Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: It has been estimated that
impotence (erectile
dysfunction, ED) affects 140 million men worldwide. Over half of all men with impotence are
thought to have some physical (medical) cause. The remainder
are believed
to have psychogenic causes of impotence. Medical causes of
impotence
include diabetes and circulatory, neurological, or urological
conditions.
Penile erection is caused by the engorgement of the penis with
blood.
This engorgement occurs when the blood vessels delivering blood
to the
penis increase the delivery of blood and the blood vessels
carrying blood
away from the penis decrease the removal of blood. Under normal
conditions, sexual stimulation leads to the production and
release of
nitric oxide in the penis. Nitric oxide then activates the
enzyme,
guanylate cyclase, which causes the production of cyclic
guanosine
monophosphate (cGMP). It is the cGMP that is primarily
responsible for the
erection by affecting the amount of blood that the blood
vessels deliver
and remove from the penis.
Sildenafil inhibits an enzyme called phosphodiesterase-5
(PDE5) which
destroys the cGMP. Thus, sildenafil prevents the destruction of
cGMP and
allows cGMP to accumulate and persist longer. The longer cGMP
persists,
the more prolonged the engorgement of the penis.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Viagra is a
blue, film-coated, rounded, diamond-shaped tablet that comes in 25, 50, and 100
mg tablets for treating impotence. Revatio comes in a 20 mg tablet and is used
for treating pulmonary arterial hypertension.
STORAGE: Tablets should be kept at room temperature, 15-
30 C
(59-86 F).
PRESCRIBED FOR: Sildenafil is
used for the treatment of erectile dysfunction of either organic
(medical
condition) or psychogenic (psychological) cause and for pulmonary
arterial hypertension.
DOSING: Sildenafil is rapidly absorbed. Maximum
observed plasma
concentrations are reached within 30 to 120 minutes (median 60
minutes) of
oral dosing in the fasted state. When sildenafil is taken with
a high fat
meal, the rate of absorption is reduced, with an average delay
in the time
to maximal concentration of 1 hour.
DRUG INTERACTIONS: Sildenafil increases the
effects
of the blood pressure lowering medications. It also increases the blood pressure lowering effects of nitrates,
for example, isosorbide
dinitrate
(Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket),
nitroglycerin
(Nitro-Dur, Transderm-Nitro) that are used primarily for treating angina. Patients taking nitrates should
not receive
sildenafil.
Patients should not combine sildenafil with Revatio (another form of sildenafil) or other PDE5 inhibitors (for example, vardenafil [Levitra], tadalafil [Cialis]).
Cimetidine (Tagamet), erythromycin, ketoconazole (Nizoral),
itraconazole
(Sporanox) and mibefradil (Posicor) can cause marked increases
in the
amount of sildenafil in the body. Patients taking these
medications should
be observed carefully if sildenafil is used.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Impotence, also known as erectile dysfunction, is a common
problem among men characterized by the consistent inability to sustain an
erection sufficient for sexual intercourse or the inability to achieve
ejaculation, or both. Impotence can have emotional causes but most often it is
due to a physical problem.
Male sexual dysfunction can be caused by physical or psychological problems. Common sexual problems in men include erectile dysfunction (impotence or ED), premature ejaculation and loss of libido. Treatment for sexual dysfunction in men may involve medication, hormone therapy, psychological therapy, and the use of mechanical aids.
Pulmonary hypertension is an abnormal elevation of the pressure in the pulmonary circulation caused by the constriction of the blood vessels that supply blood to the lungs. Shortness of breath and dizziness are symptoms of pulmonary hypertension. Treatment involves diuretics, blood thinners, calcium channel blockers, and using supplemental oxygen to increase blood oxygen levels.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Sexual dysfunction refers to a problem that arises during any phase of the sexual response cycle, preventing an individual or couple from experiencing sexual satisfaction. Physical, medical, and psychological conditions may affect sexual functioning, resulting in inhibited sexual desire, inability to become aroused, lack of orgasm, and painful intercourse. Treating the underlying physical and psychological problems usually resolves most female sexual problems.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.
The human body has two major sets of blood vessels that distribute blood from
the heart to the body. One set pumps blood from the right heart to the
lungs and
the other from the left heart to the rest of the body.
The portion of the circulation that
distributes oxygen-rich blood from the left side of the heart, throughout the
body, is referred to as the systemic circulation.
The blood then returns from
the body to the right side of the heart and passes through the lungs to
replenish oxygen.
It then returns to the left
side of the heart for another round through the systemic circulation.
The
portion of the circulation that distributes the blood from the right side of the
heart to the lungs is referred to as the pulmonary (lung) circulation.
The
pulmonary arteries are the major blood vessels that carry blood from the rig...
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