6.13 Erectile Agents

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

Nursing Considerations: Pediatric clients have shown to have an increase in mortality with sildenafil.

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

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

Side Effects/Adverse Effects: Clients taking sildenafil may expect to experience hypotension, visual or hearing loss, priapism (male), headache, or vaso-occlusive crisis. If clients have priapism that lasts longer than four hours, they should seek medical attention.^[1]

Health Teaching & Health Promotion: Clients should be instructed to take medications as directed and should seek immediate medical attention if chest pain occurs. Clients should report priapism lasting longer than four hours, dizziness, or decreased vision or hearing.^[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