Sildenafil
Sildenafil is a medication that belongs to a group of drugs called phosphodiesterase type 5 (PDE5) inhibitors. It is known by the trade name Viagra.
Here are the characteristics of sildenafil
Mechanism of action
- Sildenafil works by blocking the enzyme phosphodiesterase type 5 (PDE5), which breaks down cyclic guanosine monophosphate (cGMP).
During sexual stimulation, the release of nitric oxide (NO) in the penile tissues increases cGMP levels, causing relaxation of the smooth muscles of the blood vessels and increased blood flow to the penis.
- This allows an erection to be achieved and maintained.
Indications
- Sildenafil is primarily used to treat erectile dysfunction (erectile dysfunction) in men.
- It may also be prescribed for the treatment of arterial hypertension in the form of Revatio.
Onset of action
- Sildenafil has a rapid onset of action, usually beginning to act about 30 minutes after taking it, but in some individuals it may take up to 1 hour.
Duration of action
- The effects of sildenafil usually last 4 to 5 hours, which is the length of time it takes to achieve and maintain an erection.
Dosage
- The usual starting dose of sildenafil is 50 mg, which may be increased or decreased according to individual response and needs.
- The dose should be taken approximately 30 minutes to 1 hour before planned sexual activity.
Side effects
- Common side effects of sildenafil include headache, facial flushing, indigestion (e.g., nausea, diarrhea), vision changes (e.g., blurred vision, changes in color vision), increased blood pressure, and rarely hearing loss or changes in hearing.
Contraindications
- Sildenafil should not be taken with nitrates (e.g., nitroglycerin) because of a possible severe drop in blood pressure.
It is contraindicated in patients with severe heart problems, recent myocardial infarction or stroke.
Fluoxetine
Fluoxetine is a drug that belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It is known by the trade name Prozac.
Here are the characteristics of fluoxetine
Mechanism of action
- Fluoxetine works by increasing levels of the neurotransmitter serotonin in the brain.
- It inhibits the reuptake of serotonin into nerve cells, which increases the availability of serotonin for receptor interactions.
Indications
- Fluoxetine is approved for the treatment of depressive disorders.
- It is also used to treat obsessive-compulsive disorder (OCD), eating disorders (such as bulimia nervosa), and is sometimes prescribed for generalized anxiety disorder (GAD).
Onset of action
- The onset of action of fluoxetine may take several weeks to reach full therapeutic effect.
- The effect of the drug may be gradual, and patients may observe improvements in mood states, reductions in anxiety, or changes in behavior and thinking.
Dosage
The usual dosage of fluoxetine depends on the indication:
- For depression, it is usually started with a dose of 20 mg daily, which may be increased as needed.
- For OCD, the usual starting dose ranges from 20 mg to 60 mg daily.
- For bulimia nervosa, the usual starting dose ranges from 60 mg per day.
Side effects
Common side effects of fluoxetine may include:
- Nervousness
- Insomnia or drowsiness
- Indigestion (e.g., nausea, diarrhea)
- Decreased appetite
- Increased irritability
- Weight loss
- Changes in sexual function
Contraindications
- Fluoxetine should not be taken concomitantly with MAO (monoamine oxidase) inhibitors as it may cause serious interactions and increase the risk of serotonin syndrome.
- It is contraindicated in patients with severe liver disease or allergy to fluoxetine.
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