medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-21-192-202medsovet-2837Research ArticleУРОЛОГИЯUROLOGYНеклассические эффекты силденафила в клинической медицине: междисциплинарный подходNon-classical effects of sildenafil in clinical medicine: an interdisciplinary approachТюзиковИ. А.TyuzikovI. A.

Тюзиков Игорь Адамович – кандидат медицинских наук, профессор Российской академии естествознания (РАЕ), заслуженный работник науки и образования, врач уролог-андролог ООО «Медицинский центр «Тандем-Плюс», ООО «Медицинский центр «Арго-Премиум»

150000, г. Ярославль, Первомайский пер., д. 3В, 

156022, г. Кострома, ул. Дачная, д. 48

Tyuzikov Igor Adamovich – Cand. of Sci. (Med.), Professor of the Russian Academy of Natural Science (RAE), Honoured Worker of Science and Education, UrologistAndrologist, Medical Center «Tandem Plus» LLC, and Medical Center «Argo-Premium» LLC

3B Pervomaysky per., Yaroslavl, 150000, 

8 Dachnaya ul., Kostroma, 156022

phoenix-67@list.ruСмирновА. В.SmirnovA. V.

Смирнов Алексей Владимирович – студент лечебного факультета

150000, г. Ярославль, ул. Революционная, д. 5

Smirnov Aleksey Vladimirovich – a student of the Medical Faculty

5 Revolyutsionnaya ul., Yaroslavl, 150000

СмирноваЛ. В.SmirnovaL. V.

Смирнова Лариса Владимировна – врач функциональной диагностики, гинеколог, главный врач

156022, г. Кострома, ул. Дачная, д. 48

Smirnova Larisa Vladimirovna – Functional Diagnostics Physician, Gynecologist, Chief Medical Officer

8 Dachnaya ul., Kostroma, 156022

ЛесниковаИ. В.LesnikovaI. V.

Лесникова Ирина Вячеславовна – врач акушер-гинеколог

156022, г. Кострома, ул. Дачная, д. 48

Lesnikova Irina Vyacheslavovna – Obstetrician-Gynecologist

8 Dachnaya ul., Kostroma, 156022

Общество с ограниченной ответственностью «Медицинский центр «Тандем-Плюс»; Общество с ограниченной ответственностью «Медицинский центр «Арго-Премиум»РоссияLimited Liability Company «Medical Centre «Tandem Plus»; Limited Liability Company «Medical Centre «Argo-Premium»Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Ярославский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education «Yaroslavl State Medical University» of the Ministry of Health of the Russian FederationRussian FederationОбщество с ограниченной ответственностью «Медицинский центр «Арго-Премиум»РоссияLimited Liability Company «Medical Centre «Argo-Premium»Russian Federation201820012019021192202Copyright © Тюзиков И.А., Смирнов А.В., Смирнова Л.В., Лесникова И.В., 20192019Тюзиков И.А., Смирнов А.В., Смирнова Л.В., Лесникова И.В.Tyuzikov I.A., Smirnov A.V., Smirnova L.V., Lesnikova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2837

В обзорной статье на основе результатов современных клинико-экспериментальных исследований рассматриваются вопросы фармакотерапевтической целесообразности, патогенетической обоснованности и безопасности применения в широкой клинической практике первого и наиболее изученного ингибитора фосфодиэстеразы 5-го типа – силденафила – по «неклассическим» (неэректогенным) показаниям в рамках междисциплинарного подхода в современной медицине. Как известно, в настоящее время ингибиторы фосфодиэстеразы 5-го типа являются как терапией «первой линии» лечения эректильной дисфункции (в виде монотерапии), так и эффективным вариантом монотерапии или комбинированной фармакотерапии симптомов нижних мочевых путей на фоне доброкачественной гиперплазии предстательной железы у мужчин с эректильной дисфункцией. Однако с учетом универсальности и фундаментальности механизмов их фармакологического действия (прежде всего влияние на метаболизм одного из ключевых вазомодуляторов сосудистого русла – оксида азота NO) список потенциальных и перспективных показаний к назначению данных препаратов постоянно расширяется за счет наличия у них различных «неклассических (неэректогенных)» эффектов, что делает их весьма привлекательными для более широкого применения не только в урологической практике, но и в других медицинских специальностях. В статье более подробно и целенаправленно освещены накопленные к настоящему времени научно-практические данные об эффективности применения и потенциальных механизмах действия силденафила в кардиологии, эндокринологии, неврологии, нефрологии, акушерстве и гинекологии, андрологической репродуктологии и онкологии, а также представлены результаты исследований, подтверждающих его безопасность при лечении соответствующих профильных заболеваний.

Based on the results of modern clinical and experimental studies, the review article discusses issues of pharmacotherapeutic feasibility, pathogenetic validity and safety of the first and most studied phosphodiesterase type 5 inhibitor – sildenafil – in general clinical practice according to «non-classical» (non-erectogenic) indications in the framework of an interdisciplinary approach modern medicine. As it is known, at present, phosphodiesterase type 5 inhibitors are both the «first line» therapy for treating erectile dysfunction (as monotherapy), as well as an effective option for monotherapy or combined pharmacotherapy of lower urinary tract symptoms on the background of benign prostatic hyperplasia in men with erectile dysfunction. However, given the universality and fundamentality of the mechanisms of their pharmacological action (first of all, the effect on the metabolism of one of the key vasomodulators of the vascular bed, nitric oxide NO), the list of potential and promising indications for prescribing these drugs is constantly expanding due to the presence of various «non-classical» (non-erectogenic) effects, which makes them very attractive for wider application not only in urological practice, but also in other medical specialties. The article describes in more detail and purposefully the accumulated to date scientific and practical data on the effectiveness of the use and potential mechanisms of action of sildenafil in cardiology, endocrinology, neurology, nephrology, obstetrics and gynecology, andrological reproductology and oncology, and also presents the results of studies confirming its safety in the treatment of relevant specialized diseases.

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The authors declare that there are no conflicts of interest present.