[PHARMA] ERECTILE DYSFUNCTION Flashcards

1
Q

Risk factors of ED (4)

A

1-DM
2-hyperlipidemia
3-HTN
4-anxiety

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2
Q

drugs causing ED (7)

A

1- antihypertensives
2-antidepressants
3-antipsychotics
4-lipid lowering drugs (statin)
5-antiandrogen
6-narcotics
7-H2 blockers

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3
Q

1ry goal of therapy

A

achievement + maintenance of erection
improvement quality of life

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4
Q

ideal ED therapy

A

1-minimal side effects
2-quick onset
3- few or no drug interactions

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5
Q

non pharmacological TTT of ED (7)

A

1-exercise
2-weight loss
3-smoking cessation
4-stop drugs
5-psychotherapy
6-vacuum erection devices
7-prostheses

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6
Q

PDE5 inhibitors

A

sildenafil
tadalafil

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7
Q

sildenafil & tadalafil mechanism of action

A

(-) PDE5 in cavernousal body
(-) cGMP metabolism
↑cGMP
maintain VD

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8
Q

sildenafil & tadalafil route of administration

A

oral

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9
Q

1st choice in young patients with ED

A

sildenafil & tadalafil

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10
Q

to prevent hypotension with sildenafil & tadalafil usage:

A

start w/ small dose + gradually titrate

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11
Q

sildenafil & tadalafil use

A

1-ED
2-pulmonary HTN

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12
Q

sildenafil & tadalafil side effects (4)

A

1-VD, hypoTN
2-flushing, headaches, nasal congestion, back pain
3-affect contractility
4-visual disturbance

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13
Q

visual disturbance w/ sildenafil & tadalafil is due to

A

(-) PDE6 in retina= loss of discrimination b/w green & blue

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14
Q

sildenafil & tadalafil contraindications

A

1-with nitrates & α blockers
2-cardiac patients

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15
Q

PGE1 analog

A

alprostadil

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16
Q

alprostadil mechanism of action

A

(+) adenyl cyclase= ↑cAMP= smooth msc relaxation of BV

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17
Q

alprostadil route

A

intracavernosal injection
intraurethral insert

18
Q

route through which alprostadil is more absorbed

A

intracavernosal injection

19
Q

route through which alprostadil needs large dose to be absorbed

A

intraurethral insert (MUSE)

20
Q

alprostadil uses (2)

A

1-ED
2-maintain patency of ductus arteriosus in patients w/ congenital pulmonary stenosis pre-surgery

21
Q

alprostadil side effects (7)

A

1-penile pain
2-cavernosal fibrosis @ injection site
3-hematoma
4-bruising
5-vaginal itching in sexual partner
6-priapism
7-dizziness & tachycardia (if absorbed systematically)

22
Q

used to maintain patent ductus arteriosus in patients w/ congenital pulmonary stenosis until surgery

A

alprostadil

23
Q

causes priapism

A

alprostadil

24
Q

priapism can be prevented by

A

using lowest effective dose of alprostadil
titration

25
Q

alprostadil should be used w/ caution in patients w/

A

1-thrombocytopenia
2- on anticoagulants
3-poor quality injection technique

26
Q

Testosterone replacement regimens (TRR) indications

A

1ry or 2ry hypogonadism
↓libido
↓testosterone

27
Q

TRR route of administration

A

orally
parenterally
topically

28
Q

TRR side effects (6)

A

1-Na retention
2-Gynecomastia
3-hyperlipidemia
4-polycythemia
5-hepatotoxicity w/ oral routes
6-contact dermatitis

29
Q

gynecomastia w/ TRR is due to

A

↑conversion of testosterone into estrogen in peripheral tissues

30
Q

hepatotoxicity w/ TRR is w/

A

oral routes

31
Q

action of testosterone propionate (5)

A

androgenic:
1-sex organs development
2-2ry sex characters
3-spermatogenesis
anabolic:
1-protein synthesis
2- ↑ bone & muscle development

32
Q

action of methyl testosterone (5)

A

androgenic:
1-sex organs development
2-2ry sex characters
3-spermatogenesis
anabolic:
1-protein synthesis
2- ↑ bone & muscle development

33
Q

uses of methyl testosterone & testosterone propionate

A

male hypogonadism
cancer breast

34
Q

synthetic androgen

A

stanozolol

35
Q

stanozolol advantage

A

high anabolic effects
low androgenic effects
promote tissue building

36
Q

stanozolol disadvantage

A

abused by athletes

37
Q

stanozolol indications (4)

A

1-chronic debilitating diseases (cancer)
2-osteoporosis (in postmeno women & elderly men)
3-prolonged immobilization
4-growth in boys w/ delayed puberty

38
Q

stanozolol side effects (7)

A

1-virilization
2-acne in females
3-azoospermia
4- ↑libido in males
5-short stature in children
6-cholestatic jaundice
7-cancer liver

39
Q

finasteride mechanism of action

A

(-) 5α reductase
↓DHT

40
Q

finasteride uses

A

prostatic hyperplasia

41
Q

flutamide mechanism of action

A

competitive inhibitor at androgen receptors

42
Q

flutamide uses (2)

A

1-cancer prostate
2-acne & hirsutism in females