Flashcards in ED Deck (21)
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1
What are the two main step in the normal physiology of an erection?
1. Increased penile arterial inflow (Parasympathetic)
2. Decreased venous outflow
2
MC etiology in ED
Endothelial dysfunction
3
What is key to an erection?
Circulation
4
Possible PEx findings in ED
1. Gynecomastia, Galactorrhea: High prolactin levels can cause ED
2. Penis plaques-Can cause Peyronies testis
5
What test would you use to evaluate sleep erections?
Nocturnal Penile Tumescence
"Postage Stamp"
6
How can we test for arterial insufficiency?
Penile Duplex US
7
How can we test for venous leakage?
Cavernosometry/Cavernosography
8
What do we measure with a Cavernosometry/Cavernosography?
Rate of inflow of saline required to maintain an erection
9
General/Lifestyle Treatment in ED
1. Determine if CV status is appropriate for sexual activity
2. Smoking cessation
3. Weight control
4. Possible change in medications
10
What is the overall effect of PDE-5-I
1. Vasodilatory effect
2. Maintain Erection
11
What is a major SE of PDE-5-I
Vision loss: Non-Arteritis anterior ischemic optic neuropathy
12
What drug is CI when taking PDE-5-1?
Nitrates
13
Which PDE-5-I do you NOT have to worry about taking after meals?
Tadalafil (Cialis)
14
Vacuum Erection Device (VED) MOA
Increases arterial blood flow into corpora cavernosa
15
How is a MUSE administered? List an example
Urethral Suppository
Prostaglandin E1
16
List the Intracavernosal Injection Triple Agent
Prostaglandin E1 + Phentolamine + Papaverine
17
What is the max dose of Intracavernosal Injections per week?
3 doses/week
18
What is the major risk/complication of Intracavernosal Injections?
Priapism: Erection >4 hrs
19
Priapism Treatment
Needle aspiration with injection of Phenylephrine (vasoconstrictor)
20
Venous leakage treatment
Constriction Ring
21
