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Treatment of men with erectile dysfunction, which is the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance. In order for Aggra to be effective, sexual stimulation is required. Aggra is also indicated in pulmonary arterial hypertension.
Aggra is a selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). When sexual stimulation causes the local release of nitric oxide; inhibition of PDE5 by Aggra produces increased levels of cGMP in the corpus cavernosum. This results in smooth muscle relaxation and inflow of blood into the penile tissues, thereby producing an erection. Aggra has no effect in the absence of sexual stimulation.
Mechanism of Action: The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. When sexual stimulation causes local release of NO, inhibition of PDE5 by Sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation.
Pharmacokinetics and Metabolism: Sildenafil is rapidly absorbed after oral administration, with a mean absolute bioavailability of 41% (range 25-63%). It is eliminated predominantly by hepatic metabolism (mainly cytochrome P450 3A4) and is converted to an active metabolite with properties similar to the parent, Sildenafil. Both Sildenafil and the metabolite have terminal half lives of about 4 hours.
Absorption and Distribution: Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. When Sildenafil is taken with a high fat meal, the rate of absorption is reduced.
Metabolism and Excretion: Sildenafil is cleared by hepatic microsomal isoenzymes. After either oral or intravenous administration, Sildenafil is excreted as metabolites predominantly in the feces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of the administered oral dose).
Pharmacokinetics in Special Populations: Geriatrics: Healthy elderly volunteers (65 years or over) had a reduced clearance of Sildenafil, resulting in approximately 84% and 107% higher plasma AUC values of Sildenafil compared to those seen in healthy younger volunteers.
###Pharmacist Ahamadullah ###
###Aggra 100###
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💋Instantly Determine Your Testosterone Levels With This “Finger” Test
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I get asked all the time, “is there a way to know my testosterone levels without doing a hormone test?”
I initially ask how do you feel? How are your erections? How is your energy levels?
But, there is a physical test that can give you some insight as to how your testosterone levels are, and that’s with the finger test.
Hold your right hand up in front of you as if you were trying to protect your face in a food fight. Now look at it….
Is your ring finger (the fourth finger, counting the thumb) considerably longer than the finger you point with (the second, “index” finger)?
If your ring finger is longer, consider yourself lucky. It seems that finger size, or more specifically, finger ratio, correlates strongly with “higher” testosterone levels, as well as better success in a variety of sports.1
As you see in the picture above, the one of the left side - the ring finger is longer than the index, “pointer” finger. This means higher testosterone levels.
Now you might think I’m making this up, but I’m not.
Scientists have long noticed that men’s ring fingers are generally longer than their index fingers. With women, it tends to be the reverse: their index fingers are usually longer.
They’ve called this difference in length between the index finger and ring finger the “2D:4D ratio.”
2D stands for “second digit” — that’s your index finger, and 4D means “fourth digit” — your ring finger. So if your index finger is 2.9 inches long and your ring finger is 3.1 inches long, you have a 2D:4D ratio of .935 (2.9/3.1 = .935).
A longer ring finger compared to your index finger is considered a “low 2D:4D ratio.”
Oddly enough, the ring finger seems to have a higher number of receptors for testosterone during early fetal development. Thus, the ring finger grows in proportion to the amount of testosterone produced.
The more testosterone produced, the lower the eventual 2D:4D ratio.
Interestingly, the 4th digit of the right hand is more sensitive to fetal testosterone than the ring finger of the left hand, so use your right hand to appraise your Testosterone levels.
A longer ring finger is merely a biomarker of high levels of fetal testosterone, and this early surge of testosterone is instrumental in influencing the growth of not only the brain and heart, but also muscle and bone, all of which are vital to sports performance.
However, I want to point out that even though this has been scientifically proven in 1980, 1998 and again in 2011.. This doesn’t necessarily indicate where your testosterone levels are right NOW.
Lifestyle (diet, exercise, stress management, supplements) and more importantly, aging - are bigger and indicators of where your TRUE testosterone levels are at this moment.
Refferences:
1. Tomkinson, Grant, Dyer, Makailah, "Finger Length Could Predict Athletic Ability." LiveScience, September 7, 2017.
2. http://www.sciencedirect.com/science/article/pii/0191886983900612
3. https://fingerlengthdigitratio.wordpress.com/tag/john-manning/
4. http://www.pnas.org/content/108/39/16289
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Are you struggling with erectile dysfunction (ED) and looking for a natural solution to improve your symptoms? CBD gummies have gained popularity in recent years for their potential health benefits, including their ability to help with issues like anxiety, pain relief, and even erectile dysfunction. In this article, we will explore the use of Choice CBD gummies for ED and whether they may be the right choice for you.
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Erectile dysfunction is a common condition that affects millions of men worldwide. It is characterized by the inability to achieve or maintain an erection sufficient for sexual intercourse. There are many factors that can contribute to ED, including stress, anxiety, hormonal imbalances, and underlying health conditions. While there are prescription medications available to treat ED, some men are turning to natural remedies like CBD gummies as an alternative or complementary treatment.
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