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49 Cards in this Set
- Front
- Back
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neurogenic etiology of erectile dysfunction
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spinal cord injury
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drugs related to erectile dysfunction
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antihypertensives
antidepressants |
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health factors that increase your risk for impotence
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smoking hypertension and diabetes
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prostaglandin E1 or PGE1
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alprostadil
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mechanism of alprostadil
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induces erection by relaxation of trabecular smooth muscle and by dilation of cavernosal arteries
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effectiveness of alprostadil
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66%
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administration of alprostadil
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intracavernosal
intraurethral |
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adverse effects of alprostadil
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priapism(erection lasting longer than 6hr)
penile fibrosis penile urethral pain |
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time to erection with alprostadil
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5-10 min
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yohimbine
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alpha adrenergic presynaptic blocker
from the bark of west african tree |
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mechanism of action of yohimbine
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causes the rls of NE which increases penile blood flow
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yohimbine contraindicated with what
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anitdepressants
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adverse effects of yohimbine
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increased BP
increased HR |
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sildenafil citrate
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selective inhibitor of cyclic guanine monophosphate specific PDE5
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mechanism of action for sildenafil
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inhibits cGMP-PDE5
causes increased cGMP in penile corpous cavernosa results in NO stimulated vascular relaxation |
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what is still required for an erection with sildenafil
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sexual stimulation
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effectiveness of sildenafil
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48-52%
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sildenafil contraindicated with what
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use of nitrates
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what are the adverse effects of sildenafil
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loss of vision
headache flushings priaprism |
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other FDA approved indication for sildenafil citrate
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pulmonary arterial hypertension
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other drugs used for ED
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vardenafil
tadalafil |
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most potent PDE5 inhibitor
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vardenafil
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where are sildenafil, vardenafil, and tadalafil metabolized at
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liver P450 3A4
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ED drug with longest half life
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tadalafil then vardenafil then sildenafil
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infertility
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one year unprotected coitus without conception
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causes of female infertility
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failure to ovulate of anovulation secondary to chronic hypothalamic dysfunction
polycystic ovarian syndrome age related changes inability of corpus luteum to maintain luteal phase |
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effects of NSAIDs on infertility
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block rls of mature follicle
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effects of opiates on infertility
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supress LH secretion
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effects of corticosteroids on infertility
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inhibition of follicular development
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effects of antipsychotics on infertility
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hyperprolactinemia
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causes of infertility
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endometriosis
male factor anovulation tubual factor leteal phase abnormalities cervical factor uterine factor |
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Clomiphene
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causes hypothalmus to release GnRH which increases FSH and LH
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mechanism for clomiphene
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blocks inhibitory influence of estrogens on the hypothalamus causing ovulatory surge of gondatropins and leads to ovulation
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uses for clomiphene
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anovulatory
PCOS (use with caution) |
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adverse effects of clomiphene
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hot flashes
opthalmic effects ovarian cancer? |
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what is required before use of clomiphene
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baseline eye exam/monitoring
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major concern with clomiphene
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mutiple pregnancies
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how many courses with clomiphene
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2 course 2nd after 30 days usually no response after 2 courses of drug
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ovarian hyperstimulation
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done to assit with invitro fertilization
follicle dvlpmnt stim with injections, maturation induced by injection of hCG, luteal phase maintained with progesterone injection, |
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mechanism of gonadotropins
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directly stimulates ovaries
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functions of FSH
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stimulate follicular development
stimulate androgen conversion into estrogens |
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what are the parts of FSH
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alpha=hormone action
beta=confers specificity |
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uFSH
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purified preparation of human FSH extracted from urine of postmenopausal women LH activity has been removed
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alpha and beta rFSH
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preparations that differ from uFSH only in carbohydrate side chains
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menotropins
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purified FSH/LH extract from the urine of postmenopausal women
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mechanism of action for menotropins
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directly stimulate ovaries
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adverse effects of menotropins
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ovarian enlargement
hyperstimulation syndrome multiple births |
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hyperstimulation syndrome
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ovarian enlargement
ascites hydrothorax hypovolemia shock |
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mechanism of action for chorionic gonadotropin (HCG)
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HCG is substituted for LH becasue there are no LH preparation presently available for clinical use
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