{"id":304,"date":"2019-12-08T22:46:56","date_gmt":"2019-12-08T22:46:56","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/6-13-erectile-agents\/"},"modified":"2021-12-07T11:18:21","modified_gmt":"2021-12-07T11:18:21","slug":"6-13-erectile-agents","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/6-13-erectile-agents\/","title":{"raw":"6.13 Erectile Agents","rendered":"6.13 Erectile Agents"},"content":{"raw":"Sildenafil (Viagra) is commonly known to treat erectile dysfunction. This medication was originally developed for improvement of pulmonary hypertension, but has been found to be useful for additional indications. However, patients taking this medication cannot take nitroglycerin due to severe hypotension.\n\nMechanism of Action<\/strong>\n\nSildenafil inhibits phosphodiesterase (PDE-5) in the pulmonary smooth muscle and corpus cavernosum. This allows for relaxation in the smooth muscle.\n\nIndications for Use<\/strong>\n\nSildenafil is used in the treatment of pulmonary hypertension and erectile dysfunction.\n\nNursing Considerations Across the Lifespan<\/strong>\n\nPediatric patients have shown to have an increase in mortality with sildenafil.\n\nDose adjustments are needed for patients with hepatic and renal impairment.\n\nUse cautiously with geriatric patients with decreased hepatic, renal, and cardiac functions.\n\nAdverse\/Side Effects<\/strong>\n\nPatients taking sildenafil may expect to experience hypotension, visual or hearing loss, priapism (male), headache, or vaso-occlusive crisis. If patients have priapism that lasts longer than 4 hours, they should seek medical attention.[footnote]This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. [\/footnote]<\/sup>\n\nPatient Education & Teaching<\/strong>\n\nPatients should be instructed to take medications as directed and should seek immediate medical attention if chest pain occurs.\u00a0 Patients need education regarding the need to report priapism lasting longer than 4 hours or if they notice any dizziness or decrease in hearing ability.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nNow let's take a closer look at the medication grid on sildenafil in Table 6.13.[footnote]This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. [\/footnote]<\/sup>\n\nTable 6.13 Sildenafil Medication Grid\n\n\n\n\n
Class\/<\/strong>\n\nSubclass<\/strong><\/th>\nPrototype-<\/strong>\n\ngeneric<\/strong><\/th>\nAdministration <\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nAdverse\/Side Effects<\/strong><\/th>\n<\/tr>\n
Phosphodiesterase inhibitor<\/th>\nsildenafil<\/a><\/td>\nDo not administer with organic nitrates\n\nIf priapism persists longer than 4 hours, seek medical attention<\/td>\nDecrease pulmonary hypertension\n\nImproving erectile dysfunction symptoms<\/td>\nHypotension\n\nVisual loss, hearing loss\n\nPriapism\n\nHeadache\n\nVaso-occlusive crisis due to sickle cell anemia<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n ","rendered":"

Sildenafil (Viagra) is commonly known to treat erectile dysfunction. This medication was originally developed for improvement of pulmonary hypertension, but has been found to be useful for additional indications. However, patients taking this medication cannot take nitroglycerin due to severe hypotension.<\/p>\n

Mechanism of Action<\/strong><\/p>\n

Sildenafil inhibits phosphodiesterase (PDE-5) in the pulmonary smooth muscle and corpus cavernosum. This allows for relaxation in the smooth muscle.<\/p>\n

Indications for Use<\/strong><\/p>\n

Sildenafil is used in the treatment of pulmonary hypertension and erectile dysfunction.<\/p>\n

Nursing Considerations Across the Lifespan<\/strong><\/p>\n

Pediatric patients have shown to have an increase in mortality with sildenafil.<\/p>\n

Dose adjustments are needed for patients with hepatic and renal impairment.<\/p>\n

Use cautiously with geriatric patients with decreased hepatic, renal, and cardiac functions.<\/p>\n

Adverse\/Side Effects<\/strong><\/p>\n

Patients taking sildenafil may expect to experience hypotension, visual or hearing loss, priapism (male), headache, or vaso-occlusive crisis. If patients have priapism that lasts longer than 4 hours, they should seek medical attention.[1]<\/sup><\/a><\/sup><\/p>\n

Patient Education & Teaching<\/strong><\/p>\n

Patients should be instructed to take medications as directed and should seek immediate medical attention if chest pain occurs.\u00a0 Patients need education regarding the need to report priapism lasting longer than 4 hours or if they notice any dizziness or decrease in hearing ability.[2]<\/sup><\/a><\/sup><\/p>\n

Now let’s take a closer look at the medication grid on sildenafil in Table 6.13.[3]<\/sup><\/a><\/sup><\/p>\n

Table 6.13 Sildenafil Medication Grid<\/p>\n\n\n\n\n
Class\/<\/strong><\/p>\n

Subclass<\/strong><\/th>\n

Prototype-<\/strong><\/p>\n

generic<\/strong><\/th>\n

Administration <\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nAdverse\/Side Effects<\/strong><\/th>\n<\/tr>\n
Phosphodiesterase inhibitor<\/th>\nsildenafil<\/a><\/td>\nDo not administer with organic nitrates<\/p>\n

If priapism persists longer than 4 hours, seek medical attention<\/td>\n

Decrease pulmonary hypertension<\/p>\n

Improving erectile dysfunction symptoms<\/td>\n

Hypotension<\/p>\n

Visual loss, hearing loss<\/p>\n

Priapism<\/p>\n

Headache<\/p>\n

Vaso-occlusive crisis due to sickle cell anemia<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

  1. This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. ↵<\/a><\/li>
  2. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  3. This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":13,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-304","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":250,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/304","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/304\/revisions"}],"predecessor-version":[{"id":305,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/304\/revisions\/305"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/250"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/304\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=304"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=304"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=304"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=304"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}