ED meds Flashcards
phosphodiesterase 5 inhibitors MOA
inhibition of PDE5 increases cGMP and results in smooth muscle relaxation and inflow of blood to the penis
PDE5 inhibitor education
may take 3-4 doses for effect
lasts 4-6 hours
increased efficacy w high fat meal (sildenafil and vardenafil)
PDE5 inhibitors PK
sildenafil - 30 min to 12 h
vardenafil - 30 min to 10 h
tadanafil - 60 min to 36 h - take continuously
avanafil - 15 min to 6 h
CYP3A4
not for use in hepatic impairment
PDE5 inhibitors AE
facial flushing, HA, indigestion, nasal congestion
vision alterations - stop immediately (sildenafil)
priapism > 4h
hemodynamic instability/cardiac events
PDE5 inhibitors interactions
CYP 3A4
nitrates contraindicated
alpha blockers - hypotension
alprostadil MOA
inhibits calcium ion channels in smooth muscle causing relaxation
onset 30-60 min
ok for post MI!!!
sildenafil dosing
50 mg PO QD PRN 1 h before sexual activity
vardenafil dosing
10 mg QD PRN 1 hr before sexual activity
also orally discintegrating
avanafil dosing
QD PRN 15 min before sexual activity
alprostadil AE
penis/testicle/groin pain, bleeding/spotting, dizziness, hTN
priapism
induction of labor in pregnant female sexual partner
alprostadil dosing
2.5 mcg injection intercavernosally up to 3x/week PRN
or interurethrally BID PRN