Sildenafil and PDE-5 Inhibitors in Erectile Dysfunction Treatment

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Questions and Answers

What is the primary mechanism of action of sildenafil in treating Erectile Dysfunction?

Blocking the action of beta-adrenergic receptors
Inhibiting phosphodiesterase-5 to increase cGMP levels (correct)
Increasing the concentration of intracellular calcium
Inhibiting the release of nitric oxide

What is a unique characteristic of sildenafil's effect on vision?

It improves visual acuity
It leads to loss of blue/green discrimination (correct)
It causes mydriasis
It improves color vision

What is a major contraindication of sildenafil administration?

Age older than 65 years
Renal dysfunction
Co-administration with nitrates (correct)
Hypertension

Why does sildenafil only work in the presence of sexual stimulation?

It requires the release of nitric oxide (B) Signup and view all the answers

What is a possible consequence of administering sildenafil to patients with cardiovascular disease?

Hypotension (A) Signup and view all the answers

What is a rare but serious side effect of sildenafil?

Priapism (C) Signup and view all the answers

What is the primary mechanism of action of PDE-5 inhibitors in treating erectile dysfunction?

Increase the level of cGMP (C) Signup and view all the answers

Which of the following side effects is NOT associated with vardenafil?

Nasal decongestion (A) Signup and view all the answers

What is the main difference between vardenafil and tadalafil in terms of absorption?

Vardenafil absorption is delayed in the presence of fatty meals, while tadalafil absorption is not (B) Signup and view all the answers

What is the contraindication for vardenafil and tadalafil?

Nitrates and alpha-adrenergic antagonist drugs (A) Signup and view all the answers

What is the unique characteristic of tadalafil compared to vardenafil and sildenafil?

Longer half-life (D) Signup and view all the answers

What is the duration of action of vardenafil?

4 hours (A) Signup and view all the answers

Why do PDE-5 inhibitors only work in the presence of sexual stimulation?

Because they require the release of nitric oxide (C) Signup and view all the answers

What is the potential consequence of administering vardenafil with a-adrenergic antagonist drugs?

Hypotension (C) Signup and view all the answers

What is the primary mechanism of action of papaverine in treating erectile dysfunction?

It is a nonspecific relaxant with a musculotropic spasmolytic effect (C) Signup and view all the answers

What is the duration of action of papaverine when administered via injection into the penis?

30-60 minutes (A) Signup and view all the answers

What is the primary side effect of phentolamine that is related to its alpha-adrenergic blocking activity?

Hypotension (C) Signup and view all the answers

What is the route of administration of papaverine in the treatment of erectile dysfunction?

Intracavernosal injection (A) Signup and view all the answers

What is the primary action of phentolamine on the alpha receptors?

Blockade of alpha receptors (A) Signup and view all the answers

What is the common side effect of both papaverine and phentolamine?

Dyspepsia (B) Signup and view all the answers

What is the primary indication for the use of papaverine and phentolamine?

Erectile dysfunction (C) Signup and view all the answers

What is the mechanism of action of phentolamine in reducing hypertension?

Blockade of alpha receptors (C) Signup and view all the answers

What is the primary mechanism of action of Avanafil and other PDE-5 inhibitors?

Inhibits phosphodiesterase-5 enzyme (D) Signup and view all the answers

What is the most significant advantage of Avanafil compared to sildenafil and tadalafil?

Quicker onset of action (A) Signup and view all the answers

What is the primary indication for Avanafil and Alprostadil?

Erectile Dysfunction (B) Signup and view all the answers

What is a common side effect of PDE-5 inhibitors, including Avanafil?

Nasal congestion (D) Signup and view all the answers

What is a contraindication for the administration of Avanafil?

Nitrates and a-adrenergic antagonist drugs (A) Signup and view all the answers

What is a unique characteristic of Alprostadil?

Acts locally, with less systemic side effects (A) Signup and view all the answers

What is a common side effect of Alprostadil?

Headache (D) Signup and view all the answers

What is a potential complication of PDE-5 inhibitors, including Avanafil?

Priapism (A) Signup and view all the answers

What is the beneficial effect of androgens in men with low testosterone?

Treatment of hypogonadism (A) Signup and view all the answers

What are the two dosage forms of androgens mentioned in the content?

Gel and skin patches (C) Signup and view all the answers

What is the side effect of androgens that is related to the eye?

Increased intraocular pressure (B) Signup and view all the answers

What is the side effect of androgens that is related to the digestive system?

Vomiting (C) Signup and view all the answers

What is the side effect of androgens that is related to the cardiovascular system?

Hypotension (D) Signup and view all the answers

What is the side effect of androgens that is related to the musculoskeletal system?

Myalgia (A) Signup and view all the answers

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Study Notes

Phosphodiesterase-5 Inhibitors

Sildenafil: taken 1 hour prior to intercourse, erection lasts for 4 hours, absorption delayed in presence of fatty meals
Side effects: headache, flushing, dyspepsia, nasal congestion, loss of blue/green discrimination, hearing loss, caution with CVD, priapism, don't administer with nitrates and alpha-adrenergic antagonist drugs
Vardenafil: taken 1 hour prior to intercourse, erection lasts for 4 hours, absorption delayed in presence of fatty meals
Side effects: same as sildenafil
Tadalafil: longer half-life, absorption not impaired with food
Side effects: same as sildenafil, plus myalgia
Avanafil: quickest, 30 minutes before intercourse, half-life for 5 hours
Side effects: same as sildenafil

Prostaglandin E1

Alprostadil: acts locally, fewer side effects than PDE-5 inhibitors
Side effects: headache, penile and testicular pain, mechanical bleeding, priapism, hypotension
Onset: suppository → 5-10 minutes, injection → 2-25 minutes, duration: 30-60 minutes

Vasodilation

Papaverine: benzylisoquinolone derivative, musculotropic spasmolytic with a nonspecific relaxant effect
Side effects: dyspepsia, headache, vomiting, flushing, dizziness, myalgia, visual disturbance, increased intraocular pressure, nasal congestion, hypotension, priapism
Injected intracavernosally to increase blood flow to the penis and produce an erection
Phentolamine: alpha1 and alpha2 adrenergic blocker, blocks circulating epinephrine and norepinephrine, reducing hypertension
Side effects: same as papaverine
Injected into the penis to produce an erection

Androgens

Testosterone: beneficial for men with low testosterone (hypogonadism)
Dosage forms: gel or skin patches
Side effects: dyspepsia, headache, vomiting, flushing, dizziness, myalgia, visual disturbance, increased intraocular pressure, nasal congestion, hypotension, priapism

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