ED Flashcards
What is the main cause of erectile dysfunction
Arteriogenic -Atherosclerosis (CVS-IHD,CVD,HPT)
What is needed inorder to have a successful and functional erection
Neuro vascular
Neuro- Psychogenic factors
Vascular- NO stimulates cGMP which causes smooth muscle relaxation, PDE5 breaks down cGMP so inhibiting it (by Viagra) will cause increased circling cGMP and an increased SM relaxation and a successful longer erection (SM relaxation causes arterial dilatation and venous compression)
Initiating is neurological and maintaining is vascular
Which antihypertensive medication is ass/w erection dysfunction
Diuretics
Beta blocker (non selective)
Alpha blocker 2
(NB: Alpha blocker 1 & Angiotensin ll receptor blocker decrease the ED rate )
Which antihypertensives decrease ED rate
Alpha 1 blocker
Angiotensin ll receptor blocker
How can you differentiate between psychogenic and organic cause of ED
Presence of nocturnal erection suggests a psychogenic cause rather than an organic
In organic you don’t have an erection
Tx of ED
Lifestyle modification and Risk factor modification
Cause specific tx
1st line: PDE5 inhibitor
2nd line: intracarvenosa injection
-vacuum constriction devices
3rd line: pencil prothesis
Which PDE5 inhibitors can you give in out health context
Sildenafil (Viagra) 50-100mg
Tadalafil 5mg dly or 10-20 prn
Valdernafil 10-20 mg
STV
Which PDE5 inhibitors are long acting
Tadalafil and Vardenafil
What are the adverse effects of PDE5 inhibitors (ED meds)
Hypotension in comb with nitrates
Headache
Flushing
Dizziness
Dyspepsia
Nasal congestion
Visual disturbance (Sildenafil and vardenafil)
Which PDE5 inhibitors cause visual disturbances
Sildenafil (Viagra)
Vardenafil
Inwhivh health conditions or drugs would you increase dose of PDE5 inhibitors
TB- on rifampicin
Antipsychotics- on phenobarbital, phenytoin and carbamezapin
Inwhivh health conditions would you decrease dose of PDE5 inhibitors
HIV- on ARVs
How long is a prolonged erection
More than 4 hours
