Chapter 55 Erectile Dysfunction Q&A (1 OF 11) Sample Questions
1. DJ is a 55-year-old man who presents at the pharmacy a new prescription of Sildenafil 50 mg PRN for erectile dysfunction. DJ’s current medications include Metformin 500 mg bid, Gliclazide MR 30 mg, Rosuvastatin 10 mg daily, ASA 81 qod, and Levothyroxine 50 mg daily. DJ’s lifestyle includes occasional drinking of alcohol and eating on the run due to his busy lifestyle. The pharmacist should include which of the following counseling information for DJ?
- A. Sildenafil is less effective in diabetes
- B. Effect-may last 4 hours.
- C. Decreases night vision.
- D. Causes hypoglycemia.
Tips: There is less benefit in men with diabetes; some evidence supports the addition of folic acid 5 mg daily to increase endothelial nitric oxide production.
Side effects: headache, flushing, dyspepsia, nasal congestion, transient visual disturbances, dizziness, skin rash. Rare: priapism, permanent vision loss. Abnormal Vision: Mild and transient changes, predominantly impairment of color discrimination (blue/green), but also increased perception to light or blurred vision.
At doses above the recommended dose range, adverse events were similar to those detailed above but generally were reported more frequently.
To be taken as needed approximately 30-60 minutes before sexual activity. However, Sildenafil may be taken anywhere from 0.5 hour to 4 hours before sexual activity. The maximum recommended dosing frequency is once per day.
Given their safety, efficacy and oral administration, sildenafil, tadalafil and vardenafil are the drugs of first choice for ED, including antidepressant-induced ED. PDE5 inhibitors can only enhance an erection that is partially developing as a result of effective sexual stimulation and mental sexual arousal (or reflex erection in men with spinal cord injury). Benefit is less in men with diabetes; some evidence supports the addition of folic acid 5 mg daily to increase endothelial nitric oxide production.