Sexual Dysfunction Flashcards
flibanserin is for sexual dysfunction in women and can cause what side effect
fainting
what conditions can cause erectile dysfunction
hypertension, atheroschlerosis, diabetes (causes neuropathies)
what drugs classes can contribue to erectyle dysfunction
alcohol, antidepressants, antihypertensives (esp bb, clonidine), antipsychotics (esp 1st generation), BPH meds
what arenatural products that can treat ED
yohimbe, L- argenine, panax ginseng
1st line for treatment of ED
PDE5 inhibitors (sildenafil, vardenafil, tadalafil, avanafil)
absolute contraindication PDE-5
nitrates due to severe hypotension
main reason for treatment failure of pde5
timing of dose
what is the other indicaion of tadalafil (cialis)
benign prosthetic hyperplasia and pulmonary arterial hypertension (also sildenafil)
viagra starting dose and dose to reduce to in select conditions
50mg –> 25mg
Cialis and Levitra starting dose and dose to reduce to
10mg –> 5mg
Stendra starting dose and dose to reduce to
100mg –> 50mg
What are the select conditions to reduce dose
> 65, using an alpha-blocker, using a CYP3A4 inhibitor (PACMANG), Severe liver or renal disease
sildenafil and vardenafil timing before activity
take 1 hour before activity
tadalafil timing before activity
30 min
avanafil time before activity
15-30 min
when to seek medical help on a pde5
if the erection lasts more than 4 hours, if chest pain
warnings for pde5 inhibitors
vision loss (impaired color discrimination), hearing loss, hypotension, priapism
administration of pde5
with or without food but sildenafil and vardenafil may have decreased efficacy with a high-fat meal
how many doses per day for ED
one
if on an alpha-blocker how do you start a PDE5 inhibitor
make sure stable on alpha-blocker
what molecularly happens during an erection
local release of nitric oxide to increase cGMP and causes smooth muscle relaxation to permit blood flow in
moa of a pde5 inhibitor
block pde5 from degrading cGMP
MOA of alprostadil
it is a prostoglandin E1, a vasodilator that allows blood to flow into the arteries. Either injected into the penis or a pellet is inserted through the urethra
flibanserin and bremelanotide moa and indication
agonist activitis at 5-HTIA and used in premenopausal females only
contraindication filbanserin
contraindicated with alcohol (REMS) and in combination with CYP3A4 inhibitors
bremelanotide comes in what form and is contraindicated in what
injection, contraindicated in cardiovascular disease
revatio is what
sildenifil for PAH
adcirca is what
tadalafil for PAH
cialis is what
tadalafil
viagra is what
sildinefil
levitra
verdenafil
stendra
avanafil
