Erectile Dysfunction Flashcards
What arteries and veins lead to an erection?
Cavernosal (they are inside the penis)
Whats the muscle responsible for an erection?
Ischiocavernosus muscle (IC) (points)
Whats the muscle responsible for seman ejaculation?
Bulbocavernosus muscles (BC) (shoot)
Sildenafil
Viagra
Onset = .5 - 1 hour
Half-life = 3-5 hours
Duration of effects = 4 hours
Cyps = 3A4 and 2C9
Vardenafil
Levitra
Onset = .5 - 1 hour
Half-life = 4-5 hours
duration of effects = 5
Cyps = 3A4
Tadalafil
Cialis
Onset = 1-2 hours
half-life = 18
Duration of effects = up to 36 hours
CYPs = 3A4
Avanafil
Stendra
Onset = .25- .5
Half-life = 3 hours
Duration = up to 4 hours
CYPs = 3A4 and 2C9
What are the CYP3A4 inhibitors?
G = grapefruit juice P = HIV / Hep C protase inhibitors A = Azole antifungles C = Cimetide M = Macrolide antibiotics A = Amiodrone N = Non-DHP Ca blockers (verapmil and diltiazem) S = some statins ( Lova, simva)
G PACMANS
What are the CYP3A4 inducers
P = Phenobarbitals P = Phenytoins R = Ritampin (antibiotic) S = St. Johns wort (used in depression) C = Carbamazepine
CPR PS
Adverse effects of PDE5 inhibitors
Headache Flushing Dyspepsia (stomach upset) Nasal congestion Dizziness Visual Disturbance Back pain Priapism Hypotension Sudden hearing loss Non-arteric ischemic optic neuropathy (NAION), Very rare and an eye issue
What is the most notable adverse effect of sildenafil?
Viagra
Visual Disturbances
What is the most notable adverse effect of Vardenafil
Levitra
Nasal Congestion
What is the most notable adverse effect of Tadalafil
Cialis
Back pain, myalgias
What is the most notable adverse effect of Avanafil?
Stendra
Back pain
What are the PDE drugs used to treat pulmonary hypertension?
Sildenafil (Revatio)
Tadalafil (Adcirca)
What is alprostadil?
Stimulates smooth muscle adenyl cyclase, which increases cAMP and dilates penile arteries
**doesnt work as well as PDE 5 inhibits which work on gyulate cyclase and cGMP
What are the side effects of MUSE?
Alprostadil
Penile and/or urethral pain Vaginal pain (due to prostilagins getting into the vagina) Priapism Hypotension Dizziness
***NO DRUG INTERACTIONS
Must stand or walk for about 10 minutes while erection develops
What are the side effects of Caverject?
Alprostadil
Penile pain
Injection site pain and bruising
Priapism `
Whats something that must be avoided in when a pt is using MUSE?
Alprostadil
Pregnant women
This is because protiglandins can transfer to the female and can lead to an abortion of the child
What is the drug interaction for caverject?
Alprostadil
Anticoagulants (warfarin, heparin) increase risk for systemic bleeding
