Men's Health Flashcards
Where does Sildenafil work?
(phosphodiesterase PDE inhibitor)
Corpus cavenosum of penis
AND the arteries of the lungs , therefore used to treat primary pulmonary hypertension (secondary care ‘Revatio’ tablets)
Sildenafil is a vasodilater, therefore what are it’s side effects?
flushing, headache, dizziness (and nasal congestion)
More seriously can cause; hypotension, tachycardia and palpitations - small risk of stroke.
Contraindications of sildenafil are:
In cases where vasodilation would be dangerous; history of CV disease, stroke
Caustion if taking other vasodilators e.g. CCB and alpha-blockers - increased risk of hypotension
Dosage of sildenafil
50mg initially, up to 100mg OD, take one hour before sexual activity and adjust according to response.
Respond is delayed if taken with food.
NB. If taken with ‘poppers’ - amyl nitrate, can cause collapse.
name 3 alpha-blockers and what are their two main uses?
doxazosin, tamsulosin, alfuzosin
- relax smooth muscle in benign prostatic hyperplasia.
- Add on for resistant hypertension (relaxes smooth muscle in blood vessels)
Side effects of alpha-blockers are predicable from their MOA - what are they? (2)
- Postural hypotension
- Dizziness/ syncope
note: effect is more prominent after the 1st dose, and maybe worse omitted an anti-hypertensive medication on the 1st day alpha-blockers and started.
What’s the difference between doxazosin and tamsulosin?
Tamsulosin is ONLY licensed for benign prostatic hyperplasia
Doxazosin is licensed for BPH and hypertension
The blood pressure lowering effect of tamsulosin is less pronounced than for doxazosin.
note: take doxazosin at NIGHT because of blood pressuring lowering effect.
Alpha blockers - what to tell the patient
Can cause dizziness on standing, especially after the 1st dose. Take at bedtime to minimise the risk.
Titrate if needed, according to symptom response.
