March 2006, Volume 36 Number 3 , p 26 - 27
Weeks, Bridget RN, CS, FNP, MS; Ficorelli, Carmel T. RN, FNP, MS
AS WE DISCUSSED in the January issue, many men with erectile dysfunction (ED) can be helped with phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil (Viagra). But what about a man who can't use these newer first-line drugs or who doesn't respond to them?
First, he'll need a careful history, physical exam, and lab tests, as we outlined in our previous article. His health care provider would try to determine whether the PDE-5 inhibitor failed for some correctable reason such as:
* interactions with food or other drugs * dosing errors * drinking too much alcohol * hormonal problems, such as not enough testosterone * not enough sexual stimulation * relationship problems.
If your patient has tried all three of the first-line drugs without success and other problems are ruled out, he might consider an injectable or implantable drug, mechanical device, ...