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????????? (? ?????? : Sildenafil ), ?????? ? ??? ?????? ?????? ( Viagra ), ??? ????? ?????? ?????? ????? ?????? ????????????? PDE5, ???????? ?????? ? ????? ??????? ?????? ?? ???-????? (??????????) ?????? ????? ? ???? .

??? ?????? ?? ?????? [ ????? ??? ???? | ????? ]

?????? ????? ????? ?? ??? ???? ????? (Pfizer) ?????? ?????? ???? ??? ?? ?? ????? ??? (Angina pectoris; ??? ?? ???? ?? ???? ??), ??????? ?????? ????? ?????? ?????? ??????? ?????? ?? ???-????? ?????? ????? ?????. ?????? ????? ??? ??? ??????? ?????? . ????????? ????? ?? ?????? ?????? ?? ??? ???? ??-????? (NO) ? ??? . ???? ??-????? ???? ? ??????? ?????? ???????? ?????? (guanylate cyclase) ? ????? ????. ?????? ????? cGMP ????? ??????? ? ?????? ?????? ?-intimal cusions ?? ??????? ?????????? ????. ?????? ????? ?????? ????? ? ?? ????? ??????? ???? ?????. ????? ????????? ?? ????????? ???? ??? ?? cGMP ???? ??? ????? ? ???? ?????? ?? ????? cGMP ????????????? ?????? ??? 5 (cGMP specific phosphodiesterase type 5) PDE5 ?????? ?????? ?? cGMP. ?????? ?????? ????? ?????? ?? ???? cGMP ?????? ???? ?????. ??? ????? ???? , ????? ??? ????? ?????? ?? ??? ???? ??-????? ?-cGMP, ????????? ?? ????? ????? ?????. ???? ??? ?????? ?????? ???? 30?40 ????, ???? ?????? ?? 4 ????.

????????? ????? ????????? ?? ??? ???????? ???? ??????? ????? ??????? ???? ???????. ?? ?????? ???? ?????? ????? ????? ???? ?????? ?????? ????? ???? ???? ????? ????? ?????? ??????? ??? ????? ?????, ??????? ???? ???? ????? ????.

?????? ????? ??????? ????? ???? ?? ?????? (?? ?????: ?????? , ???????:tadalafil) ? ??????? (?? ?????: ??????, ???????:vardenafil).

???????? [ ????? ??? ???? | ????? ]

???? ????? ???? ???? ?? ?????? ???? 1996 . ???? 1998 ????? ????? ?? ????? ???? ????? ???????? ???????? (FDA) , ?????? ?????? ??????? ??????? ?????? ?????? ???? ??? ????? ??????. ???????? ????? ???? ????? ????? ?? ????? ???? ??? ?????? ?? ????. ????? ???? ????? ???????, ?????? ????? ????? ?????? ?????? ????? ????? ???? ????? ? ??? ??? ?? ??????? ???, ????? ?????? ?? ????? ??????? ???????, ???????. ??? ??????? ?????? ?????? ????? ?? ??????? ? ????? ????? ???? ????? ?? ?????: ?? ??? ???? ????? ??? ???? ?? ??????. ???? ???, ????? ?? ??? ????? ????? "????? ?????" ??, ??? ????? ???? ??????? ??????? ?? ??????. ^[1] ????? ?????? ??????? ?? ?????? ?? ??? ????? ??? ????? ?????? ??? '?????? ???????' ?????? ?????? ????? ?? ??????? ?????? ??????. ^[2]

?????? ???????? ??? [ ????? ??? ???? | ????? ]

????? ????? ?? ?????? ?????? ????? ?????, ?? ?????? ?????? ??? ?????? ???? ??????? ???. ?? ??? ?????? ? ?? ??? ?? , ?????? ????? ?????? ?????? ???????? ??????? ??????? ??? ?? ?????? ????????, ???? ?????????? ??????? (???? ??????) ??????????? ?????????? (???? ???????? ????????). ?????? ????? ?????? ?? ?????? ??????? ?????? ??? ?? ?? ??????, ?? ? ??? ?? ???? , ? ???????? ????????? ???? ???? ??? ???? ?? ???? ?? ???????. ^[3]

???? ????? ???????? ???????? ??? ??? ????? ??? ????? ?????? ?????? ??????? ? ??? ?????? ??????? ?? ????? ?? ??????? ???? ????? ??????? ?????? ????? ?????? ????????????? PDE5, ?????? ????? ?? ??? ????? ??????. ^[4] ?-FDA ???? ??????? ?? ?????? ??????, ?? ??? ?? ?? ?????? ???????? ?????? ?????? ?? ?????? ????? ???? ???? ??????? ????? ????? ?????? ???????.

????? ?????? ???????? ?? ??? ?????? ?????? ???? ????, ??? ??? ????? ???? ??? ?????? ???? ????? ???????? ?? ?????? ????? ?????.

????? ?????? ?? ???? [ ????? ??? ???? | ????? ]

?????? ????? ?????? ??????? ? ??????? , ???? ?? ??? ???? ??? . ?????? ??? ???? ??????? ?????? ????? ?????, ??? ????? ?? ?????? ???? ???? , ???? ???? ?? ??????? ??? ??? ??????????? ?? ?????? ?????, ??????? ???? ?? ????? ??????. ???? ?? ????? ?????? ?????? ???? ?? ??????. ??? ????? ?? ??? ?????? ??????? ???? ?????? ?? ????? ????? ????? ???? ? ??? ????? ????? ???. ??????? ?????? ??????? ?????? ????? ???????? ?? ??? ????? ?? ??? ????? ??????.

???? ????? ?????? ????????????? PDE5 [ ????? ??? ???? | ????? ]

?????????; ?? ?????: ?????? (Viagra)
??????? ; ?? ?????: ?????? (Levitra)
????????? ; ?? ?????: ?????? (Cialis)

?????? ?????? ??? ??????? ????? [ ????? ??? ???? | ????? ]

??? ??? ?? ????? (Pulmonary hypertension) ? ????????? ???? ?????? ??? ??? ??????. ?????? ??? ?? ??? ?? ????? ???? ?? ???? ?? ??? ???? ?? ? ?? ? ?? ??? ?? ????? ?? ????. ????????? ???? ?? ??? ????? ? ??????? ???? PDE-5 ?????? ?? ??? ??????? ???? ??????? ??????. ??? ??????? ????????? ?? ????????? ??????? ??? ?????? ????? ??? ?? ??????? ??? ? ????-???????.
????? 2005 ???? ????? ?????? ????????? ?????? ???? ??? ?? ????? ?????? ????? ?? ?? ???? ????? ???????? ????????. ?????? ?????? ????? ??? ?????? ??? ??? ?????? ??????? ????? ??? ?? ?? ??? ? REVATIO ? ?? ????? ????? ????? ???? ????.
???? ??? Raynaud's phenomenon - ????? ?? ????? ???????? ?????? ?????? ??? ????? ??????? ?? ????? ????????. ?????? ????? ????? ????? ????? ?????? "???? ???? ?????" ( ????????? , Scleroderma) ?? ???? ???. ???? 2005 ??? ?? ??? ?????????? ????? ?? ??????? ?? ?????? ??? ????.

?????? ????? ??????? ^[5][ ????? ??? ???? | ????? ]

???? ??? (?????? ???) ?? ???? ???
????? ?? ???????? ?????
??????? ?? ????? ?????, ????? ????? ?? ?????? ??????, ??? ??? (????? ??????? ?? ??? ???? ???? ??????)
?????? ? ????? ?????? , ?????
?? ?????? (??? ??? ???? ???? ????): ????? ?????? ????? ?? ??? ??? (?? ????? ??? ?????), ????? , ????? , ????? ?? ??? ???????, ?????? ??????, ?????? ????, ????? ???, ?????? ?????, ?????? ??????, ?????? ?? ?????? ?? ?????, ??? ??? ?? , ??? ?? ????, ??? ?????? , ???????? , ????? ?????? ???, ????? (??????), ??????? ????????, ???? ? ?? , ??????? ?????? ?? ??????, ??? ??? ??????, ??????? ????-???? (??????? ?????? ????), ??????, ?????? ?? ????, ??? ??????, ????? ????.
?????? (?? ???-???? ??? ?????): ???? ?????? ??? 4 ???? ?? ????? ??????? ?????? ?? ????? ????? ?? ??????? (?? ????? ??? ?????), ?????? , ??? , ???? ?? , ?????? ???? ??? , ????? ??????? ? ????? ?? ????? ?????, ????? ????? ?????? ?? ?????? ???? (TIA), ????? ?????? ? ???? , ???? ????? ???, ????? ???? ?????? ?? ????, ???? ????? , ????? ????? ??????, ????? ?? ????? ????, ?????? ???? ?? ?????, ????? ??????? ????? ?? ??????, ????? ???? ???? ?????, ????? ???????, ????? ??? ????? ????, ????? ?? ??? , ?????? ?? ? ???? ???? , ???? ???, ?????? ???? ???, ?????? .
????? (????).

????? [ ????? ??? ???? | ????? ]

???? ?????? ???????? ?? 25, 50, ?-100 ???????.

?????? [ ????? ??? ???? | ????? ]

????? ????, ????? ???? ?? ????? ??? " ???? ?????? ", ???? ?? ????? ???????? ?? ????:

"??? ???? ?? ?? ????? ????? ?????? ??? ????????. ??? ?????? ??? ??? ??? ?? ??? ????. ??? ?????? ????? ?? ????? ???? ??????? ?????, ??????? ??? ??? ????? ??????. ??? ?????? ????? ?? ???? ?????? ?? ??? ???? ???? ??????? ?????? ?????? ?????. ?? ????? ???? ????? ???? ??????. ?? ????? ???? ??? ??? ????, ???? ???, ?? ????, ?????? ????? ????? ???? ?? ?????? ??. ??? ???????? ?????? ??????, ???? ????, ???? ????? ????? ???? ???????????? ?? ??? ????? ?????????? ???? ??? ???? ??????? ????? ??? ?? ???? ?? ???????? ???????? ?? ?????." ^[6]

????? ?? ???? ??? , " ????????? ?????? " ????? ???? ????? ?? ???? ???? ???? ?? ?? ???? ?????? ?? ????? ??????: "?????, ????? ???, ???? ?? ??????, ????????, ???????, ???? ?????? ?????? ?? ????? ????, ??? ??????? ?????". ^[7]

??????? ???????? [ ????? ??? ???? | ????? ]

???? " ?????? - Viagra ", ???? " ?????????? "
???? " ????????? ??? - Sildenafil teva ", ???? " ?????????? "
????????? (??????, ????) (Sildenafil) , ???? "???????"
?? ??????, ??? ???? ??????? ???????? ????? , ???? ???? , 2 ???????? 2008
???? ??, ????? ?????? ?????? ????? ???? ????? ???? , ???? ynet , 7 ?????? 2017
???? ??? , ?????? ?????? ?????? ???? , ???? ???? ???????

????? ?????? [ ????? ??? ???? | ????? ]

^ John Tozzy & Jared S. Hopkins, The Little Blue Pill: An Oral History of Viagra , www.bloomberg.com, ????? ?? ????? ????? ????? ??? ?? ??? ?? ?????? ?????, ???? ????? ?????, ??? ??? ??? ?????? ????? ??????? ?? ???????. (???????)
^ Robert G. Evans, Tough on Crime? Pfizer and the CIHR , Healthcare Policy 5, 2010-05, ??' 16
^ ????? ?? ?? ?? ????????? ????? ??"?, ???? ????? - ??????
^ 2010 - Pfizer, Inc. 5/26/10 , wayback.archive-it.org (???????)
^ ?????? - ????? ??????? | ?????? ?????? ????? , ???? www.clalit.co.il
^ ????? ??? , ???? ?????? , ?????: ???? ????, ????? ???? , 2002, ??' 40
^ ???? ??? , ????????? ?????? , ?? ???? , 2014, ??' 123

?????: ????? ?????????? ???? ?????? ???? ? ???? ????? ????? ????? .

[1] John Tozzy & Jared S. Hopkins, The Little Blue Pill: An Oral History of Viagra , www.bloomberg.com, ????? ?? ????? ????? ????? ??? ?? ??? ?? ?????? ?????, ???? ????? ?????, ??? ??? ??? ?????? ????? ??????? ?? ???????. (???????)

[2] Robert G. Evans, Tough on Crime? Pfizer and the CIHR , Healthcare Policy 5, 2010-05, ??' 16

[:0-3] ????? ?? ?? ?? ????????? ????? ??"?, ???? ????? - ??????

[4] 2010 - Pfizer, Inc. 5/26/10 , wayback.archive-it.org (???????)

[5] ?????? - ????? ??????? | ?????? ?????? ????? , ???? www.clalit.co.il

[6] ????? ??? , ???? ?????? , ?????: ???? ????, ????? ???? , 2002, ??' 40

[7] ???? ??? , ????????? ?????? , ?? ???? , 2014, ??' 123

[1]

[2]

[3]

[4]

[5]

[6]

[7]