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With the advent of such oral drugs as Viagra®, Cialis®, and Levitra® for the treatment of erectile dysfunction (ED), the burden of first patient evaluation has fallen on the primary care provider. In Oral Pharmacotherapy for Male Sexual Dysfunction: A Guide to Clinical Management, highly experienced urologists and physician researchers review each aspect of male sexual dysfunction (interest, performance, and orgasm) and their implications for treatment. The authors address a wide variety of clinical issues, ranging from common medical risk factors for ED to the evaluation and management of men who have atypical presentations that require focused testing; from diabetic ED to the safety assessment of PDE inhibitors for cardiac patients; and from combination drug therapy for refractory patients to neuropharmacological therapies. Guidance is also provided for vacuum erection devices and surgical implants, the role of self-medication with dietary supplements, the management of post-prostatectomy ED, and the emerging pharmaceutical therapies for rapid ejaculation. On the pharmaceutical side, the authors summarize the pharmacology and development of PDE-type 5 inhibitors, review the preclinical data and 5 years of postmarketing data on Viagra®, examine the preclinical data on Levitra®, and discuss the design and conduct of US clinical trials of Cialis®.
Authoritative and informative, Oral Pharmacotherapy for Male Sexual Dysfunction: A Guide to Clinical Management clarifies for urologists, family physicians, and internists each of the diagnostic approaches to male sexual dysfunction, as well as the pharmacological strategies available for its safe and effective management.
Sommario
"Physiology and Pharmacology of Erectile Dysfunction
Rafael Carrion, Derek Bochinski, Nadeem Rahman, and Tom F. Lue
Epidemiology of Erectile Dysfunction
Jonathan D. Schiff and John P. Mulhall
Pharmacology of Phosphodiesterase Inhibitors
Erwin Bischoff
Sildenafil Citrate, the Classical PDE5 Inhibitor: A Five-Year Review of its Efficacy and Safety in the Arena of Erectile Dysfunction
Harin Padma-Nathan
Tadalafil: Clinical Trials Experience
Culley C. Carson, III
Vardenafil: Clinical Trials Experience
Ajay Nehra
Erectile Dysfunction Assessment and Management in Primary Care Practice
Louis Kuritzky and Martin Miner
When to Refer the Patient With Erectile Dysfunction to a Specialist
Ira D. Sharlip
Erectile Dysfunction: Assessing Risk and Managing the Cardiac Patient
Thorsten Reffelmann and Robert A. Kloner
Is Diabetic Erectile Dysfunction More Difficult to Treat?
Pierre Theuma and Vivian A. Fonseca
Depression and Antidepressant-Associated Erectile Dysfunction
Raymond C. Rosen
Intracavernous, Transurethral, and Topical Therapies for Erectile Dysfunction in the Era of Oral Pharmacotherapy: Salvaging First-Line Therapy Failures With Combination Therapies
Hans-Martin A. Fritsche, Mustafa F. Usta, and Wayne J. G. Hellstrom
Androgen Deficiency of the Aging Male: Enhancing Erectile Response to Oral Pharmacotherapy
Alvaro Morales and Jeremy P. W. Heaton
Central Activation of Erection and Clinical Experience
Jeremy P. W. Heaton, Alvaro Morales, and Michael A. Adams
Sustaining the Cure: Oral Pharmacotherapy Failures Salvag With Vacuum Devices and Penile Implants
Ronald W. Lewis
Prevention and Treatment of Erectile Dysfunction Utilizing Lifestyle Changes and Dietary Supplements: What Works and What is Worthless?
Mark A. Moyad
Pharma"
Riassunto
For the generation that reached sexual maturity in the 1960s, the “pill” became synonymous with sexual freedom and started a sexual revolution. For women it meant freedom from the fear of pregnancy, and for men enhanced sexual opportunity. The new era of the pill has nothing to do with fertility, but everything to do with sex. The first orally effective prescr- tion drug for treating erectile dysfunction (ED) was marketed in 1998. ® Sildenafil (Viagra ) has rejuvenated the aging male veterans of the sexual revolution, forever changed the science of sexual medicine, and tra- formed society’s perspective on aging and sex. This class of drugs, known as oral phosphodiesterase inhibitors (PDE-type 5), is highly effective in the treatment of ED. Since its introduction there has been a much greater awa- ness of ED, its comorbidities, and its effects on the quality of life. In 1997, while preparing to address the Endocrine Society on the occasion of the 92nd American Urological Association meeting, I first looked at the p- clinical studies of sildenafil. I thought “this will change everything” and it clearly has—changing practice patterns in sexual medicine, and the at- tudes of patients, potential patients, and their partners. Two new PDE-type ® ® 5 inhibitors, tadalafil (Cialis ) and vardenafil (Levitra ), were first approved by the European Committee for Proprietary Medicinal Products and subsequently by the Food and Drug Administration in 2003 and 2004.
