ED

Question 1

Classes of drugs used to treat ED

Answer 1

Phosphodiesterase inhibitors

• Sildenafil (viagra)
• Tadalafil (Cialis)
• Vardenafil

Prostaglandin E1 analogues

• Caverject (injection)

Question 2

Indications of sildenafil

Answer 2

• Erectile dysfunction
• Pulmonary arterial hypertension

Question 3

Mechanism of action of sildenafil

Answer 3

• Phosphodiesterase type 5 inhibitor
• Sustains the vasoldilatory effects of nitric oxide dependent synthesis of cGMP

Question 4

Side effects of sildenafil

Answer 4

• Headache
• Dizziness
• Nasal congestion
• Hypotension

Ocular

• Retinal hemorrhage
• Non-arteritic ischemic optic neuropathy
• Vision loss
• Increased IOP
• Cyanopsia (blue vision)

Question 5

Topical opthalmic drug interactions with sildenafil

Answer 5

• Brimonidine for glaucoma: additive hypotension risk
• Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk

Question 6

Cautions for the use of sildenafil

Answer 6

• Hereditary degenerative retinal disorders
• Low optic cup-to-disk ratio
• Non-arteritic anterior ischemic optic neuropathy history
• BP of < 90/50
• Hypertension
• Smokers
• Patiens >50years