Rx Note

Introduction Raynaud phenomenon is a common condition that is triggered by exposure to cold and/or stress , leading to vasospasm in the extremities (most commonly in the fingers and/or toes). The vasospasm causes the skin to turn white and then blue, which is followed by painful swelling when the affected areas warm and can result in amputation in severe cases. NOTE: Raynaud phenomenon can be a primary condition or can occur secondary to a connective tissue disease (e.g. systemic sclerosis) or other disease (e.g. arthrosclerosis, malignancy) Management For patients with uncomplicated Raynaud phenomenon (no progression to digital ulceration or critical ischemia), lifestyle changes are effective to control attacks. Avoid cold exposure, e.g. the use of gloves and warm clothing Smoking cessation Avoid vasoconstricting drugs, e.g. pseudoephedrine, phenylephrine, methylphenidate, beta blockers In more severely affected patients, particularly those with an underlying connective tissue diseas...

Introduction Erectile dysfunction (ED) (commonly known as impotence) is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance . It can occur at any age, with studies involving men over the age of 40 reporting rates between 19% and 50%. Prevalence also increases with increasing age and is due to chronic disease, co-morbid conditions and age-related changes. Aetiology Erectile dysfunction tends to have an organic (about 80%) or psychological cause. Organic causes broadly fall in to blood flow problems, conditions affecting nerve impulses and hormone regulation or structure abnormalities. Psychological causes range from depression to performance anxiety. Erectile dysfunction can also be a side-effect of drugs. Management Determine and treat underlying cause if possible. Erectile dysfunction is often associated with conditions such as hypertension , diabetes mellitus , hypercholesterolemia or cardiovascular disease, and may be an ind...