Padda 2023 PDEis Flashcards
phosphodiesterase inhibitors are class medications used in the management and treatment of
chronic obstructive pulmonary disease(COPD), erectile dysfunction(ED), pulmonary arterial hypertension(PAH), benign prostatic hyperplasia(BPH), acute decompensated heart failure, psoriasis, psoriatic arthritis(PA), atopic dermatitis(AD), and neonatal apnea.
MoA
In the class of medications that prevent cAMP and/or cGMP degradation, it exhibits smooth muscle relaxation, vasodilatory, and bronchodilatory effects.
most common PDE5i for ED
sildenafil
sildenafil originally used to treat
pulmonary arterial hypertension
PDE5i approved to treat ED
- sildenafil
- vardenafil
- avanafil
- tadalafil
which PDE5i is also approved for BPH
tadalafil
Cilostazol class
PDE3i
Cilostazol MoA
PDE-3 inhibitor that reversibly inhibits platelets from aggregation and is indicated to treat intermittent claudication from peripheral arterial disease(PAD)
Dipyridamole class and use
PDE-3 inhibitor and is used for postoperative prophylaxis for thrombosis, but its action on the PDE-3 enzyme is relatively weak. Dipyridamole can also be a diagnostic tool as a pharmacologic nuclear stress test. Dypriadamole increases perfusion to the myocardium, revealing reversible and irreversible ischemic areas in the myocardial muscle
milrinone class
PDE3
amrinone class
PDE3i
Milrinone and amrinone also inhibit PDE-3 enzymes, but
their actions target heart cells, increasing cAMP in the myocardium, and producing a positive inotropic effect. Both agents may be used short-term for decompensated heart failure as therapy for greater durations may precipitate ventricular arrhythmias.
Roflumilast class
PDE4i
Roflumilast MoA
acts on the target cells of lung tissue and is indicated for the treatment of reducing COPD exacerbations.
crisabarole class
PDE4i
Apremilast class
PDE4i
Apremilast/crisaborole use
psoriasis, PA, aD
Theophylline class
non-specific PDE4i
Theophylline use
COPD (symptomatic relief)
pentoxifylline class
xanthine analog; non-selective PDEi
Pentoxifylline use
muscle pain caused by PAD
anagrelide class
PDE3i
anagrelide use
thrombocythemia caused by myeloproliferative disorders
Caffeine class
PDEi (by one of its 3 MoAs; also a CNS stimulant and apnea treatment)
which are approved for ED?
- sildenafil
- tadalafil
- vardenafil
- avanafil
which are approved for BPH?
tadalafil
which are approved for pulmonary arterial hypertension
sildenafil, tadalafil
which are approved for psoriatic arthritis
apremilast
which are approved for psoriasis
apremilast
which are approved for COPD?
theophylline, roflumilast
which are approved for PAD
cilostazol, pentoxifylline
whihc are approved for postoperative thromboembolic prophylaxis?
dipyridamole
which are approved for decompensated cardiac failure
milrinone, amrinone
which are approved for AD?
crisaborole
which are approved for thrombocythemia
anagrelide
which are approved for neonatal apnea
caffeine citrate
roflumilast AEs
Gastrointestinal symptoms: nausea, vomiting, diarrhea
Weight loss
Decreased appetite
Headache
Insomnia
Dizziness
Anxiety
Worsening depression
BBW CI: cilostazol
HF
BBW CI: milrinone
should not be used for >48 hours for HF as can cause ventricular arrhythmias and result in death
