“When everybody was telling Viagra jokes, I felt the impulse to write a book explaining the subject.”
by Malcolm Rosenberg, RN & Ralph Zagha, MD

$7.95

I never said Viagra® was as important as arterial blood gases, heart sounds, hemodynamics or any of the topics covered in my nursing books. But the inspiration was the same.

A paragraph from the introduction best describes the book: “The goal of this book is to explain the physiology, pathophysiology and pharmacology of an erection. We will look at how an erection works, why sometimes problems occur and how medication and treatment can address them. If you understand how erections work, you can seek treatment more intelligently when they don’t work.”


Excerpt from Expanding Pudental Artery chapter

You may remember that Viagra®, Cialis®, and Levitra® are phosphodiesterase inhibitors. They inhibit phosphodiesterase, namely PDE5. They help establish and maintain erections by “inhibiting” phosphodiesterase from stopping the second messenger as it tries to plug the calcium channel. I know that is confusing. Pictures show it better than words.

We have a new character,
The Inhibitor.

The Inhibitor is flying through the blood stream and sees phosphodiesterase stopping cGMP plug the calcium channel. He lands on the pudendal artery…

and he tells phosphodiesterase to get out of there…

so cGmp can plug up the calcium channel. Now we have an erection.