Drug dysfunction erectile medication daily news.

May 19, 2004 (New Orleans) — New medicines — ranging from a
relative of Viagra to an arthritis drug — target the haywire immune responses
that underlie inflammatory bowel disease (IBD).

Inflammatory bowel disease is the umbrella term for a number of
conditions that cause inflammation of the bowel. The two most common ones are
ulcerative colitis and Crohn’s disease. Both of these conditions occur when the
immune system goes awry and attacks the lining of the colon. The disorders take
a toll on their victims - affecting more than 1 million in the U.S. alone –
causing belly aches, diarrhea, and other symptoms that are often severe enough
to interfere with daily activities, says James B. Lewis, MD, associate director
of the inflammatory disease program at the University of in
Philadelphia.

“We’re seeing many different approaches to treat this
inflammation,” says Stephen B. Hanauer, MD, professor of medicine and
clinical at the University of Chicago Pritzker School of Medicine.
“For example, corticosteroids already used to treat IBD, are effective
anti-inflammatory agents but they affect all tissues, causing many side
effects.”

Many of the new drugs, on the other hand, selectively target
the defects associated with IBD — an approach that promises better results
with fewer side effects, he tells WebMD.

There were a number of new approaches discussed here at
Digestive Disease Week, a major medical meeting of gastroenterologists.

Arthritis Medication Combats Crohn’s, too

The rheumatoid arthritis drug Humira helped patients with
moderate Crohn’s disease to go into remission, Hanauer says.

A man-made biological substance called a monoclonal antibody,
Humira works by blocking an inflammation-causing protein called tumor necrosis
factor alpha, or TNF-alpha, that has been implicated in both rheumatoid
arthritis and Crohn’s disease.

In a study of nearly 300 patients who did not improve despite
treatment with standard medications, 30% of those given higher doses of Humira
were in remission by four weeks later, compared with only 12% on placebo,
Hanauer reports.

Humira is an injectable drug and was extremely well tolerated,
he says.

New Immune System Drug Antibody Prevents Crohn’s Flare-Ups

In another new study, the drug Antegren helped prevent
flare-ups associated with Crohn’s disease in people who were in remission,
reports Brian G. Feagan, MD, professor of medicine in the department of
epidemiology and at the University of Western Ontario in
London.

The drug has already been shown to induce remission in Crohn’s
sufferers.

Antegren works by keeping immune system cells from leaving the
. In Crohn’s patients, this appears to prevent the immune system
attack on the gut that occurs with the disease, Feagan says. “If we can
prevent that, white blood cells would stay in the where they
belong.”

The researchers studied 339 adults with Crohn’s disease who had
improved or gone into remission after receiving three infusions of Antegren.
The patients were randomly assigned to continue to receive Antegren for up to
12 additional monthly infusions, or to placebo.

Six months later, 44% of patients given Antegren were still in
remission, compared with 26% on placebo, Feagan says. Also, 61% of those taking
the drug continued to show an improvement in symptoms, compared with 29% on
placebo.

People who took Antegren were no more likely to suffer side
effects than those on placebo, he explains.

June 25, 2001 — It probably won’t be coming soon to a bar or
urology clinic near you, but a cocktail of crushed termites, mashed ants, chili
peppers, and fruits packs a Viagra-like wallop and could be a natural
alternative to Pfizer’s little blue pill as a treatment for erectile
dysfunction, says a Cornell University plant biologist who personally vouches
for the natural compound.

On a trip to Venezuela, Eloy Rodriguez, PhD, was given some of
the substance by his hosts to use as a spice for his food. “After I took a
lot of it they looked at me with total surprise and said, ‘You’re going to need
a doctor in the morning, because it’s going to make your penis get very hard,’
and they were absolutely correct. It was very powerful,” says
Rodriguez.

You don’t need a for the “bio-Viagra,” but
you do have to travel to the Amazon region of Venezuela and ask the women of
the Yequana tribe to mix up a batch of it, he says.

“Every tribe in the Amazon has a substance, extract, or
mixture that they will tell you is used to stimulate erection. If
you go to the Caribbean you’ll find the same thing. It’s been there since the
beginning of time. I think that in earlier times, stimulants must have been
very important, because being the king or the ruler in power you had to be
sexually quite potent and be able to maintain it.”

Back in their lab in the Finger Lakes region of New York,
Rodriguez and performed a chemical analysis on the mysterious potion
and found that it contains chemicals similar to those found in Viagra, as well
as a healthy dose of testosterone, both of which might account for the
compound’s impressive action. The are currently exploring plant
derivatives from the Caribbean island of Dominica and from the Dominican
Republic that are said to have similar properties to the Yequana mixture.

“I think as one does more serious chemical research, we’re
going to uncover ‘natural’ Viagras that might even be more potent than the one
that has been made synthetically,” Rodriguez says.

April 10, 2000 (Mill Valley, Calif.) — In his early 40s, Ron Hanson was too
young to be having trouble getting and sustaining erections. But like many men,
he was too embarrassed at first to talk about the problem. Hanson (not his real
name) waited seven years to see a urologist. By the time he spoke up, erectile
dysfunction had become a household word, thanks to the popularity of the drug
Viagra. But the widely touted drug, Hanson soon learned, doesn’t work for
everyone.

When Viagra (sildenafil) hit the market in 1998, some men thought it was the
answer to their problems. Many rushed to doctor’s offices to give
it a try. According to the Grey Clinic in , which specializes in
erectile dysfunction, 17% of men between 18 and 55 experience occasional
impotence, while 6% have regular erectile . For men over 55, that
number jumps to about one in three. Some common causes of impotence are
diabetes, heart disease, and psychological problems. It also frequently occurs
after prostate cancer surgery.

Because Viagra works in a way that’s similar to drugs that contain nitrates,
however, it isn’t recommended for men who take nitrates for heart disease or
those with certain other heart conditions. In some men, it causes bad
headaches. In others, it just plain doesn’t work. In some instances, men may
notice they have trouble telling blue and green colors apart when they start
taking the drug.

During an erection, blood flows quickly into the penis, which increases its
length, width, and firmness. If the “in” vessels (arteries) are too
narrow or if blood drains too quickly through the “out” vessels
(veins), men may have trouble achieving or maintaining an erection, says Arnold
Aigen, MD, a urologist with Camino Medical Group in Sunnyvale, Calif. Viagra,
which increases inflow, may not be strong enough to work its magic if the
arteries are too narrow.

Hanson tried Viagra, but he couldn’t tolerate the headaches it caused.
Luckily, when Viagra fails, he discovered, there are several alternatives.

Alprostadil to the Rescue

A drug called Alprostadil, either alone or sometimes in conjunction with
others such as papaverine and/or phentolamine, can be injected directly into
the penis to dilate the arteries, experts say. The drug produces an erection in
about 10 minutes that can last up to an hour. But there are several
disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some
patients are averse to using a needle, which is why many men abandon the
therapy. Those who give it a try may experience pain at the injection site or
priapism (a painful erection lasting too long).

As an alternative, Alprostadil is available as a pellet-like suppository
that is inserted into the tip of the penis and absorbed through the lining of
the urethra. This can help produce erections lasting for 30 to 60 minutes,
according to the Impotence World Association (IWA). Unfortunately, the
suppositories are less effective than injections and may cause pain and
irritation, according to both Aigen and Beam.

Last November, a topical gel formulation of alprostadil was approved by the
U.S. Food and Drug Administration. It is too soon to know if this form of
alprostadil therapy will become widely used.

Mechanical Help

With a vacuum constriction device, the penis is placed in a cylinder with an
attached pump, creating a vacuum to draw blood into the penis. Firmness is
sustained by a constriction band placed around the base of the penis. The IWA
estimates the technique can produce erections for up to 30 minutes. Beam calls
the alternative “a good way to go” because it has minimal side effects,
but admits it is cumbersome and takes some practice.

Some men opt for penile implants, which involve the placement of tubes in
the penis and a pump in the scrotal sac. The pump (usually the size and shape
of a testicle) enables men to obtain an erection whenever and for as long as
they desire by pumping a saline solution from a reservoir into the penis.
Implants are a last resort, however, says Beam. “Once a prosthesis is
implanted, a patient cannot respond to anything else because it alters the
natural anatomy.”

Fortunately, Ron Hansen didn’t have to go that far. He has become used to
injecting himself with Alprostadil, which produces a firmer erection than he
experienced with Viagra, and one that lasts at least 30 minutes. It also
doesn’t cause the headaches associated with Viagra. Hanson occasionally uses
the suppositories, though they take longer to work.

For Hanson, admitting that he had a problem in the first place was the
hardest part. “But when you don’t function as you should,” he says,
“the therapy makes a big difference.”

Mari Edlin is a freelance journalist and marketing
consultant specializing in health care. She contributes
regularly to Healthplan magazine, Modern Physician, and
Managed Healthcare magazine, and works with many health care
organizations in the San Francisco Bay Area.

July 20, 2001 (Washington) — It’s called trail mix, and it’s a far cry from the healthy blend of fruits and nuts you’d take on a hike, say the experts.

Instead, it’s the latest party drug craze, consisting of ecstasy — known to cause an intense high — and Viagra, which is used to improve sexual prowess. For now, the primary users are gay men in New York City and Boston where trail mix is showing up at dance parties and clubs.

“It’s not necessarily sexual; if people want it to be sexual, they’ll put the stimulant in it. It’s just considered a more interesting version of ecstasy,” Patricia Case, ScD, of the department of social medicine at Harvard Medical School, tells WebMD.

Nor is trail mix limited to gay users; Case says many heterosexual men and teens are trying it as well. There are many popular variants of the drug , which is ground up into a powder and snorted. Ketamine, a cat tranquilizer, can sometimes be added to offer a mellower, longer high, but at a price.

“The down side is that the stimulant effect of the ecstasy can override the perception of ketamine, so that people can take too much … of the trail mix. And the ketamine then puts them into what’s called a ‘K-hole,’ which is a very unattractive state,” says Case.

As part of her studies, Case says she sees people unable to walk after taking the blend and some ultimately require medical attention. She describes their appearance as “glassy-eyed.”

Case presented her findings at the first international conference on ecstasy under way this week at the National Institutes of Health. Some 600 researchers attended the event sponsored by the National Institute on Drug Abuse, or NIDA.

Ecstasy is one street name for MDMA, a laboratory drug has that has both the power to stimulate the brain and cause a hallucinogenic-like state. Since the mid-’90s when ecstasy first appeared in the rave club scene, it’s become an increasing public health threat, according to NIDA’s director, Alan Leshner, PhD.

Though illicit drug use was generally down among youth last year, that wasn’t true for ecstasy. “The demand is very great, and it has moved out of the club scene,” Leshner tells WebMD. “Now what’s so alarming is that this year, for the first time, we saw this increase in twelfth graders, tenth graders, and eighth graders,” he says.

For example, 3.1% of U.S. eighth graders have tried ecstasy, says Leshner, and 8.2% of twelfth graders have used the illicit drug. Overall, it’s estimated that more than 100,000 13- and 14-year-olds have taken the drug.

While the high can be intense, so can be the consequences, including possible brain damage or death. Ecstasy acts on two crucial brain chemicals: dopamine, which is linked to stimulation and serotonin, a mood modifier.

Animal studies have already shown that ecstasy destroys serotonin-producing cells. “Think about going around for weeks with your brain impaired … at least,” says Leshner.

Ecstasy can also cause a fever as high as 108 degrees.

Although one doesn’t acquire a physical dependence on the drug, Leshner says people develop a compulsion to get it. And that’s not just in the big cities. Robert Carlson, PhD has done a study on ecstasy use in Ohio.

Carlson tells WebMD his state is the “heart of it all.”

“It’s far more pervasive in our high schools, at least in our part of the country, among high school aged youth and young adults,” says Carlson, a medical anthropologist at the Wright State University school of Medicine in Dayton, Ohio. He got his from a broad group including active users, police, and treatment providers.

One of the big issues, says Carlson, is that kids still haven’t heard their peers talk about overdosing on ecstasy or getting arrested. So while there’s still time, he cautions parents to discuss the issue with their children.

“You have to converse with them and just say, ‘Do you come in contact with it?’ … Then tell me about it,” says Carlson.

Nov. 14, 2001 — Viagra has helped thousands of impotent men restore their sex lives. But for men with chronic heart failure and impotence, the “little blue pill” may not be an option. Many of these men take nitrates for heart failure, which can prove deadly if combined with Viagra. But there may be an alternative. Researchers have found that a regimen of regular bike riding can improve overall health, as well as sexual function, in men with chronic heart failure.

“We found that exercise can act as a medical therapy to improve both sexual function and overall quality of life in these patients,” says study leader Romualdo , MD, director of the Lancisi Heart Institute in Ancona, Italy, in a news release.

Belardinelli team looked at about 60 men, average age 57, with stable, chronic heart failure but no prostate problems. About half of them were taking nitrates. The researchers randomly split the men into two groups. One followed an eight-week regimen of supervised stationary bicycling three times per week; the other maintained their normal lifestyles. All the men continued on whatever drugs they’d been taking. They completed on quality of life and sexual activity and underwent fitness and overall health testing before and after the study.

At the end of the study, tests revealed s in the cardiovascular systems and overall health of the exercise group but not the control group. Peak oxygen uptake had improved 18%, and blood vessels were responding more appropriately. What’s more, these objective improvements correlated with self-reported improvements in quality of life and sexual function.

“We found improvement … among patients who were cycling,” says Belardinelli. He suggests that the exercise may boost health by causing positive changes in the cells (called the ) that line the blood vessel walls. These changes would mean more oxygen-rich blood is reaching all parts of the body, including the penis.

Aug. 9, 2001 — Mention Viagra, the popular drug used to treat erectile dysfunction, and people tend to snicker. But as researchers at Boston Children’s Hospital and other centers have found, Viagra could be a life-saver for kids with a rare but potentially fatal lung disease called pulmonary hypertension.

According to the National Heart, Lung, and Blood Institute, about 300 cases of pulmonary hypertension are diagnosed in the U.S. each year. In the disease, blood pressure within a certain vessel in the lungs rises sharply for no known reason. The increase in blood pressure, or hypertension, leads to stiffening of the blood vessels in the lungs. This causes increasing shortness of breath and puts a severe, often fatal, strain on the heart.

Children with the disease are typically treated with nitric oxide delivered through a ; the gas helps the blood vessels in the lungs relax and allows more blood to flow through them. Yet when doctors try to wean them off the gas, their blood pressure can skyrocket again, putting them back in danger.

But as David Wessel, MD, and Andrew Atz, MD, reported in the journal in 1999, the same mechanism that helps men with erectile dysfunction achieve erection after taking Viagra may also help children be eased off nitric oxide. The drug works by preventing the release of nitric oxide from blood vessels, allowing the vessels to stay relaxed and blood to flow through them.

Marshall L. Summar, MD, who commented on the Viagra treatment, tells WebMD that a child’s inability to produce enough nitric oxide appears to be a factor in them developing the disease.

“Anything you can do to bolster nitric oxide production is probably going to be of some help,” he says. “There are probably some more direct ways to get at it that are a lot cheaper than Viagra that we’re looking at, but that’s for the future.” Summar is associate professor of pediatrics in the division of medical genetics and molecular physiology and biophysics at Vanderbilt University Medical Center in Nashville.

To date, Wessel and colleagues at Children’s Hospital have successfully weaned 13 of 14 children off of nitric oxide, in some cases using Viagra pills they crushed and delivered through feeding tubes. An additional 15 to 20 children have been treated at other hospitals with similar results, Wessel said in a Boston Globe interview last week.

Wessel recently returned from London, where he and nine other doctors attempted to persuade Pfizer, the maker’s of Viagra, to develop and test the drug in an formulation that would specifically treat children with pulmonary hypertension.

But because the demand for drugs to treat this disease is very small compared to the multibillion dollar market for erectile dysfunction drugs, it’s not certain whether Pfizer would be willing to commit to the estimated $4-10 million it would cost to test a drug in clinical trials.

“Our focus right now is on the medical possibilities,” Pfizer spokesman Geoff Cook tells WebMD. “There has been data out there that seems to show Viagra potentially could be a very important treatment for a condition that really has no treatments. It’s a crying medical need and that’s our focus.”

Women with arousal problems who took Viagra in a study funded by the drug’s manufacturer achieved sexual more often than those who took placebo pills. But further research is needed to prove that the impotence pill has a role in the treatment of female sexual dysfunction, experts say.

Viagra works in men with erectile dysfunction by increasing blood flow to the penis. It is not clear whether blood flow plays a role in some female sexual problems, but say the results of this study suggest that it does. The findings were presented this week at the 10th World Congress of the International Society for Sexual and Impotence Research in Montreal.

Roughly 42% of the women taking Viagra reported increased satisfaction during foreplay and sexual intercourse, compared with 28% of women taking the placebo. Likewise, 57% of the Viagra-treated women reported improved sensation in the genital area during sex, compared with 44% of women taking the placebo. Side effects of treatment with Viagra were considered mild to moderate and included headaches, flushing, runny nose, and nausea.

Viagra seemed to work best in women with sexual arousal problems who had previously satisfying sex lives. It was less effective in those who had both arousal problems and problems with sexual desire.

“Viagra doesn’t really increase desire in men, so there is little reason to believe it would do so in women,” says sexual dysfunction exert Marian Dunn, PhD. “This study shows that a subgroup of women might benefit from Viagra. A woman with normal hormone levels who is in a good relationship and used to enjoy sex but no longer does might be a good candidate.”

Dunn, who is director of the Center for Human Sexuality at SUNY Downstate Medical Center in New York, tells WebMD that female sexual dysfunction is only now beginning to get the attention it deserves.

“We don’t really have much to offer women,” she says. “I’m a sex therapist, and I know that many women are helped by therapy, but many others either don’t have access or would not be open to it. There are a lot of women out there who are suffering, and many might find this treatment to be effective.”

But psychologist Leonore Tiefer says sexual problems tend to be more complex in women than in men and probably will not be as easy to treat with drugs. An outspoken critic of drug industry-sponsored research into female sexual dysfunction, Tiefer warns of what she calls the medicalization of sex problems in women.

“In the study, 44% of the women taking placebos had improved genital sensation,” she says. “That sounds high, but it is standard for the placebo arm of Viagra studies. Once you take a pill, no matter what it is, you make love in a different way and there may be a benefit. The problem is that you shouldn’t take medicine unless you need it, and this drug has side effects.”

Viagra is not approved in the U.S. for use in women. A spokesperson for manufacturer Pfizer Inc. tells WebMD that the decision about whether to seek such approval will be made when larger clinical studies are completed.

Feb. 12, 2002 — If you’re strong enough to take the sex, you’re strong enough to take Viagra. A new study finds Viagra safe for men with heart disease — if they’re able to exercise without having the symptoms of severe disease.

Men taking nitrate drugs (such as ) to ease the symptoms of heart disease can’t use Viagra. Even when a man isn’t taking nitrates, there’s been concern that Viagra might make his underlying heart disease much worse. There have been reports of men suffering heart attacks or chest pain after taking the popular erectile dysfunction drug.

Adelaide M. Arruda-Olson, MD, PhD, led a team of Mayo Clinic researchers who studied the effects of Viagra on 105 men with coronary artery disease (or heart disease). The men took Viagra or a harmless sugar pill an hour before exercise tests. Then were switched, and the men exercised and were tested again.

The results: Viagra itself didn’t make exercise harder on the heart.

“It seems more likely that the heart attacks and pain reported with Viagra are related more to the performance of sexual activity in a patient with coronary artery disease than the use of the drug,” notes Thomas H. Marwick, MD, PhD. Marwick is a heart disease researcher at the University of Queensland in Brisbane, Australia. The Arruda-Olson study, and Marwick’s accompanying editorial, appear in the Feb. 13 issue of TheJournal of the American Medical Association.

Arruda-Olson and co-workers warn that men with heart disease should see their doctors before taking Viagra. They recommend exercise tests to determine whether patients’ hearts are strong enough for the drug.

The researchers warn that men taking drugs for their heart condition should not take Viagra.