Erectile Dysfunction (ED)

Question 1

Revatio
Viagra

• MOA
• C/I
• ADEs
• Dose/Indication
• DDI

Answer 1

Sildenafil

• MOA: PDE5 inhibitors => inc cGMP => incr SM relaxation and inflow of blood into the corpus cavernous.
• C/I: nitrate use (severe hypoTN)
• ADEs: HA, flushing, visual disturbances, insomnia, diarrhea

Dose/Indication

• ED (Viagra): 25-100 mg PO 1H prior to intercourse
• Pulm HTN (Revatio): 20 mg PO TID

DDI

• Caution w/ alpha blockers
• CYP3A4 substrate

Question 2

Adcirca
Cialis

• MOA
• Indication/Dose
• DDI

Answer 2

Tadalafil

• MOA/SEs: similar to sildenafil

Indication/Dose

• ED: 10mg 30min prior to intercourse. Work up to 36H
• BPH: 5mg PO QD
• Pulm HTN: 40mg PO QD

DDI:

• Avoid nitrate. Give 48H after last dose
• Caution with alpha-blocker: hypoTN
• 3A4 substrate

Question 3

Levitra

• MOA/SEs
• Indication
• Dose
• DDI
• Other SEs

Answer 3

Vardenafil

• MOA/SEs: similar to viagra
• Indication: ED
• Dose: 10mg 1H prior to intercourse

DDI

• Ritonavir
• Alpha-blocker
• CI with nitrates for 72H

Other SEs

• Sudden hearing loss
• Sz

Question 4

Stendra

• MOA/SEs
• Dose
• DDI

Answer 4

Avanafil

• MOA/SEs: similar viagra
• Dose: 50-200mg ~30 prior to intercourse

DDI:

• CYP3A4 inhibitor
• Alpha blocker

Question 5

MUSE

• MOA
• How to administer
• Storage

Answer 5

Alprostadil

• MOA: widening blood vessels, inc blood flow to the penis and help cause an erection
• MUSE = transurthral therapy. Small pellet that is inserted into the urethra with an applicator. When press the button on the applicator, u release the pellet. It absorbed and an erection develops in ~10 min and last ~30min. Do not use more than 2x in 24H.
• Store in fridge

Question 6

Staxyn

• Form

Answer 6

Vardenafil

• Form: ODT 10mg

Question 7

Caverject

Answer 7

Alprostadil

• Caverject: Inject into the spongy tissue to the penus (corpus cavernosum). Not to be used more than 3x/wk.

Question 8

Caverject impulse

• Storage

Answer 8

Alprostadil

• Store: unreconstituted at RT

Question 9

Caverject sterile powder

• Storage

Answer 9

Alprostadil

• Store: fridge

Question 10

Caverject solution

• Storage

Answer 10

Alprostadil

• Store in FREEZER