Sexual Dysfunction

Question 1

causes of ED/SDF

Answer 1

HTN
atherosclerosis
DM and nephropathy
stroke
sp cord injury

Question 2

drugs that can cause ED/SDF

Answer 2

SSRI/SNRI
alcohol
BB
clonidine
thiazides
1st gen APs
BPH meds (-eride)
nicotine

Question 3

what are the treatment class options for men with ED

Answer 3

PDE5-i
natural products (not rec)

Question 4

tadalafil
brand name
nickname
tablet appearance
dosing

Answer 4

Cialis
the weekender (longest lasting)
brown rounded triangle
10mg 30 min before sexual activity

Question 5

sildenafil
brand name
nickname
tablet appearance
dosing

Answer 5

Viagra
“Vitamin V” “little blue pill”
blue square
50mg one hour before sexual activity

Question 6

when do doses of PDE5-i need to be reduced? By how much?

Answer 6

reduce dose 50% when
- 65+ yo
- on alpha blocker (BPH)
- on 3A4-i (clarithro, amio, azoles, nonDHP)
- renal or liver disease

Question 7

side effects of PDE5-i

Answer 7

priapism
dec BP
DDI nitrates
tinnitus
vision changes

Question 8

tadalafil-specific SE

Answer 8

back or muscle pain within 12-24 hours

Question 9

71 yo male PMH HTN, HLD, CKD 3a, BPH on finasteride and tamsulosin is to initiate sildenafil.
What dose of sildenafil is appropriate?

Answer 9

reduced dose required due to
- >65 yo
- CKD
- on alpha blocker tamsulosin

therefore 25mg PO daily PRN

Question 10

what are tx options for premenopausal women with HSDD (hypoactive sexual desire disorder)

Answer 10

Flibanserin (Addyi)
Bremelanotide (Vyleesi)

Question 11

Vyleesi ADE

Answer 11

HTN!!
CI in uncontrolled HTN

Question 12

Addyi ADE

Answer 12

hypotension, syncope