ED meds

Question 1

phosphodiesterase 5 inhibitors MOA

Answer 1

inhibition of PDE5 increases cGMP and results in smooth muscle relaxation and inflow of blood to the penis

Question 2

PDE5 inhibitor education

Answer 2

may take 3-4 doses for effect
lasts 4-6 hours
increased efficacy w high fat meal (sildenafil and vardenafil)

Question 3

PDE5 inhibitors PK

Answer 3

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

Question 4

PDE5 inhibitors AE

Answer 4

facial flushing, HA, indigestion, nasal congestion

vision alterations - stop immediately (sildenafil)
priapism > 4h
hemodynamic instability/cardiac events

Question 5

PDE5 inhibitors interactions

Answer 5

CYP 3A4
nitrates contraindicated
alpha blockers - hypotension

Question 6

alprostadil MOA

Answer 6

inhibits calcium ion channels in smooth muscle causing relaxation

onset 30-60 min

ok for post MI!!!

Question 7

sildenafil dosing

Answer 7

50 mg PO QD PRN 1 h before sexual activity

Question 8

vardenafil dosing

Answer 8

10 mg QD PRN 1 hr before sexual activity

also orally discintegrating

Question 9

avanafil dosing

Answer 9

QD PRN 15 min before sexual activity

Question 10

alprostadil AE

Answer 10

penis/testicle/groin pain, bleeding/spotting, dizziness, hTN

priapism

induction of labor in pregnant female sexual partner

Question 11

alprostadil dosing

Answer 11

2.5 mcg injection intercavernosally up to 3x/week PRN

or interurethrally BID PRN