[PHARMA] ERECTILE DYSFUNCTION

Question 1

Risk factors of ED (4)

Answer 1

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

Question 2

drugs causing ED (7)

Answer 2

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

Question 3

1ry goal of therapy

Answer 3

achievement + maintenance of erection
improvement quality of life

Question 4

ideal ED therapy

Answer 4

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

Question 5

non pharmacological TTT of ED (7)

Answer 5

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

Question 6

PDE5 inhibitors

Answer 6

sildenafil
tadalafil

Question 7

sildenafil & tadalafil mechanism of action

Answer 7

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

Question 8

sildenafil & tadalafil route of administration

Answer 8

oral

Question 9

1st choice in young patients with ED

Answer 9

sildenafil & tadalafil

Question 10

to prevent hypotension with sildenafil & tadalafil usage:

Answer 10

start w/ small dose + gradually titrate

Question 11

sildenafil & tadalafil use

Answer 11

1-ED
2-pulmonary HTN

Question 12

sildenafil & tadalafil side effects (4)

Answer 12

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

Question 13

visual disturbance w/ sildenafil & tadalafil is due to

Answer 13

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

Question 14

sildenafil & tadalafil contraindications

Answer 14

1-with nitrates & α blockers
2-cardiac patients

Question 15

PGE1 analog

Answer 15

alprostadil

Question 16

alprostadil mechanism of action

Answer 16

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

Question 17

alprostadil route

Answer 17

intracavernosal injection
intraurethral insert

Question 18

route through which alprostadil is more absorbed

Answer 18

intracavernosal injection

Question 19

route through which alprostadil needs large dose to be absorbed

Answer 19

intraurethral insert (MUSE)

Question 20

alprostadil uses (2)

Answer 20

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

Question 21

alprostadil side effects (7)

Answer 21

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)

Question 22

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

Answer 22

alprostadil

Question 23

causes priapism

Answer 23

alprostadil

Question 24

priapism can be prevented by

Answer 24

using lowest effective dose of alprostadil
titration

Question 25

alprostadil should be used w/ caution in patients w/

Answer 25

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

Question 26

Testosterone replacement regimens (TRR) indications

Answer 26

1ry or 2ry hypogonadism ↓libido ↓testosterone

Question 27

TRR route of administration

Answer 27

orally parenterally topically

Question 28

TRR side effects (6)

Answer 28

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

Question 29

gynecomastia w/ TRR is due to

Answer 29

↑conversion of testosterone into estrogen in peripheral tissues

Question 30

hepatotoxicity w/ TRR is w/

Answer 30

oral routes

Question 31

action of testosterone propionate (5)

Answer 31

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

Question 32

action of methyl testosterone (5)

Answer 32

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

Question 33

uses of methyl testosterone & testosterone propionate

Answer 33

male hypogonadism cancer breast

Question 34

synthetic androgen

Answer 34

stanozolol

Question 35

stanozolol advantage

Answer 35

high anabolic effects low androgenic effects promote tissue building

Question 36

stanozolol disadvantage

Answer 36

abused by athletes

Question 37

stanozolol indications (4)

Answer 37

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

Question 38

stanozolol side effects (7)

Answer 38

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

Question 39

finasteride mechanism of action

Answer 39

(-) 5α reductase ↓DHT

Question 40

finasteride uses

Answer 40

prostatic hyperplasia

Question 41

flutamide mechanism of action

Answer 41

competitive inhibitor at androgen receptors

Question 42

flutamide uses (2)

Answer 42

1-cancer prostate 2-acne & hirsutism in females