Drugs used to treat Erectile Dysfunction , Drugs used to treat Osteoporosis , Drugs used to treat Obesity

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Drugs used to treat Erectile Dysfunction

Erectile Dysfunction= inability to maintain Penile erection for successful performance of

Sexual activity

ED has physical & psychological causes including vascular disease, diabetes, medications, depression, prostatic surgery

Classification

Drugs for Erectile Dysfunction

(PhosphoDiEstrase-5 inhibitor)

Sildenafil

Tadalafil

Vardenafil


Previous therapies include intrapenile inj of Alprostadil, penile implant

Phosphodiestrase-5 inhibitor PDE-5


MOA

NO activate Guanylyl cyclase... form cGMP... ↓ intracellular Ca++.....relaxation of smooth muscles...PDE-5 responsible degradation of cGMP... PDE-5 inhibitors Θ PDE-5.... Increase blood flow into Corpus Cavernosum at any level of sexual stimulation

No effect in the absence of sexual stimulation

P.K

 should be taken 1hr prior to sexual activity... Erectile enhancement upto 4hr.. Abs. delayed by high fat meal... Disintegrating tab of Vardenafil not affected by fat meal ...

S.E

 Flushing, dyspepsia, nasal congestion... disturbance in color vision (Blue/green discrimination)... Toldafil not cause color vision problem ...used with caution in CVS history.... Not used more than ONCE in a day

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Drugs used to treat Osteoporosis

Osteoporosis = condition of Skeletal fragility due to progressive loss of bone mass.

Nondrug strategies for Osteoporosis reduce bone loss in postmenopausal women include a diet of Ca++, Vit D, weight bearing exercise, smoking cessation

Biphosphonates Etidronate, Risedronate, Alendronate,

Ibandronate, Pamidronate, Tiludronate,

Zoledronic acid

Selective Estrogen-receptor modulator Raloxifene

Calcitonin Calcitonin

Topiratide Topiratide

Denosumab Denosumab

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Biphosphonate

Analogue of pyrophosphate... Decrease osteoclastic formation/activation....Increase osteoclastic Apoptosis.....inhibition of cholesterol synthesis imp for osteoclastic function

Bone forming Osteoblast not inhibited....used for prevention & treatment of postmenopausal Osteoporosis...should not take with food

S.E

diarrhea, Abdominal pain, Musculoskeletal pain, Esophagitis, Esophageal ulcer,

Selective-Estrogen –receptor modulator

Estrogen replacement effective for prevention of postmenopausal bone loss....

Raloxifene

 selective Estrogen receptor modulator... increase bone mass without

Endometrial cancer... decrease LDL & Cholesterol ...first line alternative who can‟t tolerate Biphosphonate..

Calcitonin

Salmon Calcitonin administer intranasally... reduce bone resorption...relief of pain

Topiratide

Recombinant of human Parathyroid hormone... S/C inj...stimulate Osteoblast activity over Osteoclast... increase bone density...

Denosumab

Monoclonal antibody...Receptor activator of Nuclear factor kappa-B ligand (RANKL)..... S/c inj every 6 month

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Drugs used to treat Obesity

Anorexiant Phentermine, Diethylpropion

Lipase inhibitor Orlistat


Anorexiant (Appetite suppressents)

Phetermine= ↑ release of Norepinephrine, Dopamine...inhibit reuptake...↑ level in brain

Diethylpropion have same effects

S.E

 Schedule IV controlled agent...potential for abuse...dry mouth, insomnia,

constipation.... Phentermine cause CVD, Arrhythmia, CHF, Hypertension

Lipase inhibitor

Orlistat 

 Pentanoic acid ester... inhibit Gastric & Pancreatic lipase... ↓ breakdown of Dietary fatty acid into smaller molecule...Fat Abs ↓... take 3 time with food ...

S.E

oily spotting, flatulence, fecal urgency, ↑ defecation, contraindicated in

Cholestasis & Chronic malabsorption syndrome...

interfere with Abs. of Vit B12...

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