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 for Use

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

Nursing Considerations Across the Lifespan

Pediatric clients have been 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.

Adverse/Side 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 4 hours, they should seek medical attention.^[1]

Client Education & Teaching

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