sexual dysfunction Flashcards
what neurotransmitter is released with sexual stimulation
nitric oxide
what does the release of nitric oxide cause in the erection cascade
increases synthesis of cGMP which causes smooth muscle relaxation in corpus cavernosum allowing increased blood flow to the penis
what regulates cGMP
PDE-5
how do PDE-5 drugs work
when PDE-5 is inhibited cGMP is increased which enhances blood flow to penis
when is max plasma concentration reached for PDE-5 inhibitors
30-120 minutes
high fat meal with PDE-5 inhibitors
delays absorption and decreases peak concentration
which enzymes metabolize PDE-5 inhibitors
3A4
to a lesser degree 2C
PDE-5 inhibitors and nitrites
contraindicated
can cause fatal hypotension
what medication is used to treat priapism
phenylephrine
tagamet and PDE-5 inhibitors
concentration of PDE-5 increased by 56%
PDE-5 inhibitors and erythromycin
increased concentration of PDE-5 inhibitor by 182%
what is a 3A4 inducer that decreases concentration of PDE-5 inhibitors
rifampin
typical dose and range for sildenafil
50mg 1h prior to sex
range: 25-100mg
frequency of sildenafil use
not more than once daily
when should you start sildenafil at 25mg
advanced age
cirrhosis
severe renal impairment
3A4 inhibitors
