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Rx Prep > Sexual Dysfunction - Quiz 3 > Flashcards

Sexual Dysfunction - Quiz 3 Flashcards

1
Q

What is ED?

A

Difficulty getting or sustaining an erection for sex

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2
Q

HSDD drugs are only indiated for who?

A

Premenopausal women only

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3
Q

What is an antidepressant that doesn’t cause sexual dysfunction?

A

Buproprion

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4
Q

Medications that can cause ED?

A
  1. Alcohol
  2. Antidepressants (SSRIs, SNRIs)
  3. Antihypertesives (beta-blockers, clonidine, thiazides)
  4. First gen antipsychotics
  5. Prolactin raising second gen
  6. BPH meds (finasteride, dutasteride, silodosin)
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5
Q

Non pharm tx for ED?

A
  1. Weight loss
  2. Quitting tobacco
  3. Reducing alcohol intake
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6
Q

Natural products for ED?

A
  1. Yohimbe
  2. L-arginine
  3. Panax ginseng (increases risk for bleeding)
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7
Q

What is the first line tx for ED?

A

PDE-5 inhibitors:
1. Slidenafil
2. Vardenafil
3. Tadalafil
4. Avanafil

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8
Q

Reasons for PDE5 inhibitor treatment failure?

A

Timing of dose

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9
Q

PDE5 inhibitor indicated for BPH?

A

Tadalafil (Cialis): 5 mg PO QD

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10
Q

PDE5 inhibitors that can treat PAH?

A
  1. Sildenafil (Revatio)
  2. Tadalafil (Adcirca, ALyq)
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11
Q

Describe the MOA of PDE5-I?

A

Inhibits the degradation of cGMP upon NO release to relax the smooth muscles in the arteries increasing blood flow maintaining an erection

Requires libido to work

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12
Q

Sildenafil

A

Revatio, Viagra

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13
Q

Tadalafil

A

Cialis, Adcirca, Alyq

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14
Q

Vardenafil

A

Levitra

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15
Q

Avanafil

A

Stendra

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16
Q

Starting dose of Viagra?

17
Q

Starting dose of Cialis?

18
Q

Starting dose of Levitra?

19
Q

Starting dose of Stendra

20
Q

When would you see a reduction in PDE5I starting dose? What are the lower doses?

A
  1. ≥65YO
  2. Using an alpha blocker
  3. Using CYP3A4 inhibitor
  4. Severe renal and hepatic impairment

Reduce dose by 50%

21
Q

CI for PDE5I?

22
Q

ADRs of PDE5I?

A
  1. Impaired color discrimination
  2. Hearing loss
  3. Vision loss
  4. Hypotension
  5. Priapism
  6. Chest pain
  7. HA, flushing, DZ, dyspepsia
  8. Back pain (tadalafil)
23
Q

How should you take PDEIs?

A

Sildenafil: 1 hr before
Vardenafil: 1 hr before
Tadalafil: 30 min before
Avanafil: 15-30 min before

Sildenafil and vardenafil can have decreased activity with high fat foods or large meals

Don’t take more than 1 dose per day

24
Q

Why are PDE5I CI with nitrates?

A

Can cause severe hypotension

25
Q

What is another class of drug used for ED other than PDE5I?

A

Prostaglandin E1: Alprostadil (Caverject, Muse)

26
Q

MOA of PG E1?

A

Vasodilator allowing blood flow into the cavernosal arteries -> enlarging the penis

27
Q

Difference between Caverject and Muse

A

Caverject: Intracavernous injection
Muse: Require refrigeration (Urethral pellet)

28
Q

ADRs of alprostadil?

A

Penile pain, priapism

29
Q

Drugs indicated for hypoactive sexual desire disorder? Drug classes?

A

5-HT1A agonist/5-HT2A antagonsit: Filbanserin (Addyi)
Nonselective melanosortin receptor agonist: Bremelonotide (Vyleesi)

30
Q

Formulation os Vyleesi?

31
Q

BBW of Addyi?

A

CI: acohol due to severe hypotension and syncope (REMS program)
Combination with CYP3A4 inhibitors

32
Q

ADR of Filbanserin?

A
  1. Hypotension
  2. Syncope
33
Q

CI for bremelonatide?

A

Uncontrolled hypertension or CVD

34
Q

Alprostadil

A

Caverject, Muse

35
Q

Filbanserin

36
Q

Bremelanotide

37
Q

Counseling points for all PDE5i?

A
  1. When to take it
  2. Sexual activity can put strain on heart
  3. Cause: priapism, orthostasis and hypotension, DZ, HA, flushing, and indigestion
  4. Tinnitus
  5. Vision changes
38
Q

Counseling for tadalafil (Cialis)

A

Can cause back pain (last up to 2 days)

Rx Prep (15 decks)

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