Erectile dysfunction and ED Treatment » Erectile Dysfunction

Viagra Description

Viagra Wiki — Tue, 17 Nov 2009 05:47:41 +0000

VIAGRA®

(sildenafil citrate) Tablets

VIAGRA®, an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

Sildenafil citrate is designated chemically as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H- pyrazolo[4,3-d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate and has the following structural formula

Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.5 mg/mL in water and a molecular weight of 666.7. VIAGRA (sildenafil citrate) is formulated as blue, film-coated rounded-diamond-shaped tablets equivalent to 25 mg, 50 mg and 100 mg of sildenafil for oral administration. In addition to the active ingredient, sildenafil citrate, each tablet contains the following inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, and FD & C Blue #2 aluminum lake.

INDICATIONS

VIAGRA is indicated for the treatment of erectile dysfunction.

DOSAGE AND ADMINISTRATION

For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, VIAGRA may be taken anywhere from 4 hours to 0.5 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.

The following factors are associated with increased plasma levels of sildenafil: age > 65 (40% increase in AUC), hepatic impairment (e.g., cirrhosis, 80%), severe renal impairment (creatinine clearance < 30 mL/min, 100%), and concomitant use of potent cytochrome P450 3A4 inhibitors [ketoconazole, itraconazole, erythromycin (182%), saquinavir (210%)]. Since higher plasma levels may increase both the efficacy and incidence of adverse events, a starting dose of 25 mg should be considered in these patients.

Ritonavir greatly increased the systemic level of sildenafil in a study of healthy, non-HIV infected volunteers (11-fold increase in AUC, see DRUG INTERACTIONS.) Based on these pharmacokinetic data, it is recommended not to exceed a maximum single dose of 25 mg of VIAGRA in a 48 hour period.

VIAGRA was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors or nitrates in any form is therefore contraindicated.

When VIAGRA is co-administered with an alpha-blocker, patients should be stable on alpha- blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose (see DRUG INTERACTIONS).

HOW SUPPLIED

VIAGRA® (sildenafil citrate) is supplied as blue, film-coated, rounded-diamond-shaped tablets containing sildenafil citrate equivalent to the nominally indicated amount of sildenafil as follows:

	25 mg	50 mg	100 mg
Obverse	VGR25	VGR50	VGR100
Reverse	PFIZER	PFIZER	PFIZER
Bottle of 30	NDC-0069-4200-30	NDC-0069-4210-30	NDC-0069-4220-30
Bottle of 100	N/A	NDC-0069-4210-66	NDC-0069-4220-66

Recommended Storage: Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature].

Distributed by Pfizer Labs, Division of Pfizer Inc, NY, NY 10017. Revised February 2008. FDA rev date: 2/25/2008

ED Glossary A

Viagra Wiki — Tue, 17 Nov 2009 05:38:04 +0000

UrologyHealth.org Glossary of Terms (there are 112 terms matching “A”)

abdomen:
	Also referred to as the belly. It is the part of the body that contains all of the internal structures between the chest and the pelvis.

ablation:
	Removal of diseased or unwanted tissue from the body by surgery or other means.

abnormality:
	A variation from a normal structure or function of the body.

abscess:
	An accumulation of pus anywhere in the body.

absorbent products:
	Pads and garments, either disposable or reusable, worn to contain urinary leakage. Absorbent products include shields, guards, undergarment pads, and combination pad-pant systems, diaper-like garments and bed pads.

absorptive hypercalciuria:
	Causes unabsorbed fatty acids to combine with calcium. This causes too much oxalate to be absorbed by the intestines.

acetylcholine:
	A substance that plays an important part in the transmission of nerve impulses in the parasympathetic nervous system. This system controls smooth muscles including those of the bladder and urethra.

ACTH:
	Also known as adrenocorticotropic hormone or corticotrophin. Hormone produced by the pituitary gland that stimulates the adrenal cortex to produce steroid hormones.

acute:
	Acute often means urgent. An acute disease happens suddenly. It lasts a short time. Acute is the opposite of chronic, or long lasting.

acute bacterial prostatitis:
	The least common form of prostatitis caused by bacteria traveling up the urethra and the backward flow of infected urine into the prostatic ducts.

acute incontinence:
	Urine leakage (incontinence) that comes on suddently, usually caused by a new illness or condition and can often be reversed with appropriate treatment of the condition that caused it.

acute infectious prostatitis:
	Having sudden onset, and requiring immediate medical attention; caused by bacteria.

acute renal failure:
	A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function.

acute tubular necrosis:
	Also referred to as ATN. A severe form of acute kidney (renal) failure that develops in people with severe illnesses or with low blood pressure. Patients may need dialysis. Kidney function often improves if the underlying disease is successfully treated.

adenocarcinoma:
	A cancer that develops in the lining or inner surface of an organ.

adenoma:
	A benign (non-cancerous) tumor that arises in or resembles glandular tissue.

adenomectomy:
	Surgical removal of a gland.

ADH:
	Also known as antidiuretic hormone. A natural body chemical that slows down the production of urine. Some children who wet their beds regularly may lack normal amounts of ADH.

adjuvant:
	A drug or agent added to another drug or agent to enhance its medical effectiveness.

adrenal:
	Glands that reside above the kidneys composed of an inner medulla and an outer cortex.

adrenal adenoma:
	Common, benign (non-cancerous) tumor arising from the cortex (out layer) of the adrenal gland.

adrenal cancer:
	Cancer of the adrenal glands.

adrenal carcinoma:
	Cancer of the adrenal cortex.

adrenal cortex:
	The outer layer of the adrenal gland.

adrenal gland:
	One of a pair of small glands, each of which sits on top of one of the kidneys. These glands produce hormones that help control heart rate, blood pressure, the way the body uses food and other vital functions.

adrenal medulla:
	Inner portion of the adrenal gland.

adrenal tumor:
	Abnormal mass of tissue or growth of cells in the adrenal glands.

adrenalectomy:
	Surgical removal of one or both adrenal glands.

adrenaline:
	Also known as epinephrine. Hormone secreted in the adrenal gland that raises blood pressure, produces a rapid heartbeat and acts a neurotransmitter when the body is subjected to stress or danger.

adrenocortical carcinoma:
	Cancerous tumor of the adrenal cortex.

adrenocorticotropic hormone:
	Also known as ACTH. Hormone produced by the pituitary gland that stimulates the adrenal cortex to produce steroid hormones.

afferent nerve pathway:
	Nerve pathways carrying sensory impulses.

ailment:
	A mild illness or injury, especially a persistent one.

albuminuria:
	More than normal amounts of a protein called albumin in the urine. Albuminuria may be a sign of kidney disease.

aldosterone:
	An adrenal hormone critical for salt (sodium) balance. Produced by the outer part of the adrenal cortex, its action causes a reabsorption of sodium and secretion of potassium and is critical for the maintenance of blood pressure.

alkaline phosphates:
	Enzymes released into the blood in various disorders.

alkalinity:
	The concentration of alkali, an acid-neutralizing chemical substance, in a solution measured in terms of pH.

allantois:
	A membranous sac that grows from the lower gut and it combines with the chorion to form the umbilical cord and placenta.

allograft:
	An organ or tissue transplant between two humans.

alpha-adrenergic blockers:
	Also known as alpha-blockers. Drugs used to treat high blood pressure and other conditions like an enlarged prostate or stress urinary incontinence.

alpha-blockers:
	Also known as alpha-adrenergic blockers. Drugs used to treat high blood pressure and other conditions like an enlarged prostate.

alport syndrome:
	An inherited condition that results in kidney disease. It generally develops during early childhood and is more serious in boys than in girls. The condition can lead to end-stage renal disease as well as hearing and vision problems. The common symptoms of this condition are chronic blood and protein in the urine.

ambiguous genitalia:
	External genitalia which have physical characteristics falling somewhere between normal male and female, either of which may predominate.

amyloidosis:
	A condition in which a protein-like material builds up in one or more organs. This material cannot be broken down and interferes with the normal function of that organ. In kidneys, amyloidosis can lead to proteinuria, nephrotic syndrome and renal failure.

analgesia:
	The inability to feel pain.

analgesic:
	A drug intended to alleviate pain.

analgesic-associated kidney disease:
	Loss of kidney function that results from long-term use of pain-relieving medications.

anaplasia:
	Changes occurring among groups of cancerous cells or within an individual cancer cell.

anaplastic:
	Relating to or characterized by the loss of distinctive cell features.

anatomy:
	The physical structure of an internal structure of an organism or any of its parts.

androgen:
	Male sex hormone.

androgen suppression therapy:
	The goal of hormone therapy is to lower the levels of the male hormones, androgens, that can allow prostate cancer cells to grow.

anemia:
	The condition of having too few red blood cells to carry oxygen throughout the body. People with anemia may be tired and pale, experience shortness of breath and/or may feel their heartbeat change. Anemia is common in people with chronic renal failure or those on dialysis.

anesthesia:
	Loss of sensation in any part of the body induced by a numbing or paralyzing agent. Often used during surgery to put a person to sleep.

anesthesia, general:
	Person is put to sleep with muscle relaxation and no pain sensation over the entire body.

anesthesia, local:
	Loss of sensation only in one part of the body induced by application of an anesthetic agent.

anesthesiologist:
	A physician who supervises the administration of anesthesia during surgery.

anesthetic:
	A substance that causes lack of feeling or awareness.

anesthetic creams:
	Creams that contain a small amount of a numbing chemical, most often benzocaine.

anesthetized:
	Administered an anesthetic.

aneurysm:
	An abnormal widening of a portion of a blood vessel.

angiogram:
	X-ray photograph of a blood vessel.

angiography:
	An X-ray examination of your blood vessels and lymphatics, after the injection of dye.

angiomyolipoma:
	Benign, non-cancerous kidney tumors containing smooth muscle. Often treated by nephrectomy.

aniridia:
	Absence of the iris in the eye from birth or as a result of injury or surgery.

anterior:
	At or near the front.

anti-androgen:
	Hormonal therapy drug that works by attaching itself to proteins on the surface of the cancer cell and blocking testosterone from entering the cancer cell.

antibiotic:
	Drug that kills bacteria or prevents them from multiplying.

antibiotic prophylaxis:
	Daily treatment with antibiotics to prevent infection.

antibodies:
	Proteins that fight infections.

antibody:
	Protein that fights infections.

anticholinergic:
	Blocking impulses from the part of the nervous system that controls heartbeat, blood pressure and other responses to stress. A drug that interferes with the effects of acetylcholine. These drugs assist with bladder storage by increasing bladder contractions and are used to treat urge incontinence.

anticoagulant:
	A substance that hinders clotting of blood.

antidepressants:
	Medications used to treat depression and other related conditions.

antidiuretic hormone:
	Also known as ADH. A natural body chemical that slows down the production of urine. Some children who wet their beds regularly may lack normal amounts of ADH.

antihistamine:
	Drug that blocks cell receptors for histamine, either to prevent allergic effects like sneezing and itching or to reduce the rate of certain secretions in the stomach.

antihypertensive:
	Preventing or reducing abnormally high blood pressure.

antimicrobial medications:
	An agent that kills microorganisms or suppresses their multiplication or growth.

antispasmodics:
	Capable of preventing or relieving spasms.

antiviral:
	Capable of eliminating or inactivating viruses.

anuria:
	A condition in which the body stops making urine.

anus:
	Opening at the end of the digestive tract where feces (stool) leave the body. The final two inches of the rectum.

anxiety:
	A feeling of apprehension, often characterized by feelings of stress.

aorta:
	The largest artery in the body.

aortoiliac occlusive disease:
	Refers to disorders of the two major blood vessels that feed the lower half of the body–the aorta and the iliac artery.

aortorenal bypass grafts:
	Transplant tissues used in aortorenal bypass surgery as a treatment for renal artery disease.

apical:
	Used to describe the top of something.

appendicitis:
	Swelling of the appendix causing severe pain.

appendix epididymis or testis:
	Small embryologic remnants that are attached to the upper pole of the epididymis and testicle. They serve no function but can twist causing pain and swelling in the scrotum.

arterial:
	Relating to, affecting or used in arteries.

arterial embolization:
	A blockage or obstruction of foreign substance or a blood clot, in an artery.

arteries:
	Blood vessels that carry blood from the heart to various parts of the body.

arteriography:
	A test to examine the arteries.

arteriovenous fistula:
	Surgical connection of an artery directly to a vein, usually in the forearm, created in patients who will need hemodialysis (see dialysis). The AV fistula causes the vein to grow thicker, allowing the repeated needle insertions required for hemodialysis.

artery:
	Blood vessel that carries blood from the heart to various parts of the body.

artificial insemination:
	The clinical insertion of sperm in the woman’s uterus.

artificial sphincter:
	Device used for treatment of urinary incontinence. Consists of three components: a pump, balloon reservoir and a cuff that encircles the urethra and prevents urine from leaking out.

AS-RAS:
	Also known as atherosclerotic renal artery stenosis. Abnormal narrowing of the renal artery caused by fat deposits in the inner lining.

aspermia:
	The lack of sperm.

asthenospermia:
	A defect in sperm motility.

asymmetry:
	Lack of balance.

asymptomatic prostatic inflammation:
	Inflammation of the prostate without any symptoms. This condition is usually diagnosed on biopsy and does not usually require treatment.

atherosclerosis:
	A process of progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining.

atherosclerotic renal artery stenosis:
	Also known as AS-RAS. Abnormal narrowing of the renal artery caused by fat deposits in the inner lining.

ATN:
	Also known as acute tubular necrosis. A severe form of acute kidney (renal) failure that develops in people with severe illnesses or with low blood pressure.

atrophy:
	When an organ diminishes in size.

autoimmune:
	A condition in which the body produces antibodies to its own tissue.

autoimmune disease:
	Any disorder in which the body is attacked by its own immune system. Examples are goodpasture syndrome and lupus erythematosus.

autosomal dominant polycystic kidney disease:
	Genetic disorder that results in an enlarged organ with many cysts that overtake healthy tissue and eventually causes kidney failure.

AV fistula:
	Also known as arteriovenous fistula. Surgical connection of an artery directly to a vein, usually in the forearm, created in patients who will need hemodialysis (see dialysis). The AV fistula causes the vein to grow thicker, allowing the repeated needle insertions required for hemodialysis.

azoospermia:
	Absence of sperm in the ejaculate fluid.

azotemia:
	Also referred to as azotemic. A higher than normal blood level of urea or other nitrogen-containing compounds in the blood.

Erectile Dysfunction Treatments and drugs

Viagra Wiki — Tue, 17 Nov 2009 03:42:22 +0000

A variety of options exist for treating erectile dysfunction. They range from medications and simple mechanical devices to surgery and psychological counseling. The cause and severity of your condition are important factors in determining the best treatment or combination of treatments for you.

Oral medications
Oral medications available to treat ED include:

Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)

All three medications work in much the same way. Chemically known as phosphodiesterase inhibitors, these drugs enhance the effects of nitric oxide, a chemical that relaxes muscles in the penis. This increases the amount of blood flow and allows a natural sequence to occur — an erection in response to sexual stimulation.

These medications don’t automatically produce an erection. Instead they allow an erection to occur after physical and psychological stimulation. Many men experience improvement in erectile function after taking these medications regardless of the cause of their impotence.

These medications share many similarities, but they have differences as well. They vary in dosage, duration of effectiveness and possible side effects. Other distinctions — for example, which drug is best for certain types of men — aren’t yet known. No study has directly compared these three medications.

Not all men benefit
Although these medications can help many people, not all men can or should take them to treat erectile dysfunction. You should not take these medications if:

You take nitrate drugs for angina, such as nitroglycerin (Nitro-Bid, others), isosorbide mononitrate (Imdur) and isosorbide dinitrate (Isordil)
You take a blood-thinning (anticoagulant) medication
You take certain types of alpha blockers for enlarged prostate (benign prostatic hyperplasia) or high blood pressure

Viagra, Levitra or Cialis may not be a good choice for you if:

You have severe heart disease or heart failure
You’ve had a stroke
You have very low blood pressure (hypotension)
You have uncontrolled high blood pressure (hypertension)
You have uncontrolled diabetes

Don’t expect these medications to fix your erectile dysfunction immediately.

Work with your doctor to find the right treatment and dose for you. Dosages may need adjusting. Or you may need to alter when you take the medication.

Before taking any medication — including Viagra, Levitra or Cialis — make sure to discuss with your doctor:

Potential benefits and side effects of the medication you are considering
Any illnesses or serious health problems you have now or have had in the past
Any prescription or over-the-counter medications you take (including herbal remedies)

Prostaglandin E (alprostadil)
Two treatments involve using a drug called alprostadil. Alprostadil is a synthetic version of the hormone prostaglandin E. The hormone helps relax muscle tissue in the penis, which enhances the blood flow needed for an erection. There are two ways to use alprostadil:

Needle-injection therapy. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) into the base or side of your penis. This generally produces an erection in five to 20 minutes that lasts about an hour. Because the injection goes directly into the spongy cylinders that fill with blood, alprostadil is an effective treatment for many men. And because the needle used is so fine, pain from the injection site is usually minor. Other side effects may include bleeding from the injection, prolonged erection and formation of fibrous tissue at the injection site. The cost per injection can be expensive. Injecting a mixture of alprostadil and other prescribed drugs may be a less expensive and more effective option. These other drugs may include papaverine and phentolamine.
Self-administered intraurethral therapy (Muse). This treatment involves using a disposable applicator to insert a tiny alprostadil suppository, about half the size of a grain of rice, into the tip of your penis. The suppository, placed about two inches into your urethra, is absorbed by erectile tissue in your penis, increasing the blood flow that causes an erection. Although needles aren’t involved, you may still find this method painful or uncomfortable. Side effects may include pain, minor bleeding in the urethra, dizziness and formation of fibrous tissue.

Hormone replacement therapy
For the small number of men who have testosterone deficiency, testosterone replacement therapy may be an option.

Penis pumps
This treatment involves the use of a hollow tube with a hand-powered or battery-powered pump. The tube is placed over the penis, and then the pump is used to suck out the air. This creates a vacuum that pulls blood into the penis. Once you achieve an adequate erection, you slip a tension ring around the base of your penis to maintain the erection. You then remove the vacuum device. The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse.

Vascular surgery
This treatment is usually reserved for men whose blood flow has been blocked by an injury to the penis or pelvic area. Surgery may also be used to correct erectile dysfunction caused by vascular blockages. The goal of this treatment is to correct a blockage of blood flow to the penis so that erections can occur naturally. But the long-term success of this surgery is unclear.

Penile implants
This treatment involves surgically placing a device into the two sides of the penis, allowing erection to occur as often and for as long as desired. The inflatable device allows you to control when and how long you have an erection, the semirigid rods keep the penis in a rigid state all the time. These implants consist of either an inflatable device or semirigid rods made from silicone or polyurethane. This treatment is often expensive and is usually not recommended until other methods have been considered or tried first. As with any surgery, there is a small risk of complications such as infection.

Psychological counseling and sex therapy
If stress, anxiety or depression is the cause of your erectile dysfunction, your doctor may suggest that you, or you and your partner, visit a psychologist or counselor with experience in treating sexual problems (sex therapist). Even if it is caused by something physical, erectile dysfunction can create stress and relationship tension. Counseling can help, especially when your partner participates.

Erectile Dysfunction Tests and diagnosis

Viagra Wiki — Tue, 17 Nov 2009 03:37:23 +0000

Your doctor will ask questions about how and when your symptoms developed, what medications you take and any other physical conditions you might have. Your doctor will also want to discuss recent physical or emotional changes.

If your doctor suspects that physical causes are involved, he or she will likely want to take blood tests to check your level of male hormones and for other potential medical problems, such as diabetes. Your doctor may also want to try eliminating or replacing certain prescription drugs you’re taking one at a time to see whether any are responsible for erectile dysfunction.

More specialized tests may include:

Ultrasound. This test can check blood flow to your penis. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis. The transducer emits sound waves that pass through body tissues and reflect back, producing an image to let your doctor see if your blood flow is impaired. The test often is done before and after injection of medication into the side of the penis to see if there’s an improvement in blood flow.
Neurological evaluation. Your doctor usually assesses possible nerve damage by conducting a physical examination to test for normal touch sensation in your genital area.
Dynamic infusion cavernosometry and cavernosography (DICC). This procedure involves injecting a dye into penile blood vessels to permit your doctor to view any possible abnormalities in blood pressure and flow into and out of your penis. It’s generally done with local anesthesia by a urologist who specializes in erectile dysfunction.
Nocturnal tumescence test. If your doctor suspects that mainly nonphysical causes are to blame, he or she may ask whether you obtain erections during masturbation, with a partner or while you sleep. Most men experience many erections, without remembering them, during sleep. A simple test that involves wrapping a special perforated tape around your penis before going to sleep can confirm whether you have erections while you’re sleeping. If the tape is separated in the morning, your penis was erect at some time during the night. Tests of this type confirm that there is not a physical abnormality causing erectile dysfunction, and that the cause is likely psychological.

What is Erectile dysfunction?

Viagra Wiki — Tue, 17 Nov 2009 01:02:24 +0000

Definition

Erectile dysfunction (ED) is the inability of a man to maintain a firm erection long enough to have sex. Although erectile dysfunction is more common in older men, this common problem can occur at any age. Having trouble maintaining an erection from time to time isn’t necessarily a cause for concern. But if the problem is ongoing, it can cause stress and relationship problems and affect self-esteem.

Formerly called impotence, erectile dysfunction was once a taboo subject. It was considered a psychological issue or a natural consequence of growing older. These attitudes have changed in recent years. It’s now known that erectile dysfunction is more often caused by physical problems than by psychological ones, and that many men have normal erections into their 80s.

Although it can be embarrassing to talk with your doctor about sexual issues, seeking help for erectile dysfunction can be worth the effort. Erectile dysfunction treatments ranging from medications to surgery can help restore sexual function for most men. Sometimes erectile dysfunction is caused by an underlying condition such as heart disease. So it’s important to take erectile trouble seriously because it can be a sign of a more serious health problem.

Symptoms

Erectile dysfunction is the inability to maintain an erection sufficient for sexual intercourse at least 25 percent of the time.

An occasional inability to maintain an erection happens to most men and is normal. But ongoing erection problems are a sign of erectile dysfunction and should be evaluated. In some cases, erectile dysfunction is the first sign of another underlying health condition that needs treatment.

Causes

Male sexual arousal is a complex process involving the brain, hormones, emotions, nerves, muscles and blood vessels. If something affects any of these systems — or the delicate balance among them — erectile dysfunction can result.