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PHCY320 GULT19 Men's Health- ED, Prostate Health & Baldness + SK5 Cases 1-2 Study Set Exam
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PHCY320 GULT19 Men's Health- ED, Prostate Health & Baldness + SK5 Cases 1-2 Study Set Exam ...
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PHCY320 GULT19 Men's Health- ED,Prostate Health & Baldness + SK5
Cases 1-2 Study Set Exam
Erectile Dysfunction (ED) - Answer The consistent or recurrent inability to obtain and/or
maintain an erection sufficient for satisfactory sexual activity.
Why ED called a canary in a coal mine - Answer ED shares many risk factors for heart
disease and warrants a cardiac risk assessment in most patients
Lifestyle modification for ED - Answer Smoking cessation, exercise, diet, limit alcohol
intake, reducing stress, control hypertension, control cholesterol
Pharmaceutical treatments for ED - Answer Phosphodiesterase type-5 inhibitors (PDE5i)
eg. Sildenafil, tadalafil and vardenafil
Phosphodiesterase type-5 inhibitors (PDE5i) MoA - Answer Non-competitively inhibits
PDE-5 which prevents cGMP breakdown, leading to decreased Ca levels for smooth
muscle relaxation/vasodilation (increase blood flow) to allow an erection to occur in
response to sexual stimulation.
cGMP is naturally broken down by - Answer PDE-5
Decrease in cGMP leads to - Answer Increased Ca levels
Increased Ca level leads to - Answer Smooth muscle contraction/vasoconstriction
(decreased blood flow).
Tadalafil time to take? - Answer Longer half-life for people who don't want to worry
about when to take the medicine before sex.
Vardenafil and Sildenafil time to take? - Answer Shorter half-life so need to be taken few
hours before sex.
Sildenafil supply (must follow strictly to supply checklist) - Answer Pharmacist-only
medicine by registered pharmacist whose completed a training programme; must be
supplied in 100mg or less strength in manufacturer's original pack, containing no more
than 12 solid dosage units for ED treatment in 35-70y males.
Phosphodiesterase type-5 inhibitors (PDE5i) SE - Answer Rare (1% or less);
well-tolerated. eg. headache or dyspepsia
Phosphodiesterase type-5 inhibitors (PDE5i) Contraindications - Answer Hypotension,
recent stroke, unstable angina, recent MI, Nitrates
, Phosphodiesterase type-5 inhibitors (PDE5i) Interactions - Answer Cimetidine,
erythromycin, rifampicin.
Risk factors/causes of ED - Answer Antihypertensives, antidepressants, antihistamines,
anti-psychotics, digoxin, low testosterone/thyroid/prolactin,
depression/anxiety/substance abuse, arterial cholesterol/DM/HTN/trauma/surgery,
multiple sclerosis, Peyronie's disease/phimosis, COPD/Alzheimer's/renal/liver, smoking,
drinking, CV risks
Phosphodiesterase type-5 inhibitors (PDE5i) Patient counselling - Answer Check CVRA,
take about 1 hour before sexual activity, pt who anticipate sexual activity at least twice
weekly - 5 mg Tadalafil od or reduced to 2.5 mg od according to response,
may take longer for effect if taken with food, mental & physical stimulation required,
anxiety can counteract effects, efficacy of the 3 drugs varies from patient to patient so
try at least 4 attempts with 2 different PDE5i in the absence of contraindications before
declaring failure
Sildenafil is metabolised - Answer mainly by CYP450 3A4 and 2C9 enzymes.
Priapism - Answer A continuous, painful erection (treatment shouldn't be delayed >6h)
Referral for ED - Answer PDE-5i failures or if contraindications exist (refer to checklists).
Prostate - Answer A gland that helps make the fluid of semen, located underneath the
bladder, in front of the rectum, and wraps around the urethra. Its activity and growth is
stimulated by androgens e.g. testosterone.
Prostatitis - Answer An inflammation of the prostate commonly caused by an infection
and can be acute or chronic.
Benign prostatic hyperplasia (BPH) - Answer Gradual enlargement of the prostate as
men age which often causes urinary problems that's not due to cancer. Common in men
>60y.
Prostate cancer - Answer Cancer of the prostate.
Prostatitis Signs & symptoms - Answer Pain/burning sensation when
urinating(dysuria), frequent urination esp at night (nocturia), urgency to urinate, painful
ejaculation/blood in sperm.
If untreated can progress to systemic symptoms: fever/chills, n/v, body aches, pain in
genital area/groin/lower abdomen/lower back, UTI, and cloudy/bloody urine.
Prostatitis Risk factors - Answer Age (young/middle-aged more at risk), previous
diagnosis of prostatitis, infection in the bladder or urethritis, pelvic trauma, urinary
catheter, HIV/AIDS, had prostate biopsy.
Prostatitis Treatment - Answer Antibiotics (cotrimoxazole or trimethoprim), alpha
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