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16 Cards in this Set

  • Front
  • Back

Erectile dysfunction

Common cause- peripheral neuropathy, atherosclerosis, HTN

Also spinal injury, depression, stroke

Drugs that cause ED


Anticancer (leuprolide, flutamide, busulfan, cyclophosphamide)


Antidepressants-SSRI, SNRI

Antihypertensive- beta blockers, clonidine, methyldopa

Antipsychotics- haloperidol, chlorpromazine, fluphenazine, thioridazine

BPH- finasteride, dutasteride, silodosin


H2RA- cimetidine, nizatidine, ranitidine


Opioids (chronic)- methadone

Non- drug Tx


Vacuum devices, implant/surgery

Yohimbe(not good, has ADR), L-arginine, panax ginseng

Drug tx

1st line- PDE-5 inhibitors- eg. tadalafil

2nd- Alprostadil(inj/urethral supp)

Alt uses for PDE-5: sildenafil (viagra and revatio): viagra=ED, Revatio= PAH/ tadalafil(Cialis and Adcirca): cialis=ED and BPH, Adcirca= PAH

PDE-5 inhibitors

Local release of nitric oxide -> more cGMP and muscle relaxation-> more blood flow

CI- nitrate or riociguat use

Warning- impaired color discrimination, hearing/vision loss, hypotension, priapism (>4hr; get help)

Sx- HA, flush, dyspepsia, muscle/back pain (tadalafil, lasts <2days)

Best on empty stomach (tadalafil doesnt matter)

No more than 1 dose/day


Viagra, revatio (PAH)

50mg 1hr before sex

Revatio- 5-20mg TID


Cialis(bph and ed), adcirca (PAH)

10mg 30min. Before sex

The weekend pill

Adcirca- 40mg qd


Levitra, staxyn odt

10mg before sex



100mg 15min. Before sex

Conditions that require lower dose

3A4 inhibitors

Alpha blockers

Hepatic impairment

Renal impairment (except viagra)

Lower by half


Prostaglandin E1- vasodilation

Inj or urethral suppository

Invasive and painful, doesnt last as long as PDE-5 inhibitors

Caverject, Edex

Alprostadil injection

Inj 1.25-2.5mg into base of penis and titrate for effect(5-10min. For 1 hr)

CI- sickle cell anemia, multiple myeloma, leukemia, penile implant, deformation

Sx- pain, priapism, scarring

Refrigerate, recon before use


Alprostadil urethral pellet

Insert 125-250mcg into urethra

CI- Urethral stricture, hypospadias and curvature

Sx- pain, priapism

Urinate before insertion


Hypoactive sexual desire disorder

Low sexual desire that causes marked distress or interpersonal difficulty, not due to drug or health condition

5-HT1a agonist and 5-HT2a antagonist

For hypoactive sexual desire disorderFlibanserin- AddyiREMS avoid if pregnant100mg qhs, dc if no benefit 8wkBoxed- hypotension, alcohol, 3A4 inhibitors, hepatic impairmentCI- same as boxed


5-HT1A agonist and 5-HT2A antagonist

Premenopausal women only


100mg qhs, dc if no benefit 8wks

Boxed- severe hypotension risk with alcohol, mod/sev 3A4 inhibitor, or hepatic impairment

CI- same as boxed

Warning- hypotension, CNS depression

Sx- dizziness, nausea, insomnia, dry mouth, somnolence