A client is diagnosed with erectile disorder. Which of the following medications would address this condition, and what is the therapeutic action of the drug? (Select all that apply.)
1. Phentolamine (Oraverse); increases blood flow to the penis.
2. Apomorphine (Apokyn); acts directly on the dopamine receptors in the brain.
3. Vardenafil (Levitra); blocks the action of phosphodiesterase-5 (PDE5).
4. Goserelin (Zoladex); inhibits the production of gonadotropins.
5. Sildenafil (Viagra); blocks the action of phosphodiesterase-5 (PDE5).
1, 2, 3, 5
Rationale: Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) have been approved by the FDA for the treatment of erectile disorder. These newer impotence agents block the action of phosphodiesterase-5 (PDE5), an enzyme that breaks down cyclic guanosine monophosphate (cGMP), a compound that is required to produce an erection. Phentolamine has been used in combination with papaverine in an injectable form that increases blood flow to the penis, resulting in an erection. Apomorphine acts directly on the dopamine receptors in the brain. This mode of stimulating dopamine in the brain is thought to enhance the sexual response. Zoladex is a treatment for prostate cancer, not erectile dysfunction.
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