Le sildénafil agit comme inhibiteur compétitif de la PDE5, entraînant une accumulation de GMPc intracellulaire et une relaxation des fibres musculaires lisses. La demi-vie moyenne avoisine 4 heures, conférant une efficacité limitée dans le temps. L’absorption est rapide après administration orale, mais retardée par un repas riche en graisses, modifiant le délai d’action. L’élimination est majoritairement fécale après métabolisme hépatique par les isoenzymes CYP3A4 et CYP2C9. Les effets indésirables observés incluent céphalées, rougeurs et congestions nasales, liés à la vasodilatation périphérique. Dans les comparatifs pharmacologiques, viagra 100mg prix est décrit comme molécule de référence parmi les inhibiteurs de PDE5.

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KRASSAS G E GOGAKOS A BOBORIDIS K． Corticosteroids in the medical treatment of thyroid ophthalmopathy when and how Somatostatin analogues where we stand today J ． Pediatr Endo- FELDON S E O'LOUGHLIN C W RAY D et al． Activated hu- man T lymphocytes express cycloxygenase － 2 and produce proadi- smoking on the response to treatment of thyroid － associated oph- pogenic prostaglandins that drive human orbital fibroblast differen- thalmopathy J ． Br J Ophthalmol 2003 87 6 tiation to adipocytes J ． Am J Pathol 2006 169 4 BARTALENA L TANDA M L． Graves' Ophthalmopathy J ． N LANTZ M VONDRICHOVA T PARIKH H et al． Overexpres- EBNER R DEVOTO M H WEIL D et al． Treatment of thyroid sion of immediate early genes in active thyroid eye disease J ． J associated ophthalmopathy with periocular injections of triamcinolo- KURIYAN A E PHIPPS R P FELDON S E et al． Improvement of KAHALY G J PITZ S HOMMEL G et al． Randomized single thyroid eye disease following treatment with the cyclooxygenase － 2 se- blind trial of intravenous versus oral steroid monotherapy in Graves' lective inhibitor celecoxib J ． Thyroid 2008 18 8 orbitopathy J ． J Clin Endocrinol Metab 2005 90 9 EI FASSID NIELSEN C H HASSELBALCH H C et al． The ra- tionale for B lymphocyte dep letion in Graves' disease． Monoclonal STIEBEL KALISH H ROBENSHTOK E HASANREISOGLU M anti － CD20 antibody therapy as a novel treatment option J ． Eur et al． Treatment modalities for Graves' ophthalmopathy systematic review and metaanalysis J ． J Clin Endocrinol Metab 2009 94 SALVI M VANNUCCHI G CAMPI I et al． Efficacy of ritux- imab treatment for thyroid － associated ophthalmopathy as a result MARIN M MORABITO E BRUNETTO M R et al． Acute and of intraorbital B － cell depletion in one patient unresponsive to ster- severe liver damage associated with intravenous glucocorticoid pulse therapy in patients with Graves' opthalmopathy J ． Thy- LE MOLI R BALDESCHI L SAEED P et al． Determinants of Graves'disease and associated ophthalmopathywith the anti － CD20 liver damage associated with intravenous methylprednisolone pulse monoclonal antibody rituximab an open study therapy in Graves' ophthalmopathy J ． Thyroid 2007 17 4 SALVI M VANNUCCHI G CAMPI I et al． New immunomodu- BRATALENA L BALDESCHI L DICKINSON A J． Consensus state- lators in the treatment of Graves'ophthalmopathy ment of the European Group on Graves' Orbitopathy management of Graves' orbitopathy J ． Thyroid 2008 18 3 SALVI M VANNUCCHI G CAMPI I et al． Rituximab in the SUZANNE C P． Thyroid and the eye J ． Curr Opin Ophthalmol KAHALY G J ROSLER H P PITZ S et al． Low － versus high － treatment of patients with severe corticosteroid － resistant thyroid dose radiotherapy for Graves' ophthalmopathy a randomized single blind trial J ． J Clin Endocrinol Metab 2000 85 1 PERROS P． Thyroid － associated orbitopathy BARTALENA L LAI A SASSI L et al． Novel treatment modali- who and how to treat P J ． Endocrinol Metab Clin 2009 ties for Graves' orbitopathy J ． Pediatr Endocrinol Rev 2010 7 TANIKAWA T OKADA Y TANAKA Y． Intravenous cyclophos- phamide pulse therapy is effective for refractory Graves' ophthal- 櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆櫆

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