Sexual Dysfunction

Question 1

What is ED

Answer 1

Difficulty getting or sustaining an erection that is firm enough for sex

Question 2

Medications that cause ED

Answer 2

Alcohol
Antideprressants (SSRI, SNRI)
Antihypertensives: BB, clonidine, thiazides
Antipsychotics
BPH (Finasteride, dutasteride, silodosin)

Question 3

Supplement for ED

Answer 3

L-arginine, yohimbe, pan ginseng

Question 4

MOA of PDE5I

Answer 4

Release NO → increases cGMP and causes smooth muscle relaxation → ↑ blood flow

Blocks PDE5 from breaking down cGMP

Question 5

Types of PDE5I

Answer 5

Slidenafil
Vardenafil
Tadalafil
Avanafil

Question 6

Slidenafil

Answer 6

Viagra

Revatio (PAH)

Question 7

Vardenafil

Answer 7

Levitra

Question 8

Tadalafil

Answer 8

Cialis

Adcirca (PAH)

Question 9

Avabafil

Answer 9

Stendra

Question 10

Starting dose of Slidenafil

Answer 10

50 mg PO 1 hr before

Question 11

Starting dose of Levitra

Answer 11

10 mg PO 1 hr before

Question 12

Starting dose of Cialis

Answer 12

10 mg PO 30 min before

Question 13

Starting dose of Stendra

Answer 13

100 mg PO 15-30 min before

Question 14

Criteria to reduce dose for PDE5I

Answer 14

≥65 YO
On alpha-blocker
CYP3A4 inhibitor
Severe renal or liver impairment

Reduce by 50%

Question 15

CI of PDE5I

Answer 15

Nitrates

Question 16

ADR of PDE5I

Answer 16

Impaired color discrimination
Hearing loss
Vision loss
Hypotension
Priapism
HA, flushing, DZ, dyspepsia

Question 17

How to take PDE5I

Answer 17

Slidenafil nd Vardenafil ↓ efficacy when taken with high-fat or large meals

Question 18

MOA of alprostadil

Answer 18

Prostaglandin E1, vasodilator to improve blood flow to cavernosal arteries

Question 19

Alprostadil

Answer 19

Caverject (Inj)
Muse (pellets)

Question 20

ADR of Alprostadil

Answer 20

Penile pain, priapism

Question 21

Storage on Muse

Answer 21

Refrigerate

Question 22

MOA of Flibanserin

Answer 22

5-HT1A agonist and 5-HT2A antagonsit

Question 23

MOA of Bremelanotide

Answer 23

Nonselective melanocortin receptro agonist

Question 24

Flibanserin

Answer 24

Addyi

Question 25

Bremelanotide

Answer 25

Vyleesi

Question 26

BBW of Flibanserin

Answer 26

Alcohol → hypotension and syncope REMS DDI with CYP3A4 inhibitors

Question 27

CI of Bremelanotide

Answer 27

Uncontrolled HTN and known CVDi

Question 28

Indications for flibanserin and bremelanotide

Answer 28

Premenopausal females only