Sildenafil
Sildenafil, commonly known as Viagra, is a member of the phosphodiesterase type 5 (PDE5) inhibitors group, primarily utilized for treating erectile dysfunction.
Mechanism of Action
- This medication effectively blocks the enzyme PDE5, leading to an increase in cyclic guanosine monophosphate (cGMP) levels. This process enhances blood flow to the penis during sexual arousal through relaxation of smooth muscle in blood vessels.
- As a result, it facilitates the achievement and maintenance of an erection.
Indications
- Sildenafil is primarily indicated for the treatment of erectile dysfunction in men.
- Additionally, it may be prescribed as Revatio for arterial hypertension.
Onset of Action
- The onset of action for sildenafil occurs rapidly, typically within 30 minutes to 1 hour post-ingestion.
Duration of Action
- The effects generally last for approximately 4 to 5 hours, allowing sufficient time for successful sexual activity.
Dosage
- The standard starting dose is 50 mg, which can be adjusted based on individual needs and response.
- It is recommended to take the dose roughly 30 minutes to 1 hour before engaging in sexual activity.
Side Effects
- Common side effects may include headache, flushing, indigestion (e.g., nausea, diarrhea), visual disturbances (e.g., blurred vision), increased blood pressure, and, in rare cases, hearing changes.
Contraindications
- Sildenafil should never be combined with nitrates (e.g., nitroglycerin) due to the risk of severe hypotension.
- It is contraindicated for individuals with severe cardiovascular issues, recent heart attacks, or strokes.
Fluoxetine
Fluoxetine, marketed under the brand name Prozac, is a selective serotonin reuptake inhibitor (SSRI) used primarily to treat various depressive disorders.
Mechanism of Action
- This medication increases serotonin levels in the brain by inhibiting its reuptake into the nerve cells, enhancing receptor interaction availability.
Indications
- Fluoxetine is approved for treating depressive disorders.
- It is also utilized for obsessive-compulsive disorder (OCD), eating disorders like bulimia nervosa, and occasionally for generalized anxiety disorder (GAD).
Onset of Action
- Fluoxetine may take several weeks to achieve its full therapeutic effect, with gradual improvements in mood, anxiety, and behavior.
Dosage
The recommended dosage varies based on the condition:
- For depression, initiation usually starts at 20 mg daily, adjustable as required.
- For OCD, the initial dose often ranges from 20 mg to 60 mg daily.
- For bulimia nervosa, treatment typically starts at 60 mg per day.
Side Effects
- Possible side effects include nervousness, insomnia or drowsiness, indigestion (e.g., nausea, diarrhea), reduced appetite, increased irritability, weight loss, and alterations in sexual function.
Contraindications
- Fluoxetine should not be administered in conjunction with MAO inhibitors due to severe interactions that could trigger serotonin syndrome.
- It is also contraindicated for patients with severe liver disease or those allergic to fluoxetine.
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