ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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The First Line Oral Pharmacotherapy For The Treatment Of Erectile Dysfunction
Dr. Kubilay İNCİ,a Dr. Ali ERGENa
aÜroloji ABD, Hacettepe Üniversitesi Tıp Fakültesi, ANKARA
Erectile dysfunction (ED) is a common medical condition that affects the sexual life of millions of men and increases in frequency with time. Introduction of the phosphodiesterase inhibitors has revolutionized the management of this common problem, encouraging many more men to seek treatment. PDE 5 inhibitors block the breakdown of cGMP in corpora cavernosa of the penis. The higher cGMP levels, therefore, act as amplifiers of the normal erectile physiology and are dependent on intact libido, sexual stimulation. At present, first-line oral pharmacotherapy for most patients with ED is a phosphodiesterase type 5 (PDE-5) inhibitor, of which three are currently available worldwide: Sildenafil, vardenafil and tadalafil. All three PDE 5 inhibitors are effective in most men with erectile dysfunction in the general population and in select populations, such as men with diabetes mellitus, and patients who have had nerve-sparing radical prostatectomy. Tadalafil has a longer duration of action than sildenafil and vardenafil. None of these PDE inhibitors should be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use either drugs because the combination can cause a sudden drop in blood pressure. This review describes the pharmacologic and clinical features of the PDE 5 inhibitors and the other oral agents in the first-line treatments of ED.Keywords: Impotence, drug therapy, sildenafil, vardenafil, tadalafilTurkiye Klinikleri J Surg Med Sci 2007, 3(38):26-33
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