PDE 5 Inhibitors Adverse Effects/ Side effects

Question 1

Adverse effects like headache and facial flushing result from _______ or _______.

Answer 1

Vasodilation; smooth muscle relaxation

Question 2

Tadalafil is associated with more lower back and limb pain due to its greater inhibition of

Answer 2

Phosphodiesterase type 11

Question 3

most common adverse effects of phosphodiesterase type 5 inhibitors are

Answer 3

Headache, facial flushing, dyspepsia, nasal congestion, and dizziness.

Question 4

Sildenafil and vardenafil cause a decrease of about 8 to 10 mm Hg in _______ and a 5 to 8 mm Hg decrease in _______ blood pressure starting approximate______hour after a dose is taken and last for______hours

Answer 4

Systolic; diastolic
1 and 4

Question 5

Avanafil and tadalafil typically produce smaller decreases in blood pressure compared to sildenafil and vardenafil, especially when used with other _______ or _______.

Answer 5

Antihypertensives; αadrenergic antagonists

Question 6

If a patient experiences angina during sexual intercourse after taking a phosphodiesterase type 5 inhibitor, they should stop and rest for the next _______ minutes.

Answer 6

5 to 10

Question 7

Patients taking multiple antihypertensives or nitrates, or those with baseline hypotension, need to use phosphodiesterase type 5 inhibitors with caution due to the potential for _______ or _______.

Answer 7

Dizziness; palpitations

Question 8

What is the doserelated adverse effect associated with sildenafil, vardenafil, and avanafil regarding vision?

Answer 8

Increased sensitivity to light, blurred vision, or transient loss of blue–green color discrimination.

Question 9

What is the mechanism behind the visual adverse effects caused by these drugs?

Answer 9

nhibition of phosphodiesterase type 6 in the photoreceptor cells of retinal rods and cones.

Question 10

When do visual adverse effects commonly occur after oral dosing of these drugs?

Answer 10

1 to 2 hours after oral dosing when peak serum concentrations are achieved.

Question 11

Which drug is associated with a lower incidence of visual adverse effects compared to sildenafil and vardenafil?

Answer 11

Tadalafil.

Question 12

When should all phosphodiesterase type 5 inhibitors be stopped immediately according to product labeling?

Answer 12

If the patient reports vision loss.

Question 13

What genetic disease associated with retinal phosphodiesterase deficiency should make clinicians cautious in using these drugs?

Answer 13

Retinitis pigmentosa.

Question 14

What does NAION stand for?

Answer 14

Nonarteritic anterior ischemic optic neuropathy.

Question 15

What is a significant characteristic of NAION?

Answer 15

Sudden, unilateral, painless blindness, which may be irreversible.

Question 16

Why is caution advised regarding the use of phosphodiesterase type 5 inhibitors in relation to NAION?

Answer 16

Due to the potential of the blood pressure-lowering effects of these medications to decrease blood flow to the optic nerve, potentially leading to sudden unilateral vision decrease.

Question 17

In terms of timing, when has NAION been observed in relation to the use of phosphodiesterase type 5 inhibitors?

Answer 17

It has been observed at variable and unpredictable times after starting these inhibitors, ranging from 6 hours to months or years after the first dose.

Question 18

What does the FDA recommend for patients at risk of NAION regarding these medications?

Answer 18

They should consult an eye specialist, address any risk factors for NAION, and be cautious about using phosphodiesterase type 5 inhibitors.

Question 19

Who are at risk for NAION?

Answer 19

People with eye conditions like glaucoma, macular degeneration, diabetic retinopathy, high cholesterol, high blood pressure, those who had eye surgery or trauma, those aged 50 or older, and smokers.

Question 20

If a person is diagnosed with NAION while taking a phosphodiesterase type 5 inhibitor, what is the recommendation?

Answer 20

They should stop using the inhibitor because there’s a 15% to 25% risk of NAION in the other eye in the next 5 to 10 years.

Question 21

What has been reported in some cases after using a phosphodiesterase type 5 inhibitor?

Answer 21

Acute unilateral hearing loss.

Question 22

How soon did the hearing loss typically occur after starting the treatment?

Answer 22

It happened within 1 to 3 days of starting the treatment.

Question 23

What are the symptoms that could accompany the hearing loss?

Answer 23

Tinnitus or vertigo.

Question 24

What is a rare adverse effect associated with phosphodiesterase type 5 inhibitors, particularly sildenafil and vardenafil?

Answer 24

Priapism (prolonged and painful erection).

Question 25

What risk has been associated with sildenafil use?

Answer 25

Increased risk of melanoma (a type of skin cancer
activates
BRAF, a human gene that produces a protein that causes proliferation of melanoma cells.