ED

Question 1

analog of PGE1

Stimulation of adenyl cyclase causes increased production of cAMP which causes smooth-muscle relaxation of the arterial blood vessels to
and sinusoidal tissues in the corpora. This results in enhanced blood flow to and blood filling of the corpora

Answer 1

Alprostadil

Question 2

can cause weight gain, or exacerbate

hypertension, congestive heart failure, and edema

Answer 2

sodium retention a/e of testosterone replacement therapy

Question 3

caused by inhibition of PDE11 in muscle

Answer 3

back and muscle pain PDE5 inhibitors

Question 4

Caution is recommended in airplane pilots

Answer 4

PDE5; rely on green and blue

lights for landing planes

Question 5

decreases intracellular calcium
concentrations to produce smooth-muscle relaxation in cells of the arteries
and cavernosal sinuses. Arterial blood flow to and blood filling of the corpora
are enhanced, and a penile erection results

Answer 5

cAMP

Question 6

enhances the activity of
guanylate cyclase, which increases the conversion of cyclic guanosine
triphosphate to cGMP

Answer 6

Nitric oxide

Question 7

enhances the production of nitric oxide by endothelial cells and
nonadrenergic-noncholinergic neurons

Answer 7

acetylcholine

Question 8

Female sexual partners may experience vaginal burning, itching, or
pain

Answer 8

Intraurethral alprostadil

Question 9

First line for ED

Answer 9

Sildenafil, tadalafil, vardenafil

Question 10

How is priapism managed?

Answer 10

In addition, needle aspiration

of sludged blood in the corpora or intracavernosal injection of α-adrenergic agonists (e.g., phenylephrine) can be used

Question 11

Hypotension
i. Increased sensitivity to light
ii. Blurred vision
iii. Loss of blue-green color discrimination
Back and muscle pain
Priapism
Sudden hearing loss usually on one side involving partial or complete
loss of usual hearing; reversible
Headache, facial flushing, rhinitis (due to vasodilation)

Answer 11

Sildenafil, tadalafil, vardenafil

Question 12

indicated in symptomatic

patients with primary or secondary hypogonadism

Answer 12

Testosterone replacement

Question 13

Intracavernosal
Cavernosal plaques or areas of fibrosis at injection sites
Burning discomfort or dull pain near the injection site or during the erection
Priapism

Intraurethral
Urethra injury leading to urethral stricture and difficulty voiding
Urethral pain
Female sexual partners may experience vaginal burning, itching, or pain
Priapism

Answer 13

Alprostadil

Question 14

intracavernosal - second line for ED

combination therapy - third line for ED

Answer 14

Alprostadil

Question 15

Nitrates (severe hypotension)

Contraindicated in patients at risk of
ophthalmologic problems

Caution in airplane pilots

Answer 15

Sildenafil, tadalafil, vardenafil

Question 16

patients with sickle cell disease or

lymphoproliferative disorders are at risk of what adverse effect of ED drugs?

Answer 16

Patients at risk of priapism

Question 17

PDE5 Inhibitors

decrease catabolism of cGMP

Answer 17

Sildenafil, tadalafil, vardenafil

Question 18

Priapism is rare especially with (1) and (2) because of their
shorter durations of action

Answer 18

1. sildenafil and 2. vardenafil

Question 19

Contraind.
Prostate cancer
BPH

Answer 19

Testosterone replacement

Question 20

Rank order of PDE5 inhibitors: Back and muscle pain

Answer 20

Sildenafil = vardenafil > tadalafil

Question 21

Rank order of PDE5 inhibitors: Hypotension

Answer 21

Sildenafil = vardenafil > tadalafil

Question 22

Rank order of PDE5 inhibitors: Priapism

Answer 22

Tadalafil > sildenafil = vardenafil

Question 23

Rank order of PDE5 inhibitors: Visual adverse effects

Answer 23

Sildenafil > vardenafil > tadalafil

Question 24

resulting from the conversion of testosterone to estrogen

in peripheral tissues

Answer 24

gynecomastia

Question 25

Severe hypotension can occur when PDE5 inhibitors are used in patients taking?

Answer 25

nitrates

Question 26

Sickle cell disease (risk of priapism) Lymphoproliferative disorders (risk of priapism) Thrombocytopenia Anticoagulants Patients with poor-quality injection technique (patients with psychiatric disorders, obese patients, patients who are blind, and patients with severe arthritis)

Answer 26

Alprostadil

Question 27

``` Sodium retention Gynecomastia Decreased HDL cholesterol levels Polycythemia Hepatotoxicity (oral) contact dermatitis (topical) ```

Answer 27

Testosterone replacement

Question 28

Summarize ED treatment

Answer 28

PDE5 inhibitors or non pharmalogic intracavernosal alprostadil injection therapy combination nonpharm with intracavernosal, or intracavernosal with intraurethral penile prosthesis

Question 29

The progression of an erect penis to a flaccid state results from the actions of (1) on (2), which contracts vascular smooth muscle to decrease arterial inflow to the corpora and contracts sinusoidal tissue in the corpora

Answer 29

norepinephrine | α1-adrenergic receptors

Question 30

This correct symptoms of hypogonadism, which include malaise, loss of muscle strength, depressed mood, and decreased libido stimulates androgen receptors in the CNS and is thought to be responsible for maintaining normal sexual drive

Answer 30

Testosterone replacement

Question 31

This results from the agent’s inhibition of phosphodiesterase type 6 in the photoreceptor cells in the retina

Answer 31

Loss of blue-green color discrimination (PDE5 inhibitors)

Question 32

how do nitrates cause severe hypotension when taken with pde5 inhibitor?

Answer 32

nitrates supply NO which increases activity of guanylyl cyclase which converts GTP to cGMP; the hypotensive effects of both drugs cause the issue