Doumas Michael, Lazaridis Antonios, Katsiki Niki, Athyros Vasilios
2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, 49 Konstantinoupoleos street, 54643 Thessaloniki, Greece.
Curr Drug Targets. 2015;16(5):420-6. doi: 10.2174/1389450115666141111111301.
Erectile dysfunction is usually of vascular origin and is frequently encountered in men with cardiovascular disease. The introduction of phosphodiesterase-5 inhibitors has revolutionized the management of patients with erectile dysfunction. Currently available phosphodiesterase-5 inhibitors have distinct pharmacokinetic and pharmacodynamic properties, thus permitting for tailoring sexual therapy according to patient characteristics and needs. Phosphodiesterase-5 inhibitors possess vasorelaxing properties and exert systemic hemodynamic effects, which need to be taken into account when other cardiovascular drugs are co-administered. Special caution is needed with alpha-blockers, while the co-administration with nitrates is contra-indicated due to the risk of life-threatening hypotension. This review presents the advent of sexual therapy, describes the mechanism of action and the specific characteristics of commercially available phosphodiesterase-5 inhibitors, summarizes the efficacy and safety of these drugs with special emphasis on the cardiovascular system, and discusses the clinical criteria used for the selection of each drug for the individual patient.
勃起功能障碍通常源于血管问题，在患有心血管疾病的男性中很常见。磷酸二酯酶-5抑制剂的引入彻底改变了勃起功能障碍患者的治疗方式。目前可用的磷酸二酯酶-5抑制剂具有独特的药代动力学和药效学特性，因此可以根据患者的特征和需求定制性治疗方案。磷酸二酯酶-5抑制剂具有血管舒张特性并产生全身血流动力学效应，在联合使用其他心血管药物时需要考虑这些因素。与α受体阻滞剂合用时需特别谨慎，而与硝酸盐类药物合用则因有危及生命的低血压风险而被禁忌。本综述介绍了性治疗的出现，描述了市售磷酸二酯酶-5抑制剂的作用机制和具体特性，总结了这些药物的疗效和安全性，特别强调了对心血管系统的影响，并讨论了为个体患者选择每种药物所使用的临床标准。
