Before the treatment of erectile dysfunction, it is important to guide patients to remove various causes and risk factors that cause erectile dysfunction.Many incentives and risk factors can be overcome, such as drug factors, smoking and alcohol, improvement of husband and wife feelings, etc.It is also necessary to strengthen the treatment of primary diseases, such as diabetes, hypertension, and endocrine diseases.Recently strives to develop new safe and effective, and have specific treatment of erectile dysfunction.Research hotspots are mostly concentrated in the development of NO donors that have relaxed the penis sponge body. Drugs that treat erectile dysfunction should be based on the pathogenic mechanism of erectile dysfunction, and the scientific smooth muscle relaxation should be implemented on the basis of molecular biology and pharmacological action mechanisms.The clinical experimental method of drugs must be scientific, including the test of random placebo controls and random cross -test methods. Statistical analysis of sufficient research on samples is used.Oral drugs that treat erectile dysfunction can be roughly divided into drugs that act on central systems, peripheral nervous systems, endocrine systems, and neurotransmitters.
1. Wan Aiko (Westland Nafa)
Wan Ai is a selectively inhibiting the activity of DRErase V (PDE-5), increasing the level of CGMP in the cell, causing cell calcium ion outflow and causing smooth muscle relaxation and inducing penile erection is the first-line oral drug for the treatment of ED.1h before sexual intercourse is taken at a dose of 50 & mdash; 100mg, and the clinical effectiveness of erectile dysfunction is 82%.It is currently the best oral drug for the treatment of erectile dysfunction. The mechanism of action is shown in Figure 37.
Recommended clinical usage methods: For patients with different degrees and different causes of erectile dysfunction, the history of five NO suppliers or nitrite drugs is recently taken. Those who have no medium and high -risk cardiovascular disease can withstand sexual life. 30 & mdash; 60ray orally, the duration of the medicinal effect is about 4L. If the effect of 50 mg is satisfied, it can continue to be treated. The effect can be reduced to 25mg; if 50 mg is invalid, it can be repeatedly used for more than 3 observations or increase the dose to 100mg.The maximum dose is 100 mg/time, 1 time/d.
Wan Ai can absorb rapidly, in an empty stomach, 30 & mdash; 120min (medium -level 60min) after orally reaches the plasma peak concentration (the latest shows that those who have reactors to Wan Aike are 12min; 86%need 30rain).The high -fat diet slows the absorption of Wan Aike, T & RSquo;, average delay of 60rain, C & Hellip; average reduction by 29%.Wan Ai can absorb rapidly after being orally. The absolute biological utilization is about 40%. It is mainly based on liver metabolism (mainly cytochrome P450 3A4), and it will be transformed into an active metabolite.The metabolites have similar characteristics to Westland.The average half-life of Western African and metabolites is about 4H-Wan Ai Ke. He liver-graniteram enzymes are mainly removed through CYP 3A4 (main channels) and CYP 2C9 (secondary pathway).The main circular metabolites come from N & Mdash; Nafei;This metabolites are similar to Westland's non -similar PDE selectivity. In vitro research, it shows that its effect on PDE5 is about 50%of the original drugs. The plasma concentration of this metabolites is about 40%of Western Africa.Therefore, about 20%of Western Nakaic Pharmaceuticals comes from its metabolites.After oral or intravenous injection application, Westland's non -metabolites are mainly excreted from feces (about 80%of the oral dosage), and a small part of it is excreted from the urine (about 13%).Intersection
Wan Aike has good tolerance. In clinical trials of placebo control, the most common side effects are headaches (16%), face flushing (10%), and indigestion (7%). There are no significant differences from the placebo (Wan Ai Keke is 2.5%and 2, 3%of the placebo, respectively).Adverse events are generally short -lived, and the nature is light to moderate.It was found in the 4 & mdash; 26 weeks of 26 weeks that 3%of patients had light visual color, light sensitivity, and blurred vision.
Due to the known effect of Wan Ai Ke on the NO-CGMP pathway (see the mechanism part of the effect), Wan Ai may enhance the antihypertensive effect of nitrate, so patients taking any dosage nitrate. Contraindications.For patients with allergies to Wan Aiko, allergies are prohibited.
