Current oral treatments for erectile dysfunction

Abstract

Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection adequate for satisfactory sexual intercourse. It is a significant male health problem of global dimensions affecting approximately 150 million men worldwide. A broad range of options are currently available for the management of ED. They include oral agents (phosphodiesterase 5 inhibitors, dopamine agonists and alpha-receptor blocking drugs), intracavernosal injection (papaverine, phentolamine, prostaglandin E1, vasoactive intestinal peptide), transurethral vasoactive agents (prostaglandin E1), vacuum erection devices, vascular surgery and penile prostheses. Here we review the physiology of penile erection and the currently available oral preparations. In addition, novel therapeutic strategies to improve erectile function are discussed.

Ca2+Sensitivity of Smooth Muscle and Nonmuscle Myosin II: Modulated by G Proteins, Kinases, and Myosin Phosphatase

“…All the known components of the RhoA/ ROK pathway, including MYPT1 and CPI-17, are present in corpus smooth muscle in which, moreover, RhoA content is 17-fold higher than in ileum smooth muscle and RhoA activation is demonstrable (412). Naturally, the therapeutic use of ROK inhibitors for erectile dysfunction is being considered (180). ADP-ribosylation of endogenous RhoA with transfected C3 reduces the sensitivity of hamster resistance vessels to extracellular Ca 2ϩ (34), and Y-27632 dilates the basilar artery of anesthetized normotensive rats, suggesting that in these blood vessels, like in corpus cavernosum, RhoA/ROK is constitutively active, and it is likely to be a tonically active regulator in several tissues of the whole organism.…”

Naturally Isolated Pyridine Compounds Having Pharmaceutical Applications

“…It has a long past and is most commonly used as an antibacterial agent [58,59]. Papaverine 47 is used as a vasodilator under the trade name Para-Time® SR and is used as oral medicine to treat erectile dysfunction (Figure 12) [60]. Ellipticine 48 is used in cancer treatment, as it is alleged to act through DNA intercalation and inhibition of topoisomerase II [61]…”

Development of Simplified Vasoactive Intestinal Peptide Analogs with Receptor Selectivity and Stability for Human Vasoactive Intestinal Peptide/Pituitary Adenylate Cyclase-Activating Polypeptide Receptors

“…VIP is proposed to play a role in a number of disease states (Gozes and Furman, 2004), including a role in growth of cancer cells (Moody, 1996;Moody et al, 2003;Gozes and Furman, 2004), various central nervous system disorders (Gozes and Brenneman, 2000;Dogrukol-Ak et al, 2004;Gozes and Furman, 2004), various inflammatory disorders such as rheumatoid arthritis (Gozes and Brenneman, 2000), and various immunological disorders (Delgado et al, 2004), and a role has been proposed for VIP in treatment of asthma (Groneberg et al, 2001), impotence (Sandhu et al, 1999;Kalsi et al, 2002), and for treatment of septic shock (Kalsi et al, 2002;Delgado et al, 2004), central nervous system disorders (Gozes and Brenneman, 2000;Dogrukol-Ak et al, 2004), and diabetes (Yung et al, 2003).…”