Chapter 51. Erectile Dysfunction
Which of the following is the most significant difference between the available PDE5 inhibitors?
Option A: Incorrect. PDE5 inhibitors all have the same mechanism of action.
Option B: Incorrect. PDE5 inhibitors all have the similar adverse effects.
Option C: Incorrect. PDE5 inhibitors all have the similar efficacy.
Option D: Correct. Half life is the most significant difference between the PDE5 inhibitors with tadalafil having the longest.
A 60-year-old patient presents to the clinic with his wife and states he has had progressively worsening ED over the past year. He is obese and has a diagnosis of metabolic syndrome. His wife claims that over the past couple of years his libido has waned, and he seems "down." He has gained weight and experienced an increase in fatigue as well. His medications include metformin and losartan. He gets some exercise and they feel as if their diet is healthy. What are his symptoms most suggestive of?
A. Organic ED with most significant risk factor of hypogonadism
B. Organic ED with most significant risk factor of metabolic syndrome
C. Organic ED with most significant risk factor of losartan
D. Psychogenic ED due to untreated depression
Option A: Correct. He is presenting with classic symptoms of hypogonadism—weight gain, decreased libido, and fatigue.
Option B: Incorrect. While metabolic syndrome is a contributing factor in his ED, it is not the most significant with his presenting signs and symptoms.
Option C: Incorrect. Angiotensin receptor blockers are not typically associated with worsening ED.
Option D: Incorrect. While he may have depression due to his inability to achieve an erection, his symptoms are suggestive of hypogonadism. Hypogonadism may also contribute to depression.
Sexual stimulation leads to the release of ________, which enhances the production of __________________ to induce an erection.
Option A: Incorrect. NO is released in response to stimuli which enhances production of ...