erectile and ejaculatory conditions

Question 1

side effects of whihc drugs and whihc risk factors can lead to eretile dysfunction

Answer 1

antihypertensives
antidpressants
antispychotics
cytotoxic
Recreational drugs including alchol
obesity, smoking, hypercholesteroleamia, metabolic syndrome, sedentary lifestyle

Question 2

what can unexplained erectile dysfunction be a sign of

Answer 2

cardiovascular riskfactors whihc should be addressed

Question 3

what is first line for erectile dysfunction

Answer 3

1st line- exercise, smoking cessation, reduced alcohol
1st line drug oral phosphodiasterase type 5 inhibitor
increases blood flow to penis
short acting- avanafil, sildenafil, vardenafil so can be used for occasional use
ling acting; tadalafil an be used as low daily dose or as an when
pt should receive 6 doses of an individual phosphodiesterase type 5 inhibitor at the max dose before being classified as a non responder

Question 4

what is second line for erectile dysfunction

Answer 4

intracavernosal, intraurethral or topical application of alprostadil
under medical supervison

Question 5

what is premature ejaculation

Answer 5

charateristics: brief ejaculatory latency, loss of control and psychological distress
it can be secondary to erectile dysfunction in whihc case erectile should be treated first

Question 6

what is the treatment for premature ejaculation

Answer 6

non drug: psychosexual counselling, education and behavioural treatments
for pts with lifelong premature ejaculation use dapoxetine is first line as and when
alt include other SSRI and clomipramine regularly

Question 7

what is the caution surrounding prescribing SSRI for premature ejaculation

Answer 7

young adolescents and adults already with depressive siorder esp suicidal

Question 8

what can pts expect a within a few days of starting treatment

Answer 8

ejaculation delay- more evident after 1 to 2 weeks