B8-071 Treatment of Male Sexual Disorders Flashcards
testosterone deficiency is defined as 2 morning levels less than […] ng + symptoms
300
inability to consistently achieve and maintain a satisfactory erection for sexual activity
erectile dysfunction
why is it important to identify underlying comorbid conditions in ED patients?
high correlation of underlying CVD/diabetes
what is the mechanism of PDE5 inhibitors?
increase cGMP –> NO –> smooth muscle relaxation
-afils
PDE5 inhibitors
major contraindication to PDE5 inhibitors
nitrates for chest pain
men with ED and TD have better benefit when a PDE5i is combined with […]
testosterone therapy
ED med that bypasses the nerves
also can be used in patients that fear injections
MUSE (alporatadil)
urethral suppository
persistent erection lasting 4 or more hours
priapism
which type of priapism is more dangerous?
low flow
[high vs low flow priapism]
painful
glans is soft
low flow
[high vs low flow priapism]
caused by sickle cell disease
low flow
[high vs low flow priapism]
can be caused by trazadone, cocaine, and prazosin
low flow
[high vs low flow priapism]
can be caused by incorrect use of intracavernosal agents
low flow
treatment for low flow priapism
irrigation & distal shunts
(no proximal shunts)
[high vs low flow priapism]
cause tissue death/necrosis
low flow
[high vs low flow priapism]
non-painful
glans full
high flow
[high vs low flow priapism]
caused by trauma resulting in AV fistula
high flow
high vs low blood flow priapism can be determined via what test?
ABG
treatment of high flow priapism
embolization
when using VED, patients should not wear the ring greater than […] min
30 min
bleeding/clotting disorders are a contraindication to what ED treatment?
VED
acquired penile deformity due to fibrosis
peyronie’s disease
most common cause of delayed ejaculation
SSRIs
(followed by neurologic diseases)
common causes of premature ejaculation
anxiety, ED, TD, thyroid
common causes of aspermia
DM, autonomic dysfunction, previous surgery
“lack of sex drive” refers to
libido
the most common disorders affecting libido include disturbances in [3]
testosterone levels
pysch disorders
hormone disorders
physiologically, an erection is the result of increased […] and decreased […] to the penis
physiologically, an erection is the result of increased [blood flow] and decreased [outflow] to the penis
[…] stimulation results in ejaculation and detumescence
sympathetic
MOA of PDE 5i
inhibit cGMP breakdown
results in increased NO/decreased calcium –>smooth muscle relaxation –> increased blood flow via vasodilation
which PDE 5i has the longest half-life?
tadalafil
[…] is the best test to determine high flow priapism vs. low flow
penile blood flow
a blood gas with a pO2 below […] is diagnostic of low flow priapism
40
erection is a function of the […] nervous system
parasympathetic
Point, squeeze, shoot
erection: NO leads to the increase of [….], allowing for smooth muscle relaxation
cGMP
NE leads to the increase of […], allowing for smooth muscle contraction –> antierectlice
intracellular Ca++
emission is a function of the […] nervous system
sympathetic
Point, squeeze, shoot
MOA of PDE 5i
decrease breakdown of cGMP
