Term
| What is the main cause of erectile dysfunction? |
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Definition
Reduced blood flow to the penis. Commonly caused by diseases, including diabetes, hypertension, heart disease, and nerve damage (usually from diabetes)
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Term
| Name common drugs that cause sexual dysfunction? |
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Definition
Blood pressue medications- espically beta blockers, clonidine, methyldopa
Antipsychotics - particularly SSRIs and SNRIs
The BPH drugs finasteride, dutasteride and sildosin
Chemoterapeutic agents that decrease sex hormone levels, Leuprolide
Cimetidine-which blocks androgenic hormones
Opiods, especially methadone
Nicotine (smoking) |
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Term
| What is the main class of drugs used to treat ED? |
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Definition
| phosphodiesterase type 5 (PDE5) |
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Term
| Are PDE-5 inhibitors used for any others indictions than ED? |
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Definition
Yes. Under different names for pulmonary arterial hypertension (PAH) - do not use same drugs under different names concurrently (duplicate therapy).
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Term
| What is the brand name(s) for the PDE-5 inhibitor used for PAH? |
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Definition
Sildenafil (Revatio): 20 mg TID taken approx 4-6 hours apart
Tadalafil (Adcirca): 40 mg taken once dialy
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Term
| Is sexual stimulation required for PDE - 5 inhibitors to function? |
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Definition
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Term
| Brand name for sildenafil (ED indication) |
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Definition
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Term
| Brand name for Vardenafil |
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Definition
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Term
| Brand name for Tadalafil (ED indication) |
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Definition
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Term
| How to take Sildenafil and Vardenafil |
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Definition
Best when taken on an empty stomach, avoid with fatty food (tadalafil is with or without food) |
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Term
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Definition
Erection lasting more than 4 hours. This is an medical emergency! |
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Term
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Definition
| Statement. Not a question. |
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Term
| Name a major contraindication for PDE-5 inhibitors |
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Definition
PDE5-Is are contraindicated with NITRATES!
This also includes illicit drugs such as amyl nitrate and butyl nitrate ("poppers").
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Term
Suppose a patient with ED has taken a PDE5-Is and then develops angina, can nitroglycerin be used? |
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Definition
Nitrogylcerin should not be used until after 24 hours for sildenafil or vardenafil and after 48 hours for tadalafil.
In an acute emergency, nitrates are used though. |
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Term
| Name a caution for PDE5-Is? |
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Definition
Caution with PDE5-I and Concurrent Alpha Blocker Therapy:
Tamsulosin (Flomax)
Doxazosin (Cardura)
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Term
Why is there caution for PDE5-Is being given with alpha-adrenergic blocking agents? |
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Definition
PDE5-I and alpha-adrenergic blocking agents are both vasodilators with BP lowering effects. When vasodilators are used in combination, an additive effect on BP may be anticipated. In some patients, concomitant use of these two drug classes can lower BP significantly leading to symptomatic hypotension (e.g. dizziness, light headedness, fainting) |
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Term
How should a person on alpha-blocking therapy initiate PDE5-I therapy and vice versa? |
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Definition
Patients should be on stable alpha-blocker therapy before PDE5 inhibiton and that lowest doses of the PDE5 I be used to initiate therapy. Conversely, if a patient is already taking an optimal dose of PDE5 inhibitor and an alpha blocker needs to be started, the alpha blocker should be started at the lowest dose.
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Term
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Definition
| Statement. Not a question. |
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