Drugs for Erectile Dysfunction Flashcards
What is the MOA of Alprostadil?
Alprostadil is a PGE1 analog that increases the activity of Adenylate cyclase and leads to smooth muscle relaxation.
How is Alprostadil administered?
Alprostadil is administered as a urethral suppository or Intra-cavernosal injection.
What are the adverse effects of Alprostadil?
Pain in urethra, penis, and/or testes
Rare CV effects
Which PDE-5 inhibitors can be used to treat erectile dysfunction?
Avanfil
Sildenafil
Tadalafil
Vardenafil
What Are the adverse effects associated with the PDE-5 inhibitors?
HA, flushing, bleeding CV effects (MI, angina) Non-arteritic optic neuropathy Retinal artery occlusion Hearing loss
What is the major contraindication for PDE-5 inhibitors?
Organic Nitrates (hypotension)
What other drug-drug interactions must one be aware of when dealing with PDE-5 inhibitors?
Alpha blockers (hypotension) Other CYP interacting drugs
What is unique about Sildenafil?
Prolonged T1/2 by high fat meal.
What is unique about Tadalafil when compared with the other PDE-5 inhibitors?
Tadalafil has a half life of 35hrs compared with the others which have half lives of <5hrs
What is the unique adverse effect associated with Vardenafil?
QT prolongation
Does low testosterone cause ED?
No!!! but testosterone may be an effective treatment in hypo-gonadal men. May increase PDE5 response.
What is the MOA of Yohimbine?
Yohimbine is a mild MAO inhibitor that agonizes or antagonizes virtually every nervous receptor. Predominantly, however, it is an alpha-2 agonist, which decreases smooth muscle contraction.
What adverse effects are associated with Yohimbine?
CNS effects (crosses BBB) Worsens Renal failure
What is a strange adverse effect of sildenafil?
Loss of vision
Which PDE-5 inhibitor will elicit erection soonest?
Avanafil b/c it reaches peak plasma concentration soonest
