Erectile Dysfunction Flashcards
What are drugs used for ED?
Alprostadil Avanafil Sildinafil Tadalafil Vardenafil Yohimbine
Alprostadil MOA and AEs? Delivery?
MOA: PGE1 analog Increase adenylate cyclase action: cAMP activate PKA decrease Ca+ Smooth muscle relaxation
AE: CV rare, pain in genitals
Delivery: INJECTION! do not inject in midline. minimal systemization
What are the MOAs of any of the -afil’s?
PDE5 inhibitors:
increase cGMP levels
decrease Ca+
smooth muscle relaxation
What are the AE’s of the -afil’s?
Flushing Priapism CV EFFECTS! (MI, angina) Non-arteric optic neuropathy Retinal artery occlusion Hearing loss
What are PDE5 inhibitors ABSOLUTELY contraindicated with?
Nitrates for chest pain, hypertension
What are possible interactions of the PDE5 inhibitors?
Alpha blockers (hypotension) CYP drugs
What PDE5inh are prolonged by high fat meals?
Avanafil
Sildenafil
What PDE5innh has the longest duration?
Tadalafil (35 hours, others <5)
What PDE5inh causes QT prolongation?
Vardenafil
Does low T cause ED?
No! but T might help in hypogonadal men to increase PDE5 response
What is Yohimbine?
MOA:
mild MAOi that antagonizes literally every nerve receptor
a2 autoreceptor agonism decreases sympathetic stimulation of a2’s
increased NO leads to increased cGMP
vasodilation
What ED drug crosses the BBB?
Yohimbe
What ED drug worsens renal failure?
Yohimbe
What is the one of the most prevalent causes of ED?
Drugs!
What is the most common AE of ED drugs?
Headache
