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6.13: Erectile Agents

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    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.

    Mechanism of Action

    Sildenafil inhibits phosphodiesterase (PDE-5) in the pulmonary smooth muscle and corpus cavernosum. This allows for relaxation in the smooth muscle.

    Indications for Use

    Sildenafil is used in the treatment of pulmonary hypertension and erectile dysfunction.

    Nursing Considerations Across the Lifespan

    Pediatric patients have shown to have an increase in mortality with sildenafil.

    Dose adjustments are needed for patients with hepatic and renal impairment.

    Use cautiously with geriatric patients with decreased hepatic, renal, and cardiac functions.

    Adverse/Side Effects

    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]

    Patient Education & Teaching

    Patients should be instructed to take medications as directed and should seek immediate medical attention if chest pain occurs. 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]

    Now let’s take a closer look at the medication grid on sildenafil in Table 6.13.[3]

    Table 6:13 Sildenafil Medication Grid
    Class/

    Subclass

    Prototype-

    generic

    Administration Considerations Therapeutic Effects Adverse/Side Effects
    Phosphodiesterase inhibitor sildenafil Do not administer with organic nitrates

    If priapism persists longer than 4 hours, seek medical attention

    Decrease pulmonary hypertension

    Improving erectile dysfunction symptoms

    Hypotension

    Visual loss, hearing loss

    Priapism

    Headache

    Vaso-occlusive crisis due to sickle cell anemia


    1. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
    2. uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral
    3. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵

    This page titled 6.13: Erectile Agents is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Ernstmeyer & Christman (Eds.) (OpenRN) via source content that was edited to the style and standards of the LibreTexts platform.