■ Overview:What goes up, mustcome down. It’s an old story, but nevermore unwelcome than today, as legionsof baby-boomer males (and evenpost-baby-boomers) confront theirdeclining virility and sexual potency. That’s why Viagra®
cological gold as soon as it hitpharmacies in 1998. Then it wentplatinum, as Viagra became a franchise builderfor Internet pharmacies. And faster than you cansay “sex-stasy,” Viagra was on the recreationaldrug map, as both gay and straight revelersadopted it as a way of reversing the effects ofecstasy, amphetamines, and other drugs knownto impair sexual function.
■ Appearance: Blue, diamond-shaped tablets,with “25,” “50,” or “100” embossed on oneside, denoting tablet strength.
■ Actions/Effects: Viagra works by dilatingblood vessels throughout the body, allowingblood to flow more readily to the heart, lungsand other organs. In addition, Viagra relaxessmooth muscle contractions in the penis. About70 percent of men using it report some improve-ment in achieving and maintaining an erection. Effects usually begin within 30 minutes, and lastabout 4 hours.
■ Risks/Side Effects: Side effects include head-ache, flushed skin, and anxiety. More seriousrisks can include distorted vision and pri-apism—a painful, prolonged erection that mayrequire medical intervention. After 69 deathswere linked to Viagra during its first threemonths on the market, the U.S. Food and DrugAdministration issued a warning against usingit with amyl nitrate (“poppers”), nitroglycerin,and nitrous oxide. Since each dilates blood ves-sels, a dangerous drop in blood pressure canresult, leading to possible heart attack or stroke. Also, those taking protease inhibitors should notuse Viagra without consulting a physician.
■ Medical Uses: In addition to its primary uses,Viagra is being tested against pulmonary hyper-tension in children and infertility in women.
■ Trends: Viagra was quickly adopted by usersof ecstasy (and other club drugs known to de-crease sexual performance), a combination themedia quickly dubbed “sex-tasy.”Health officials warn that menwho take Viagra with alcohol ordrugs are more likely to indulgein unsafe sex. In a study of 844 male patients inSan Francisco, 32% of gays and 7% of straightmen who reported using Viagra were more likelyto have multiple sexual partners and to have con-tracted a sexually-transmitted disease than menwho had not used it.
■ Demographics: On the heels of its fast start,Viagra was soon joined on the prescription-drughit parade by act-alike drugs Levitra® and Cialis®. Cumulatively, the drugs accounted for more than16.7 million U.S. prescriptions in 2005.
This is one in a series of fact sheets on drugs and healthpublished by Do It Now Foundation. Please call for a com-plete list of titles—or visit our web site at www.doitnow.org.
CORRESPONDENCE Ann Thorac Surg 2012;94:1782–9 References Davide Pacini, MD 1. Parolari A, Pesce LL, Pacini D, et al. Monzino Research Department of Cardiac Surgery Group on Cardiac Surgery Outcomes. Risk factors for S Orsola-Malpighi Hospital perioperative acute kidney injury after adult cardiac sur- University of Bologna gery: role of perioperative ma
1. Le médecin a prescrit à Mr X. une injection de vitamine K en intraveineuse directe. Vous disposez d’ampoules de vitamine K de 1 ml contenant 50 mg de produit actif. Quel volume (en ml) devez-vous injecter ? 2. Vous devez injecter par voie intramusculaire 250 mg de vitamine B1 par jour, en une seule fois. Vous disposez d’ampoules de 2 ml de vit. B1 dosées à 100 mg. Quel volume (en ml)
■ Overview: What goes up, mustcome down. It’s an old story, but nevermore unwelcome than today, as legionsof baby-boomer males (and evenpost-baby-boomers) confront theirdeclining virility and sexual potency.
■ Risks/Side Effects: Side effects include head-ache, flushed skin, and anxiety. More seriousrisks can include distorted vision and pri-apism—a painful, prolonged erection that mayrequire medical intervention. After 69 deathswere linked to Viagra during its first threemonths on the market, the U.S. Food and DrugAdministration issued a warning against usingit with amyl nitrate (“poppers”), nitroglycerin,and nitrous oxide. Since each dilates blood ves-sels, a dangerous drop in blood pressure canresult, leading to possible heart attack or stroke.