Tuesday 31 May 2011

Sildenafil


Sildenafil Basic Facts:
  • Type 5 phosphodiesterase (PDE5) inhibitor (competitive binding agent).
  • Prevents breakdown of cyclic GMP.
  • The molecular structure of sildenafil is similar to that of cyclic GMP.
  • Used predominantly in treatment of male erectile dysfunction
  • Prolongs penile corporeal smooth muscle relaxation.
  • Sildenaphil is only effective when cyclic GMP is present in penile smooth muscle.
Sildenafil Clinical Uses:
  • Altitude sickness
  • Male erectile dysfunction
  • Pulmonary artery hypertension
Sildenafil Adverse Reactions:
  • Dyspepsia
  • Facial flushing
  • Headache
  • Nasal congestion
  • Priapism
  • Visual disturbance of blue/green colour discrimination
Sildenafil Drug Interactions:
  • Alpha-blockers - hypotension
  • Cimetidine - increases sildenafil concentrations.
  • Erythromycin - increases sildenafil concentrations.
  • Nitric oxide donors - ie amyl nitrite (Popper)
  • Organic nitrates
  • Protease inhibitors - increases sildenafil concentrations.
Sildenafil Contraindications:
  • Conditions predisposing to priapism.
  • Hypotension
  • Nitrate use
  • Recent cerebrovascular accident
  • Recent myocardial infarction
  • Retinitis pigmentosa
  • Severe hepatic dysfunction
  • Severe renal impairment
Sildenafil Pharmacokinetics:
  • Absorption reduced if taken with a high fat meal - delays maximum plasma concentration by 1 hour, maximum concentration reduced by 1/3rd.
  • Metabolized by liver enzymes.
  • Excreted by both the liver & kidneys.
Tags: Altitude Sickness - cGMP - Cyclic GMP - Erectile Dysfunction - Phosphodiesterase - Pulmonary Hypertension - Sildenafil - Sildenaphil
Posted by Medicalchemy
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