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Sildénafil

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor, famously marketed as Viagra.

Here are the key features of sildénafil:

Mechanism of Action

• Sildenafil inhibits the enzyme phosphodiesterase type 5 (PDE5), which normally degrades cyclic guanosine monophosphate (cGMP). This results in improved blood flow during sexual arousal as nitric oxide (NO) triggers increased cGMP, relaxing smooth muscles in penile blood vessels.
• This enables the achievement and maintenance of an erection.

Indications

• Sildenafil is primarily indicated for the treatment of erectile dysfunction in men.
• Additionally, it may be used for managing arterial hypertension under the brand name Revatio.

Onset of Action

• The onset of sildenafil is rapid, typically within 30 minutes, though it may take up to 1 hour for some individuals.

Duration of Action

• The effects of sildenafil generally persist for 4 to 5 hours, sufficient for sustained erectile function.

Dosage

• The initial recommended dose of sildenafil is 50 mg, adjustable based on individual response and requirements.
• This should be taken roughly 30 minutes to 1 hour prior to anticipated sexual activity.

Effets secondaires

• Common side effects include headache, facial flushing, gastrointestinal upset (nausea, diarrhea), vision changes (blurred vision, color perception alterations), increased blood pressure, and in rare cases, hearing impairment.

Contre-indications

• Use of sildenafil is contraindicated with nitrates (e.g., nitroglycerin) due to the risk of severe hypotension, and in patients with significant cardiac issues or those recovering from a recent heart attack or stroke.

Duloxétine

Duloxetine is classified as a selective serotonin and norepinephrine reuptake inhibitor (SSNRI), marketed under the name Cymbalta.

Explore the characteristics of duloxétine:

Mechanism of Action

• Duloxetine enhances serotonin and norepinephrine levels in the central nervous system, which can elevate mood and diminish pain perception.

Indications

• Approved for various conditions, including:
• Troubles dépressifs
• Generalized Anxiety Disorder (GAD)
• Neuropathic pain (e.g., diabetic peripheral neuropathy, fibromyalgia)
• Chronic pain linked to back disorders

Onset of Action

• It may take several weeks to see full effects in the treatment of depression; however, benefits for anxiety or pain may manifest sooner in some patients.

Dosage

• Duloxetine doses typically start low and are incrementally increased based on tolerability and response.
• The standard dosage for depression is between 40 to 60 mg daily.
• For diabetic peripheral neuropathy or fibromyalgia pain, a common prescription is 60 mg daily.

Effets secondaires

• Common side effects encompass:
• Bouffées de chaleur
• Bouche sèche
• Gastrointestinal disturbances (constipation or diarrhea)
• Sleep disturbances (insomnia or drowsiness)
• Perte d'appétit
• Headaches
• Heightened anxiety or nervousness
• Reduced libido or sexual dysfunction

Contre-indications

• Should not be used in patients with certain liver conditions or when taking monoamine oxidase inhibitors (MAOIs).
• Pregnant women should exercise caution during the last trimester when considering duloxetine.