Erectile Dysfenction

Question 1

Erectile dysfunction

Answer 1

Persistent inability to attain and maintain an erection - physical or psychological cause as well as drug side effects

Question 2

Treatment - what is first line - what is short acting, what is longer acting?? When is it used?

Answer 2

1st line - phosphodiesterase type 5 inhibitor
Increased blood flow to the penis - still requires sexual stimulation
Short acting - Avanafil,sildenafail,vardenafil - occasional use as required
Longer acting - tadalafil - used as required or as a regular lower daily dose to allow spontaneous sexual activity

Question 3

Patients should have how many doses max before being classed as non responder??

Answer 3

Patients should have six doses at the maximum dose with sexual simulation before being classified as a non responder

Question 4

Second line- and what lifestyle changes (intracavernnosal,intrautheral or topical what?)

Answer 4

Intracavernnosal, intraurethral or topical alprostadil - under specialist supervision

Life style changes - smoking cessation,reduce alcohol intake

Question 5

Phosphodiseterase Type 5 inhibitors - what are their side effects? What are the contraindications?

Answer 5

Side effects - flushing, dizziness,nasal congestion, migraine

Contraindications- patients taking nitrates, have hypotension, patients with unstable angina/stroke, patients with angina during intercourse, patients who should have sexual activity

Question 6

Priapism

Answer 6

Erection lasting longer than 4 hours - seek medical attention

Question 7

Alprostadil - near to wear a condom if partner is….

Answer 7

Wear condom if patient is of child bearing age, pregnant or lactating

Question 8

Interactions

Answer 8

Nitrates
Alpha blockers