Comment
Author: Admin | 2025-04-28
Priapism), and history of malignancy (leukemia, multiple myeloma).1 Contrasting with the other subtypes of priapism, venous flow is left unimpeded, exposing the cavernosum to oxygenated blood. The erection is not fully rigid, often painless, and not associated with long-term erectile dysfunction.1,3,5 See Table 1 for clinical features of priapism. Drug-Induced Priapism Pharmacologically induced priapism is not often considered as a side effect in many common medications and recreational drugs. Awareness of this potential side effect may improve patient outcomes in the management of depression, hypertension, lower urinary tract disorders, and hypercoagulable disorders, such as SCD, and reduce the likelihood of priapism.6 Of the drug-induced cases of priapism, more than half are linked to the use of typical antipsychotics. Use or abuse of psychopharmaceuticals is a common factor in ischemic priapism; trazodone is the most commonly associated prescription drug, and among recreational drug abusers, cocaine is associated with priapism. Additional recreational substances associated with priapism include alcohol and amphetamines. Other pharmaceuticals associated with priapism include the newer atypical antipsychotics, antihypertensives, and anticoagulants.7,8 However, there are no indicators that can predict who may develop drug-induced priapism, which may present at any time during therapy or with the addition of new medications.9 The majority of cases of pharmacologic priapism remain to be fully explained but are likely to be multifactorial physiological disorders. Risk of priapism associated with medications is attributed to alpha-1-adrenergic receptor antagonism or veno-occlusive effects. The alpha-1-receptor is predominant in the urinary tract and vital to smooth-muscle contraction. Antagonism of alpha1-receptor may lead to arterial dilation that triggers venous stasis due to increased intracavernosal pressure, thus inhibiting penile detumescence. Veno-occlusive incidents can occur with medications or imbalance of the sympathetic autonomic nervous system that regulates phosphodiesterase inhibitors and thus prevents termination of the erectile response. In any circumstance, the offending agent, if known, should be discontinued and an early treatment plan initiated.8-10 Antipsychotics Sexual dysfunction is prevalent among patients taking antipsychotic drugs (APDs) because they antagonize dopaminergic transmission in the central nervous system. APDs are best classified as typical and atypical, with the two classes differing by varying affinities to dopamine
Add Comment