madman
Super Moderator
1:25:20-2:14:20
Take home points:
* ERECTILE DYSFUNCTION (ORGANIC/PSYCHOGENIC)
* 90% of the patient will have an ORGANIC CAUSE
* ORGANIC is usually very PROGRESSIVE
* at 70 YRS old 2/3 of men will have SOME DEGREE of ERECTILE DYSFUNCTION
* 2 types of erection (psychogenic/reflexogenic)
* in the cell the most important PATHWAY is the NITRIC OXIDE PATHWAY
* the most important NITRIC OXIDE would be from the NERVE ENDING to INDUCE the ERECTION but to MAINTAIN it, it would be the NITRIC OXIDE from the ENDOTHELIUM that would be the MOST IMPORTANT
* the TESTOSTERONE EFFECT is MAINLY on the LIBIDO/SEXUAL DESIRE
* MEDICATIONS the worst are the ANTIHYPERTENSIVES and the 2 worst are the THIAZIDE DIURETIC and the NON-SELECTIVE BETA-BLOCKERS (the old beta blockers)
* when you look OVERALL at THE RISK FACTOR I mean the WORST are the ANTIDEPRESSANTS, second is HYPERTENSION or VASCULAR
* we know now it's almost a PREDICTOR of CARDIOVASCULAR DISEASE
* the LINK between ERECTILE DYSFUNCTION and CARDIOVASCULAR DISEASE is the ENDOTHELIUM or ENDOTHELIUM DYSFUNCTION
* you have to see the ENDOTHELIUM as a LIVE STRUCTURE, I told you the IMPORTANCE of the ENDOTHELIUM is to MAINTAIN the ERECTION by LIBERATION of NITRIC OXIDE during SEXUAL ACTIVITY so it is VERY VERY IMPORTANT
* ONSET OF DYSFUNCTION - GRADUAL is usually ORGANIC except an ACUTE SURGERY whereas PSYCHOGENIC ERECTILE DYSFUNCTION is OFTEN MORE ACUTE
* the WORST TYPE of LIPID is actually the TRIGLYCERIDE if their HIGH they INCREASE the ENDOTHELIAL DYSFUNCTION
* PDE5 DESTROY THE CYCLIC GMP so the PDE5 INHIBITOR that goes with the name they INHIBIT this and then you have a MAXIMUM EFFECT of the CYCLIC GMP and the CALCIUM goes out of the CELL the MUSCLE CELL and you get the MAXIMUM EFFECT ALL THE TIME
Take home points:
* ERECTILE DYSFUNCTION (ORGANIC/PSYCHOGENIC)
* 90% of the patient will have an ORGANIC CAUSE
* ORGANIC is usually very PROGRESSIVE
* at 70 YRS old 2/3 of men will have SOME DEGREE of ERECTILE DYSFUNCTION
* 2 types of erection (psychogenic/reflexogenic)
* in the cell the most important PATHWAY is the NITRIC OXIDE PATHWAY
* the most important NITRIC OXIDE would be from the NERVE ENDING to INDUCE the ERECTION but to MAINTAIN it, it would be the NITRIC OXIDE from the ENDOTHELIUM that would be the MOST IMPORTANT
* the TESTOSTERONE EFFECT is MAINLY on the LIBIDO/SEXUAL DESIRE
* MEDICATIONS the worst are the ANTIHYPERTENSIVES and the 2 worst are the THIAZIDE DIURETIC and the NON-SELECTIVE BETA-BLOCKERS (the old beta blockers)
* when you look OVERALL at THE RISK FACTOR I mean the WORST are the ANTIDEPRESSANTS, second is HYPERTENSION or VASCULAR
* we know now it's almost a PREDICTOR of CARDIOVASCULAR DISEASE
* the LINK between ERECTILE DYSFUNCTION and CARDIOVASCULAR DISEASE is the ENDOTHELIUM or ENDOTHELIUM DYSFUNCTION
* you have to see the ENDOTHELIUM as a LIVE STRUCTURE, I told you the IMPORTANCE of the ENDOTHELIUM is to MAINTAIN the ERECTION by LIBERATION of NITRIC OXIDE during SEXUAL ACTIVITY so it is VERY VERY IMPORTANT
* ONSET OF DYSFUNCTION - GRADUAL is usually ORGANIC except an ACUTE SURGERY whereas PSYCHOGENIC ERECTILE DYSFUNCTION is OFTEN MORE ACUTE
* the WORST TYPE of LIPID is actually the TRIGLYCERIDE if their HIGH they INCREASE the ENDOTHELIAL DYSFUNCTION
* PDE5 DESTROY THE CYCLIC GMP so the PDE5 INHIBITOR that goes with the name they INHIBIT this and then you have a MAXIMUM EFFECT of the CYCLIC GMP and the CALCIUM goes out of the CELL the MUSCLE CELL and you get the MAXIMUM EFFECT ALL THE TIME
