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51 Cards in this Set
- Front
- Back
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four types of dysfunction
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arterial
venous nerve psychogenic |
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most ed due to
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vascular
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only bout 3% due to
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testerone
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t/f
stop drugs that are causing ed |
f
don't stop |
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med hx that can lead to ed
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meds
rec drug use dm, htn, hyperlipidemia sx anemia, renal failure trauma spinal cord injury |
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nonpharm tx of ed
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sex counseling
vacuum erection devices penile implants |
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t/f
pt satisfaction of the vacuum device depends on education |
t
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prob w/ vacuum
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bruising
requires manual dexerity |
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last resort to ed
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penile implants
infection possible |
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local pharmco for ed
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prostaglandin
MUSE |
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route for prostaglandin
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supp
injection |
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MUSE (alprostadil) route
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urethral suppository
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muse onset of action
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about 5-10 min
|
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duration of muse
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about 60 min
|
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how effective is muse
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about 30-60% effective
|
|
how many people experience aching
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25%
|
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what can affect muse
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body position
etoh stress affect response |
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problem w/ penile injection
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scar tissue
prolonged erection bruising |
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where's the penile injection given
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base of penis
erection chamber |
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for ed meds who are cautioned
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age 65
hepatic/renal impairment cv risk retinal disorders spinal cord injury |
|
viagra CI w/
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nitrates
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viagra enhance the effect of --- ---- thru inhibition of PDE5
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NO
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PDE5 inhibition allows
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more cGMP
this is also in the eye, so watch out w/ retinal disorders |
|
starting dose of viagra
max dose |
starting: 25 mg
max dose: 100 mg |
|
t/f
necessary to give viagra q day |
f
give 1 hr before sex |
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w/ meds are decreased w/ fatty meals
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viagra and levitra
NOT cialis |
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viagra can interact w/ the following meds
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antidepressants
antifungals hiv protease inhibitors macrolide antibiotics amiodarone ciprofloxacin grapefruit juice |
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adverse effects of viagra
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flushing
ha |
|
higher doses of viagra produce
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dyspepsia
abd vision |
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t/f
most se of viagra are transient |
t
|
|
levitra has same MOA as
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sildenafil
|
|
levitra is more specific for ---
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PDE5
|
|
which has a faster onset of action levitra or viagra
|
levitra
|
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t/f
ok to use levitra in dm and prostatectomy pts |
t
|
|
levitra is CI w/
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nitrates
alpha blockers ( watch out for decreased BP) |
|
dose of levitra
|
5 mg - 20 mg
|
|
t/f
levitra and viagra have the same MOA. so can use either if one doesn't work |
f
ok to try levitra if viagra doesn't work |
|
can doses for levitra and viagra be split
|
yes
|
|
what's viagra metabolized by
|
CYP 3A4, 2C9
|
|
t/f
cialis has the same MOA of sildenafil |
t
|
|
t/f
cialis is less specific for PDE5 |
f
more specific |
|
which has the longest duration of action
|
cialis
|
|
what's cialis CI w/
|
nitrates
alpha blockers (except flomax) |
|
caution w/ ---- when taking cialis
|
etoh
no more than 6 ounces can lead to hypotension |
|
dose for cialis
|
5-20 mg prn
2.5 mg - 5 mg q day |
|
which med do you take q day
|
cialis
|
|
yohimbine is an ---- blocker
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a2
|
|
papaverine is a ---- --- relaxant
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smooth muscle
|
|
how is papaverine taken
|
injected w/ alprostadil
|
|
this influcences libido
|
testosterone
may have little or no effect on ed |
|
t/f
there;s risk for an mi if taking viagra, cialis, or levitra if the pt is at low risk of cv |
f
|
