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The agent for the treatment of erectile dysfunction is a reversible selective inhibitor of PDE5-specific cGMP. If sexual arousal induces a local release of nitric oxide, inhibition of PDala by tadalafil causes an increase in the level of cGMP in the nucleus of the penis. As a result, the smooth muscles of the arteries weaken, blood rushes to the tissues of the penis, causing an erection. Tadalafil is not effective without sexual stimulation. In vitro studies have shown that tadalafil is a selective PDE5 inhibitor. PDE5 is an enzyme found in the smooth muscles of the pelvic organs, viscera, bone muscles, plates, kidneys, lungs, and brain. Tadalafil is more active against PDE5 than other phosphodiesterases. Tadalafil is 10,000 times more active against PDE5 than PDE1, PDE2, PDE4, which are found in the heart, brain, blood vessels, liver and other organs. Tadalafil is 10,000 times more active in blocking PDE5 than PDE3, an enzyme found in the heart and blood vessels. For PDE5, this PDE3 selectivity is important because PDE3 is an enzyme involved in myocardial contraction. In addition, tadalafil is 700 times more active against PDE5 than PDE6, which is located in the retina and is responsible for phototransfer. Tadalafil is also 10,000 times more active against PDE5 than PDE7-PDE10. Works 36 hours. The result appears 16 minutes after the onset of sexual arousal. In healthy people, tadalafil did not cause significant changes in systolic-diastolic pressure compared with placebo in the supine position (mean maximum decrease by 1.6 / 0.8 mm Hg. Art.) (Mean decrease by 0.2 / 4.6 mmHg.). S.s.): Art.): Tadalafil does not cause significant changes in heart rate. Tadalafil has no color effect (blue / green) due to its low binding to PDE6. In addition, tadalafil does not affect visual acuity, electrography or internal pressure ա pupil size. There was no clinically significant effect on sperm count in men who received tadalafil in daily doses for 6 months.

But a fair riskadjustment system for this condition requires a better understanding of the factors affecting utilization. Clear diagnostic standards need to be developed before implementation of the program, this study was performed to evaluate the relationship of sres with hypoxic environment. Sres have been recorded by an erectometer rigiscan on three mountain climbers mean age. During a day stay at an altitude ranging from to m above sea level. Twentyfour records have been made at progressively increasing altitudes. A data analysis was carried out on a statistical mean of the three values of each variable and an analysis of variance anova and newmankeuls test were carried out for multiple comparison among groups. At altitudes over m.
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