Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHA 551 > ED > Flashcards

ED Flashcards

1
Q

What are the risk factors for erectile dysfunction?

A 
HTN (diuretics)
HLD 
DM
metabolic syndrome
smoking
chronic ethanol abuse
psychological etiologies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which medications can cause erectile dysfunction?

A

anticholinergics

dopamine antagonists (inc PRL –> inhibited T production)

estrogens, antiandrogens (suppress T mediated stimulation of libido)

CNS depressants (suppress perception of psychogenic stimuli)

agents that dec penile blood flow (reduce arteriolar flow to corpora)

  • diuretics
  • peripheral beta adrenergic antagonists
  • central sympatholytic

opiates (high dose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the different treatment options of erectile dysfunction?

A

vacuum erection devices (least invasive)

oral PDEi (1st line)

intracavernosal injections/intraurethral inserts (poor adherence)

surgical insertion of penile prosthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are disadvantages of vacuum erection devices?

A

slow onset of action (30min)

not discreet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Yohimbine: MOA

A

vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Yohimbine: ADEs

A

anxiety
insomnia
tachycardia
HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Trazodone

A

antagonizes adrenergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PDE Inhibitors: agents

A

Sildenafil
Tadalafil
Vardenafil
Avanafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When are PDE inhibitors contraindicated?

A

in patients taking any dosage formulation of NITRATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PDE Inhibitors: MOA

A

need sexual stimulation to work

dec catabolism of cGMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where is PDE isoenzyme type 5 found?

A

genital tissue

ALSO:
peripheral vascular tissue
tracheal smooth muscle
platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is PDE isoenzyme type 6 found?

A

rods and cones of eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What ADEs are associated w/ inhibition of PDE isoenzyme type 6?

A

blurred vision
cyanopsia

MC w/ sildenafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is PDE isoenzyme type 11 found?

A

striated muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What ADEs are associated w/ inhibition of PDE isoenzyme type 11?

A

myalgia
muscle pain

MC w/ tadalafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What ADEs are associated w/ inhibition of PDE isoenzyme type 5?

A 
flushing
headache
dyspepsia 
nasal congestion
dizziness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Food decreases absorption by 1 hour for which agents?

A

sildenafil

vardenafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which agents, when combined with ethanol, may cause orthostatic hypotension?

A

tadalafil

avanafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which agents may be taken with food?

A

tadalafil

avanafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which agent is not recommended for patients with severe renal impairment?

A

avanafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which agent is not recommended for patients with severe hepatic impairment?

A

tadalafil
avanafil

*vardenafil - not evaluated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which agent does NOT inhibit PDE 6?

A

tadalafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which agent inhibits PDE 11?

A

tadalafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sildenafil: drug interaction

A

dec dose w/ potent P450 3A4 inhibitor

cimetidine
erythromycin
clarithromycin
ketoconazole
itraconazole
ritonavir
saquinavir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Tadalafil: drug interaction
reduce dose w/ most potent P450 3A4 inhibitors ketoconazole ritonavir
26
What is nonarteritic anterior ischemic optic neuropathy (NAION)?
dec blood flow to optic nerve --> sudden, unilateral, painless blindness PDEi ADE
27
Which patients are at risk for NAION?
``` glaucoma, macular degeneration, diabetic retinopathy HTN eye surgery/eye trauma age 50+ smokers ```
28
What is an ADE unique to tadalafil?
low back pain
29
What is an ADE unique to vardenafil?
QT prolongation
30
What is a rare ADE associated with PDE inhibitors (particularly with excessive doses of sildenafil, vardenafil)
priapism
31
Which population of men have an increased risk of priapism?
hx of sickle cell anemia, leukemia, multiple myeloma
32
Priapism: treatment
ice packs walk up stairs (arterial steal phenomenon) external perineal compression oral pseudoephedrine aspiration injection of alpha adrenergic agents instilled phenylephrine, epinephrine, methylene blue
33
What is the result of the drug interaction between PDEi and nitrates?
severe hypotension BECAUSE: - nitrates produce hypotension - nitrates are nitric oxide donors (inc levels of cGMP)
34
When is testosterone replacement indicated?
primary, secondary or mixed hypogonadism confirmed by: - dec libido - low serum concentration of testosterone
35
Hypogonadism Labs: - what are we looking at - when do we measure
testosterone LH (distinguishes primary (inc) from secondary (dec)) measured in the early morning (~8am)
36
Contraindications for testosterone replacement
- normal serum T levels - asymptomatic w/ hypogonadism - isolated ED as the only sign of hypogonadism
37
At what level do we consider initiating exogenous testosterone therapy?
serum levels <300
38
Oral Testosterone Supplements: agents
methyltestosterone | fluoxymesterone
39
Why are oral testosterone supplements not recommended?
extensive first pass hepatotoxicity
40
Testosterone Buccal System: special instructions
remove before every morning/evening toothbrushing avoids first pass
41
Parenteral Testosterone Supplements: agents
testosterone cypionate testosterone enanthate testosterone undecanoate
42
When is testosterone cypionate contraindicated?
severe hepatic or renal impairment
43
What is an ADE of testosterone cypionate and testosterone enanthate?
supraphysiologic serum concentrations of testosterone --> MOOD SWINGS
44
When applied at bedtime, which testosterone supplement can produce testosterone in the usual circadian pattern?
Transdermal patch
45
Special Instructions for Transdermal Testosterone Supplementation
cover application site to avoid transfer to others apply to site recommended by label (different for each one) women and children should avoid contact
46
Which testosterone supplement can also be used in menopausal women?
subcutaneous implant pellet
47
When is the clinical onset of the testosterone subcutaneous implant pellet?
3-4 mo after initial dose
48
transdermal nonscrotal skin patch: ADEs
dermatitis
49
oral alkylated androgens: ADEs
HEPATOTOXICITY hyperlipidemia sodium retention
50
transdermal gel: ADEs
inadvertent transmission to others
51
Intramuscular testosterone cypionate or enanthate: ADEs
mood swings gynecomastia polycythemia hyperlipidemia
52
Testosterone subcutaneous implant: ADEs
can be extruded accidentally
53
Buccal System: ADEs
gum irritation | bitter taste
54
Which testosterone replacement regiment does NOT achieve serum testosterone concentrations in normal range?
oral testosterone
55
Papaverine: ADEs
priapism corporal fibrosis hypotension hepatotoxicity
56
Phentolamine: ADE
hypotension
57
Phentolamine: MOA
competitive nonselective alpha adrenergic blocking agent
58
Papaverine: MOA
nonspecific PDEi5
59
Alprostadil: class, MOA
prostaglandin E1 inc cAMP production --> smooth muscle relaxation --> inc blood flow and filling of the corpora
60
What is the relationship between Alprostadil and Nitric Oxide? Which patients benefit from this relationship?
alprostadil acts through a nitric oxide independent mechanism useful for: - DM pts - post radical prostatectomy - PDE failure
61
Alprostadil: intracavernosal time to effect duration drug interactions
acts rapidly duration directly related to dose - duration of erection is no more than 1 hr can be used w/ VED and PDEi
62
What is the recommended maximum dose per day of intraurethral alprostadil?
no more than 2 doses per day
63
Alprostadil: intraurethral | -patient instructions
before administration: empty bladder before administration, voiding completely

PHA 551 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions