It is assumed that within the coming year or 2, more specific recommendations regarding which screening tests should be performed on those patients who present with ED will follow. Over-the-BIBF 1120 chemical structure counter Access to ED Medication Another interesting aspect of this meeting was a lecture given by Ian Eardley, MD, from Leeds, UK, in which he

discussed a study that was performed by the National Health Service in the United Kingdom in conjunction with several Boots pharmacies in the Manchester, UK, area. This study attempted to determine how patients would Inhibitors,research,lifescience,medical respond to the ability to obtain their initial PDE5 inhibitors directly from the pharmacy rather than from a physician. This Inhibitors,research,lifescience,medical study was performed to gain some insight into whether, in the future, PDE5 inhibitors could be prescribed by pharmacists rather than physicians (as some other medications are in the United Kingdom). Although there was a cost by the patient to the pharmacy to obtain the initial 2 prescriptions, the study showed that most of the patients who went to the pharmacy Inhibitors,research,lifescience,medical to obtain their initial PDE5 inhibitor prescriptions failed to follow-up with their physicians, which was a requirement for patients to obtain any further PDE5 inhibitor

prescriptions. Although the results of this study can be interpreted in many ways, it is obvious that there are patients (some of whom traveled over 300 miles to get their Inhibitors,research,lifescience,medical prescriptions) who still do not want to consult with a physician about their ED. The aforementioned study seems apropos because sildenafil citrate (Viagra; Pfizer, New York, NY) will be going off-patent some time in 20125 and there is a possibility that this class Inhibitors,research,lifescience,medical of drugs (PDE5 inhibitors) may be made available to patients over the counter (OTC). Support for this concept was given in a poster session a day later by Vera Stecher, of Pfizer, who showed in pooled data from

67 double-blind, placebocontrolled studies that the drug at the 50-mg and 100-mg doses was very safe in men over age 65 and 75 years.6 Of interest, these elderly men, when compared with younger men, had a decreased incidence of headache and nasal congestion, but an increase in the incidence of dyspepsia. Although all the US Food Adenylyl cyclase and Drug Administration (FDA)-approved PDE5 inhibitors have been shown both in clinical trials and in practice to be safe and effective, whether the FDA will ever consider the PDE5 inhibitors as an OTC drug at some time in the future remains to be determined. Sexual Dysfunction in Women Another interesting report came from Irwin Goldstein, MD, and his group in San Diego, CA, which addressed sexual dysfunction in women.