ERECTILE DYSFUNCTION

Question 1

Erectile dysfunction

Answer 1

persistent inability to attain and maintain an erection

Question 2

Treatment

Answer 2

1. phosphodiesterase type 5 inhibitor

Question 3

MOA for PD-5i

Answer 3

PDE5 inhibition = increase CGMP
release of NO in corpus cavernous = increase cGMP = smooth muscle relaxation = inflow of blood

Question 4

Short acting PD-5i

Answer 4

avanafil
sildenagil
vardenafil
occasional use prn

Question 5

Longer acting PD-5i

Answer 5

tadalafil
prn or as a regular lower daily dose to allow for spontaneous sexual activity

Question 6

Maximum dose

Answer 6

6 dose maximum before being classified as a non responder

Question 7

Second line treatment

Answer 7

Intracernosal, intraurethral or topical alprostadil
under medical supervision

Question 8

lifestyle changes

Answer 8

smoking cessation
reduce alcohol intake

Question 9

side effects

Answer 9

flushing
dizziness
nasal congestion
migraine

Question 10

Counselling

Answer 10

• Take before food
• Onset of effect may be delayed if taken with food

Question 11

Contraindication

Answer 11

hypotension
unstable angina/ stoke
angina during intercourse

Question 12

Priapism

Answer 12

erection lasting longer than 4 hours
seek medical attention

Question 13

Alprostadil counselling

Answer 13

wear condom if patient is of child bearing age, pregnant or lactation

Question 14

Interactions

Answer 14

nitrates
alpha blockers - hypotensive effect