PDE 5 Inhibitors Adverse Effects/ Side effects Flashcards
Adverse effects like headache and facial flushing result from _______ or _______.
Vasodilation; smooth muscle relaxation
Tadalafil is associated with more lower back and limb pain due to its greater inhibition of
Phosphodiesterase type 11
most common adverse effects of phosphodiesterase type 5 inhibitors are
Headache, facial flushing, dyspepsia, nasal congestion, and dizziness.
Sildenafil and vardenafil cause a decrease of about 8 to 10 mm Hg in _______ and a 5 to 8 mm Hg decrease in _______ blood pressure starting approximate______hour after a dose is taken and last for______hours
Systolic; diastolic
1 and 4
Avanafil and tadalafil typically produce smaller decreases in blood pressure compared to sildenafil and vardenafil, especially when used with other _______ or _______.
Antihypertensives; αadrenergic antagonists
If a patient experiences angina during sexual intercourse after taking a phosphodiesterase type 5 inhibitor, they should stop and rest for the next _______ minutes.
5 to 10
Patients taking multiple antihypertensives or nitrates, or those with baseline hypotension, need to use phosphodiesterase type 5 inhibitors with caution due to the potential for _______ or _______.
Dizziness; palpitations
What is the doserelated adverse effect associated with sildenafil, vardenafil, and avanafil regarding vision?
Increased sensitivity to light, blurred vision, or transient loss of blue–green color discrimination.
What is the mechanism behind the visual adverse effects caused by these drugs?
nhibition of phosphodiesterase type 6 in the photoreceptor cells of retinal rods and cones.
When do visual adverse effects commonly occur after oral dosing of these drugs?
1 to 2 hours after oral dosing when peak serum concentrations are achieved.
Which drug is associated with a lower incidence of visual adverse effects compared to sildenafil and vardenafil?
Tadalafil.
When should all phosphodiesterase type 5 inhibitors be stopped immediately according to product labeling?
If the patient reports vision loss.
What genetic disease associated with retinal phosphodiesterase deficiency should make clinicians cautious in using these drugs?
Retinitis pigmentosa.
What does NAION stand for?
Nonarteritic anterior ischemic optic neuropathy.
What is a significant characteristic of NAION?
Sudden, unilateral, painless blindness, which may be irreversible.
Why is caution advised regarding the use of phosphodiesterase type 5 inhibitors in relation to NAION?
Due to the potential of the blood pressure-lowering effects of these medications to decrease blood flow to the optic nerve, potentially leading to sudden unilateral vision decrease.
In terms of timing, when has NAION been observed in relation to the use of phosphodiesterase type 5 inhibitors?
It has been observed at variable and unpredictable times after starting these inhibitors, ranging from 6 hours to months or years after the first dose.
What does the FDA recommend for patients at risk of NAION regarding these medications?
They should consult an eye specialist, address any risk factors for NAION, and be cautious about using phosphodiesterase type 5 inhibitors.
Who are at risk for NAION?
People with eye conditions like glaucoma, macular degeneration, diabetic retinopathy, high cholesterol, high blood pressure, those who had eye surgery or trauma, those aged 50 or older, and smokers.
If a person is diagnosed with NAION while taking a phosphodiesterase type 5 inhibitor, what is the recommendation?
They should stop using the inhibitor because there’s a 15% to 25% risk of NAION in the other eye in the next 5 to 10 years.
What has been reported in some cases after using a phosphodiesterase type 5 inhibitor?
Acute unilateral hearing loss.
How soon did the hearing loss typically occur after starting the treatment?
It happened within 1 to 3 days of starting the treatment.
What are the symptoms that could accompany the hearing loss?
Tinnitus or vertigo.
What is a rare adverse effect associated with phosphodiesterase type 5 inhibitors, particularly sildenafil and vardenafil?
Priapism (prolonged and painful erection).
What risk has been associated with sildenafil use?
Increased risk of melanoma (a type of skin cancer
activates
BRAF, a human gene that produces a protein that causes proliferation of melanoma cells.
