Which of the following agent is not used in erectile dysfunction?

Ans. c. Phenylephrine (Ref: KDT 7/e p303-304, 6/e p295-296; Harrison 19/e p326, 18/e p377)PGE2, Vardenafil (phosphodiesterase-V inhibitor) and Alprostadil (PGE1) are used in erectile dysfunction.Phenylephrine is not used in erectile dysfunction.L-arginine - increased NO - Increases c-GMP - Decreased Ca2+ - Smooth muscle relaxation - ErectionTreatment of Erectile DysfunctionSildenafilOnly approved and effective oral agents for erectile dysfunctionQUseful in wide range like in psychogenic, diabetogenic, vasculogenic, post radical prostatectomy (nerve sparing procedure) and spinal cord injury.Acts by inhibiting phosphodiesterase V (PDE -V)Q and releasing NOQ from nerve endings and endothelium.C-GMP is metabolized by PDE-V which is inhibited by sildenafil.Other phosphodiesterase-V inhibitors: TadalafliQ and vardenafilQPIPE therapy: (PapaverineQ/Phentolamme induced penile erection)AndrogenQIntra-urethral alprostodil (PGE1)QPenile prosthesis, vacuum constriction deviceRemember:Master Johnson technique is for premature ejaculationQ.Beta blockers can cause erectile dysfunctionQ.Drugs causing Erectile DysfunctionEnzyme Inhibitors: Ketoconazole, cimetidineAll Anti-hypertensives: Minimum with ACE inhibitors, maximum with beta-blockersAll abusive drugs at high doseFemale hormonal drug given to male, e.g., SERM, estrogen, exmestaneAll psychotic drugsAnti-depressants and anti-psychotic drugs