ED

Question 1

What are the four systems necessary for a normal erection

Answer 1

Vascular
Nervous
Hormonal
Psychological

Question 2

What are chronic medical conditions associated with ED

Answer 2

HTN
DM
prostate issues
Coronary & peripheral vascular disease
Neurologic disorders
Endocrine disorders
Psychiatric disorders
Dyslipidemia
Renal failure
Liver disease
Penile disease

Question 3

What medication classes are associated with ED

Answer 3

antihypertensives
lipid meds
antidepressants
Histamine antagonist
antipsychotics
anticonvulsants
antiandrogens
Recreational drugs

Question 4

What is general approach to treating ED

Answer 4

identify and reverse underlying cause
assess ability to perform sexual activity
consider partner issues

Question 5

What are MOA, AE and CI for Phosphodiesterase Type 5 inhibitors with ED

Answer 5

MOA:
inhibit cGMP breakdown by PDE5, so NO/cGMP can aid in erection

AE:
HA
facial flusing
dyspepsia
nasal congestion
dizziness
abnormal vision
prolonged or priapism erections
decrease BP
optic neuropathy issues

CI:
Nitrates
alpha-blockers
high CV risk
sickle cell anemia
multiple myeloma
leukemia

Question 6

What are MOA, dosing, AE and CI for Alprostadil with ED

Answer 6

MOA:
stimulate adenyl cyclase and that increases cAMP

DOSE:
Caverject 1.25 - 60 mcg 5-10 min before sex
Muse (urethral) 125 - 1000 mcg 5-10 min before sex

AE:
local pain
syncope
dizziness
priapism
fibrotic reaction

CI:
priapism
sickle cell anemia
anticoagulants
bleeding disorders

Question 7

What are AE and CI for testosterone with ED

Answer 7

AE:
gynecomastia
dyslipidemia
polychthemia
acne
weight gain
HTN
edema
HF

CI:
prostate cancer
breast cancer
BPH