T4-Erectile Dysfunction

Question 1

How do you get an erection?

Answer 1

Sexual stimulation occurs causing the release of nitric oxide which releases cyclic GMP [muscle relaxation of corpus cavernosum]. The muscle relaxation causes the penis to fill up with blood. ERECTION!

Question 2

What does PDE5 do?

Answer 2

Causes the erection to subside

Question 3

People with ED have too much ___ and their erection doesn’t last or never happens–i.e they have ED.

Answer 3

PDE5

Question 4

What is the type of drug given to people with ED?

Answer 4

PDE-5 Inhibitors

Question 5

What is the MOA of PDE5 inhibitors?

Answer 5

Cause selective inhibition of PDE5, which increases the preserves cGMP levels in the penis, thereby making the erection harder and more long lasting

Question 6

T/F: PDE-5 inhibitors only enhance the normal erectile response to sexual stimuli.

Answer 6

TRUE; if there is no sexual stimuli and you are taking a PDE5 inhibitor, nothing will happen

Question 7

What are 3 ED drugs?

Answer 7

All end in -fil
Slidenafil
Vardenafil
Tadalafil

Question 8

What are the 3 indications for the -fil?

Answer 8

• ED
• Pulmonary arterial HTN (PAH)
• Benign prostate hypertrophy (BPH)

Question 9

When should clients take their ED med?

Answer 9

30-60 minutes before sexual activity

Question 10

Which ED meds are PRN? How long do these effects last?

Answer 10

Slidenafil and vardenafil; 4-6 hours

Question 11

Which ED med is known as “the weekender” (can also be taken daily) and how long does its effects last?

Answer 11

Tadalafil; 36 hours

Question 12

What are the adverse effects to ED drugs?

Answer 12

Headache
Flushing
Dyspepsia
Nasal Congestion

Question 13

What are the RARE adverse effects of ED drugs? (4)

Answer 13

1. Hypotension
2. Priapism
3. Hearing loss
4. Vision disturbances

Question 14

Rare adverse effects: what is priapism?

Answer 14

Erection greater than 4 hours! MUST get to a doc and get penis drained before 6 hours or there will be permanent ED

Question 15

Rare adverse effects: What happens if a patient has hearing loss?

Answer 15

Reports of sudden hearing loss that is unilateral –this is RARE!!

Question 16

Rare adverse effects: What happens with vision disturbances?

Answer 16

Blue tinge to the vision

Question 17

What are the 2 drug interactions that happen with ED drugs?

Answer 17

1. Nitrates

2. Alpha blockers

Question 18

What happens if you take a nitrate and an ED drug?

Answer 18

Nitrates increase cGMP formation and ED drugs decrease cGMP breakdown= SO MUCH cGMP!! This can cause life threatening hypotension; must wait 24 hours or longer before taking a nitrate after taking an ED drug

Question 19

What nitrates can ED patients not take?

Answer 19

ALL FORMS; Nitroglycerin SL tabs and patches and isosorbide dinitrate!!!!

Question 20

What are alpha blockers commonly used in? What is their suffix? and what happens if you combine an ED drug with an Alpha Blocker?

Answer 20

BPH; -zosin or -osin; POSTURAL HYPOTENSION

Question 21

What happens if you take an ED drug with an alpha blocker? Why?

Answer 21

Postural hypotension; hypotension is a rare adverse effect of ED drugs + Alpha blockers dilate arterioles and can LOWR BP

*a normal dose of ED drug may cause the BP to drop by ~8mmHg, if taking with a nitrate or alpha blocker, this will cause a drastic decrease!!

Question 22

What is the client teaching regarding ED drugs? (3)

Answer 22

1. Avoid nitrates
2. Go to doc if erection is longer than 4 hours
3. Ask about prostate meds (alpha blockers)