Chapter 50: Sexual Dysfunction Flashcards
(21 cards)
Key drugs that can cause ED
- Alcohol
- Antidepressants (esp SSRIs and SNRIs)
- BB, clonidine
- FGAs (e.g., chlorpromazine), prolactin-raising
- SGAs (e.g., risperidone, paliperidone)
- Finasteride, dutasteride, and silodosin (mostly retrograde ejactulation)
Natural products that can be used for ED
yohimbe, L-arginine, ginseng
Which ED med is also used for BPH
Tadalafil
Which ED meds are also used for PAH
sildenafil and tadalafil
PED5 inhibitors MOA
sexual stimulation → release of NO → increases cGMP → smooth muscle relaxation → blood flows in → erection
PDE5i block PDE-5 from degrading cGMP
Sildenafil brand name
Viagra
Tadalafil brand name
Cialis
Sildenafil starting dose and when should it be taken
50 mg
~1 hour before sexual activity
Vardenafil starting dose and when should it be taken
10 mg
~1 hour before sexual activity
Tadalafil starting dose and when should it be taken
10 mg
at least 30 min before sexual activity
Tadalafil on demand dosing
5-20 mg daily PRN
Avanafil starting dose and when should it be taken
100 mg
15-30 min before sexual activity
PDE5i CI
do not use with nitrates or riociguat
PDE5i warnings
impaired color discrimination, hearing loss, vision loss, hypotension, priapism
Seek emergency medical help with PDE5i if erection lasts > __ hrs
4
PDE5i SE
HA, flushing, dizziness, dyspepsia, back pain (mostly with tadalafil)
PDE5i doses should be decreased by 50% if:
- > /= 65 years old
- Using alpha blocker
- Using 3A4 inhibitor
- Severe renal or liver disease
What is the mechanism of action (MOA) of Alprostadil?
Alprostadil is a prostaglandin E1 vasodilator.
What are the formulations of Alprostadil?
Alprostadil can be injected into the penis or a pellet can be inserted through the urethra.
What are the side effects (SE) of Alprostadil?
Side effects include penile pain and priapism.
What is the mechanism of action (MOA) of Filbanserin?
Filbanserin acts as an agonist at 5-HT1A receptors and an antagonist at 5-HT2A receptors.
