ErectileDysFC Flashcards
Erectile Dysfunction Causes
Diseases: diabetes, HTN, heart disease, nerve damage
Hormone imbalances
Psychological issues (including stress)
Neurological illness
Drugs
Drugs that Cause Erectile Dysfunction
Blood pressure medications: especially beta blockers, clonidine, methyldopa
Antipsychotics: haloperidol, chlorpromazine, fluphenazine, thioridazone
Antidepressants: SSRIs and SNRIs
Atomoxetine
BPH Drugs: finasteride, dutasteride, silodosin
Cimetidine
Opiods
Nicotine
Phosphodiesterase 5 Inhibitors MOA and names of the 3
Following sexual stimulation, PDE5 inhibitors increase Blood flow to the penis
Sildenafil (Viagra)
Vardenafil (Levitra, Staxyn ODT)
Tadalafil (Cialis)
PDE5 CI and cautions
CI: use with nitrates
Caution with Alpha Blocker Therapy (tamsulosin, doxazosin, etc)
Sildenafil (Viagra) dosing ? Ddis?
Food?
Start at 50mg 1 hour before intercourse (25mg in elderly and CrCl <30)
Best when taken on an empty stomach, avoid with fatty food
Use lower doses if concurrent 3A4 inhibitor use
se of viagra
SE: dizziness, sudden drop in BP, headache, dyspepsia, flushing, runny nose, stomach/back pain, priapism, vision and hearing problems
Vardenafil (Levitra, Staxyn ODT) dosing , food guidelines and cyp 3a4 use
Start at 10mg 1 hour before intercourse (5mg in elderly)
Best when taken on an empty stomach, avoid with fatty food
Use lower doses if concurrent 3A4 inhibitor use
Tadalafil (Cialis) dosing
Ddis?
Start at 10mg 1 hour before intercourse or 2.55mg daily for men who use >2 times/week
Use lower doses if concurrent 3A4 inhibitor use
cialis , food?
Take with or without food
se cialis
SE: dizziness, sudden drop in BP, headache, dyspepsia, flushing, runny nose, stomach/back pain, priapism, vision and hearing problems
Intracavernosal Alprostadil (Caverject) how to use
Injected via syringe into penis
se of caverject
SE: penile pain
hematoma
priapism
when does caverject cuase an erection ?
Causes erection 510 mins after injection (max 3x/week and 1x/day)
how to store caverject
Refrigerate vials, reconstitute prior to use
Transurethral Alprostadil (MUSE) how to admnister
Inserted into urethra
se of alprostadile in MUSe
SE: penile pain
how to store MUSE
Refrigerate
TriMix gel (Papaverine, Phentolamine, Alprostadil) how to administer
Inserted into urethra, doses of 500mcg
se of TRIMIX
SE: penile pain
how to obtain TirMix
Compounded (not FDA approved)
caution should be used with ED drugs and what other class?
Alpha blocker therapy (tamsulosin, doxazosin)
what labratory test can be used to distinguish between prostate cancer and BPH?
PSA prostate specific antigen is seen in prostate cancer
what is the MOA of alpha blockers in BPH?
they relax smooth muscle of the prostate and bladder neck to improve urine flow.
what are the nonselective alpha blockers?
terazosin (Hytrin) and doxazosin (Cardura)
