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Sildenafil

Sildenafil is a renowned medication categorized as a phosphodiesterase type 5 (PDE5) inhibitor, commonly associated with the brand name Viagra.

Explore the key features of Sildenafil below:

Mechanism of Action

• Sildenafil inhibits the enzyme phosphodiesterase type 5 (PDE5), preventing the breakdown of cyclic guanosine monophosphate (cGMP). This process is stimulated by nitric oxide (NO) during sexual arousal, leading to increased cGMP levels, relaxation of smooth muscles, and enhanced blood flow to the penis.
• This mechanism facilitates the achievement and maintenance of an erection.

Indications

• Sildenafil is primarily prescribed for treating erectile dysfunction in men.
• It is also available in its branded form Revatio for managing arterial hypertension.

Onset of Action

• The effects of Sildenafil typically begin within 30 minutes but may take up to 1 hour in some users.

Duration of Action

• The efficacy of Sildenafil lasts approximately 4 to 5 hours, sufficient for achieving and maintaining an erection.

Dosage

• The recommended starting dose of Sildenafil is 50 mg, adjustable based on individual response and requirements.
• Dosing should occur 30 minutes to 1 hour before anticipated sexual activity.

Side Effects

• 可能的副作用包括头痛、面部潮红、消化不良（如恶心、腹泻）、视觉变化（如视力模糊、色觉变化）、血压升高，以及罕见的听力丧失或听力变化。

Contraindications

• Sildenafil must not be used alongside nitrates (e.g., nitroglycerin) due to the risk of severe hypotension. It’s contraindicated in individuals with significant heart conditions or recent myocardial infarction or stroke.

Duloxetine

Duloxetine, categorized as a selective serotonin and norepinephrine reuptake inhibitor (SSNRI), is popularly known as Cymbalta.

Discover the essential characteristics of Duloxetine below:

Mechanism of Action

• Duloxetine enhances serotonin and norepinephrine levels in the central nervous system, which aids in mood improvement and pain perception reduction.

Indications

Duloxetine is indicated for:

• Depressive disorders
• Generalized Anxiety Disorder (GAD)
• Neuropathic pain, including diabetic peripheral neuropathy and fibromyalgia
• Chronic pain in patients with persisting back conditions

Onset of Action

• The therapeutic effects of Duloxetine may require several weeks to fully materialize in depression treatment.
• In certain cases, it may act more rapidly for anxiety or pain relief.

Dosage

• Duloxetine is usually initiated with low doses, progressively increased according to patient response and tolerability.
• Standard daily dosages for depression range from 40 to 60 mg.
• For diabetic peripheral neuropathy or fibromyalgia, a common prescribed dose is 60 mg daily.

Side Effects

• Common side effects may include hot flashes, dry mouth, gastrointestinal symptoms (such as constipation or diarrhea), insomnia or drowsiness, anorexia, headaches, elevated anxiety, and sexual dysfunction.

Contraindications

• Duloxetine is contraindicated in patients with certain liver diseases or those taking monoamine oxidase inhibitors (MAOIs).
• Pregnant women should use caution when taking Duloxetine, particularly during the last trimester.