title: Genders and the concurrent use of cocaine and alcohol: Pharmacological aspects.
abstract: OBJECTIVE
  Gender-related differences in the pharmacological effects of addictive drug are an emerging issue. This review examines gender differences in both pharmacokinetic and pharmacodynamic aspects of alcohol and cocaine intake since they cause complex pharmacological interactions, not least the formation of the active metabolite cocaethylene.
  
  
  METHODS
  The MEDLINE database was searched from 1990 to 2014 in order to find articles related to gender differences in alcohol, cocaine and cocaethylene pharmacokinetics and pharmacodynamics.
  
  
  RESULTS
  Besides the well known gender differences in alcohol pharmacokinetics, women appear more susceptible to alcohol-mediated brain damage and seem to suffer more than men the acute effects of alcohol on hepatic and gonadal hormones. No significant gender differences have been found in the pharmacokinetics of cocaine taken alone; yet, in women pharmacological sensitivity to the drug seems to vary in relation to menstrual cycle; moreover, progesterone attenuates subjective effects of cocaine in women. Higher ratings at a subjective measure of mental/physical well-being have been observed in women when given cocaine and alcohol, alone or in combination. Finally, among subjects dependent on both alcohol and cocaine, men only benefit from naltrexone, whereas women used more cocaine during the trial and were less compliant to therapy than men.
  
  
  CONCLUSIONS
  The observed subtle gender differences in the pharmacokinetics and pharmacodynamics of both alcohol and cocaine may have no subtle influence on the natural history of the co-abuse of the two drugs by women.
authors: Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; Drug Addiction and Clinical Pharmacology Unit, University Hospital Umberto I, Sapienza University of Rome, Rome, Italy. Electronic address: manuela.graziani@uniroma1.it.
authors: Manuela
authors: M
authors: Graziani
authors: Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; Drug Addiction and Clinical Pharmacology Unit, University Hospital Umberto I, Sapienza University of Rome, Rome, Italy.
authors: Paolo
authors: P
authors: Nencini
authors: Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; IRCSS Santa Lucia Foundation, Rome, Italy.
authors: Robert
authors: R
authors: Nisticò
mesh_terms: D000818:Animals; D003042:Cocaine / Q000493:pharmacokinetics / Q000494:pharmacology*; D004347:Drug Interactions; D000431:Ethanol / Q000493:pharmacokinetics / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D012727:Sex Characteristics; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000378:metabolism*
chemical_list: D000431:Ethanol; D003042:Cocaine
keywords: Alcohol; Cocaethylene; Cocaine; Gender; Pharmacodynamics; Pharmacokinetics; Pharmacology