Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Exam 3 lecture 6 > Flashcards

Exam 3 lecture 6 Flashcards

1
Q

define ED

A

inability to maintain erection sufficient for penetration to permit satisfactory sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

decreased libido

A

decreased sexual drive or desire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

increased libido

A

precocious puberty; inappropriate and excessive sexual drive or desire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

delayed ejaculation

A

aka “dry sex”; ejaculation is delayed or absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

retrograde ejaculation

A

ejaculate passes retrograde into the bladder instead of toward the anterior urethra (antegrade) & out of the penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

infertility

A

insufficient # of sperm, abnormal morphology or have inadequate motility & fail to fertilize the ovum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

psychogenic cause of ED

A
  • not as receptive to sexual stimuli
  • age-related decline in arousability
  • situational: partner related, performance related
  • psychological distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

organic cause of ED

A
  • neurogenic:(innervation issue- stroke, dimentia, tumor, DM, chronic ETOH)
  • vascular: (impaired blood flow)- PVD, HTN, trauma, atherosclerosis
  • hormonal: decr. test, hyperprolactinemia, hypothyroidism, hyperthyroidism
  • medication induced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

medications that can cause ED

A

anticholinergics, antidepresssants/antipsycotics, DA antagonists, estrogens/antiandrogens, CNS depressants, HTN drugs, other (cigarettes & alcohol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

international index of erectile function (IIEF)

A

pt questionare to objectively measure symptoms.

  • includes: erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall satisfaction
  • classifies: severe- no ED
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pharmacologic therapies to treat iodiopathic ED

A
  • PDE5 inhibitors

- synthetic prostaglandin E1 analog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

first line therapy for management of ED

A

PDE5 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pros of PDE5 inhibitors

A
  • effectivness, route of administration, low side effects, discreet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PDE5 inhibitor MOA

A
  • blocks PDE5 -> NO breakdown of cGMP-> NO increase in Ca-> smooth muscle RELAXATION-> incr. blood flow-> erection prolonged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

dutumenscence

A

return of penis to relaxed state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PDE5 selective

A

-genital tissue, tracheal smooth muscle, platelets- bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PDE6 selective

A

(Sildenafl»vardenafil)

- photoreceptors in the retina- incr. sensitivity to light, blurred vision, loss of blue-green color discrimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PDE11 selective

A

(Tadalafil»>all others)

- skeletal muscle- back & muscle pain

19
Q

PDE5 inhibitor contraindications

A

concurrent use of regular or intermittent nitrates

20
Q

PDE5 inhibitor side effects

A
  • common: HA, dizziness, flushing dyspepsia
  • severe(rare): priapism, hearing impairment, visual disturbances, myalgias/back pain, nonarteritic anterior ischemic optic neuropathy (NAION)
21
Q

priapism

A

erection lasting >4hours

22
Q

nonarteritic anterior ischemic optic neuropathy (NAION)

A
  • blood flow blocked to the optic nerve
  • rapid onset of painless, unilateral vision loss
  • risk factors: glaucoma, etc
23
Q

PDE5 inhibitor drug interaction

A
  • nitrates
  • CYP3A4 inhibitors (macrolides & azoles)
  • antihypertensives (alpha 1- blockers)
  • alcohol
24
Q

which drugs do you need to take on an empty stomach or low fat meal?

A

sildenafil & vardenafil

25
Q

synthetic prostaglandin E1analog

A

alprostadil

26
Q

alprostadil MOA

A

increases production of cCAMP-> muscle relaxation

27
Q

pros of alprostadil

A
  • efficacy

- good for multiple ED etiologies

28
Q

cons of alprostadil

A
  • inconvenient administration- injection/suppository
  • unnatural erection
  • needle phobia
  • cost of therapy
29
Q

duration of erection is directly related to the dose for what drug?

A

alprostadil

30
Q

alprostadil injection dose

A
  • vasculogenic, pyschogenic: 2.5mcg; 60mcg max
  • neurogenic: 1.25mcg; range 1.25-20)
  • max 3 doses/wk with >24 hours inbetween
31
Q

alprostadil (Caverject or Edex) counseling points

A
  • store at RT
  • reconstitute prior to use
  • inject 5-10 minutes prior
  • erection will last ~1 hour
32
Q

alprostadil (MUSE) counseling points

A
  • intraurethral suppository
  • store in fridge
  • empty bladder before use
  • sit, stand or walk around while erection develops- improve erection quality
33
Q

erections with alprostadil shouldn’t last longer than

A

1 hour

34
Q

3 parts of a vacuum erection device (VED)

A

pump, cylinder and tubing

35
Q

VED MOA

A

vacuum pressure draws blood into the corpora cavernosa

  • onset of action: 0.5 hours
  • better response in combo with alprostadil
36
Q

what is first line in patients in monogamous relationships?

A

VED

37
Q

secondary erectile dysfunction due to

A

hypogonadism- use hormone replacement therapy (HRT)

38
Q

signs/symptoms of low testosterone

A
  • decreased libido
  • decreased muscle strength
  • depressed mood
  • normal levels: 300-1100
39
Q

supplemental testosterone does not

A

directly treat ED, but improves libido

40
Q

formulations that testosterone comes in

A

PO, buccal, IM, patch, gel, implant

41
Q

testosterone therapy side effects

A
  • cardio: edema, flushing, HTN, < HDL
  • CNS: aggrssion, anxiety, excitation
  • derm: acne, hirsutism, dry skin
  • endo: hypoglycemia, gynecomastia, weight gain, Na retention
  • worsening sleep apnea, increased Hct
42
Q

topical testosterone patch is applied when and where?

A

at night. Scrotum, arms, buttocks or back

43
Q

topical testosterone gel is applied when and where?

A

in the morning, shoulders, upper arms, abdomen

44
Q

hebal ED treatment

A
  • yohimbine
  • aphrodisiac
  • central alpha 2 antagonist
  • not recommended

Reproduction (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions