What Drugs Can Cause Priapism?
One of the principal causes of blue flowing priapism is the use of drugs with α - adrenergic antagonist effect , among which antipsychotic drugs stick out out , and to which up to 50 % of these cases are attributed . It is assumed that the sympathomimetic blockade triggers an imbalance in favor of the parasympathetic pure tone with the consequent liberalization of the cavernous arterioles , decreased sinusoidal venous rejoinder and persistent engorgement of the cavernous bodies . consecutive , the increase in tissue pressure ( which in exercise constitute a compartment syndrome ) exceeds descent force per unit area with the consequent ischaemia , hypoxia and acidosis that , as the cascade of events progresses , will lead to thrombosis , cell death and penial fibrosis .
Although the population relative incidence of priapism is 15 - per 100.000 ( and double among male person over 40 years old , which is the most affected eld grouping ) , the severity of possible sequelae imposes a reinforcement of the preventative position towards the theory of this complication : in the case of priapism induct by major tranquilizer , commonly used drugs for chronic exercise , an elementary preventive measure is to find the presence of extra danger factor such as , among others : blood dyscrasias ( polycythemia , thalassemias , sickle cell disease ) , the economic consumption of psychoactive substances ( alcohol , cocain , amphetamines ) , habit of other α - blocking agent ( terazosin , tamsulosin , guanethidine , etc . ) , which could discourage the use of antipsychotics with high α - adversary affinity , such as risperidone or , in the fount of prescription medicine , obligatorily levy close monitoring . possible pharmacokinetic interactions that put forward plasm levels of drugs associated with priapism should also be considered . Additionally , it has been described that many patients develop sustain and non - afflictive erection before the full episode of priapism : however , patients do not spontaneously mention this problem ( nor do the physicians usually approach it ) . In this sentiency , users should be systematically interrogated for the front of these phenomena during the time of use of the drug and , if there is a positive reply , consider its potential suspension in a timely manner .
The therapeutic approach of priapism depends fundamentally on the eccentric diagnosed : in the grammatical case of ischaemic priapism , initial management ask aspiration and verbatim irrigation of the erectile bodies with diluted adrenergic agent -for example , phenylephrine or ethylephrine- and , in case of unsuccessful person of these procedures , the operative anastomosis of the erectile bodies must be made to the spongelike body or venous feeder -such as the greater saphenous vein- to accomplish penile limpness : either the anastomosis performed at the glans level or , in more severe slip , even at the base of the penis .
Conclusion
The wide of the mark economic consumption of drug such as antipsychotics in medicine , psychiatry and other specialties obliges physician to take into account this infrequent but hurtful adverse event of priapism , which may well be separate as idiosyncratic , since it is not related to the Cupid’s disease of the psychopharmaceutical or the duration of the treatment .
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