration of medications into the urethra (transureth ral delivery), application of medications to the skin (transdermal del ivery) and it is hoped that oral agents will be available in the very near future. This article reviews the world literature on the medicati ons that have been investigated to date and their delivery routes.