TY  - CHAP
M1  - Book, Section
TI  - Erectile Dysfunction
A1  - Lee, Mary
A1  - Sharifi, Roohollah
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
PY  - 2017
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  the  Management  of  Erectile  DysfunctionCollectPatient  characteristics  (e.g.,  age,  race)Patient  history  (past  medical  history,  marital/partner  status,  family  history,  social—sexual  history,  situations  in  which  erectile  dysfunction  occurs;  tobacco,  recreational  drug,  or  alcohol  use)Administer  International  Index  of  Erectile  Function  screening  questionnaire  if  feasible  (see  Diagnosis  section)Current  and  past  medications,  including  prescription  and  nonprescription  medications,  or  nonpharmacologic  interventions  for  erectile  dysfunction  (see  Table  83-4)If  patient  is  not  responding  to  a  phosphodiesterase  type  5  inhibitor,  details  on  how  and  when  patient  is  using  the  medication  (see  Phosphodiesterase  Type  5  Inhibitor  Efficacy  section)Current  psychologic  status  (emotional  stressors,  depression,  performance  anxiety)  (see  Clinical  Presentation  box)Objective  data  (see  Diagnosis  section)Blood  pressure,  heart  rate,  height,  weight,  and  BMIPhysical  examination  to  rule  out  hypogonadism  and  prostate  dysfunctionLabs  (e.g.,  blood/serum  glucose,  lipids,  testosterone)Cardiovascular  risk  assessment,  if  indicated  (see  Diagnosis  section  and  Table  83-3)AssessPatient  and  partner's  expectations  regarding  therapy  and  costsPatient's  physical  ability  to  engage  in  or  contraindications  to  sexual  intercoursePresence  contraindications  to  phosphodiesterase  type  5  inhibitors  (see  Table  83-3)Current  use  of  medications  contributing  to  erectile  dysfunction  (see  Table  83-2)Plan*Optimize  treatment  for  underlying  causes  of  erectile  dysfunction  (e.g.,  hypertension,  coronary  artery  disease,  dyslipidemia,  diabetes  mellitus,  smoking,  chronic  ethanol  abuse)Discontinue  medications  contributing  to  erectile  dysfunction  when  possible  (Table  83-2)Treat  hypogonadism  when  presentPsychotherapy  for  psychogenic  causes  of  erectile  dysfunctionDrug  therapy  regimen  including  specific  agent(s),  dose,  route,  frequency,  and  duration;  specify  the  continuation  and  discontinuation  of  existing  therapies  (see  Tables  83-4  and  83-5  and  Figures  83-2  and  83-5,  83-6,  83-7)Nonpharmacologic  or  surgical  intervention  when  medications  are  contraindicated  or  are  not  effective  (see  Figures  83-2  and  83-3)Patient  re-education  if  nonresponsive  to  phosphodiesterase  type  5  inhibitor,  if  appropriate  (see  Phosphodiesterase  Type  5  Inhibitor  Efficacy  section)Monitoring  parameters  including  efficacy  (e.g.,  BP,  cardiovascular  events,  kidney  health),  safety  (medication-specific  adverse  effects),  and  timeframe  (see  Tables  83-6  and  83-7)Patient  education  (e.g.,  purpose  of  treatment,  dietary  and  lifestyle  modification,  drug  therapy)Referrals  to  other  providers  when  appropriate  (e.g.,  physician,  urologist)Implement*Provide  patient  education  regarding  all  elements  of  treatment  plan  Schedule  follow-up  for  several  weeks  after  therapy  initiationFollow-up:  Monitor  and  EvaluatePatient  satisfaction  with  quality  and  quantity  of  penile  erectionsPresence  of  adverse  effectsAdjust  medication  doses  or  change  to  alternative  agent  as  clinically  indicated*Collaborate  with  patient,  caregivers,  and  other  health  professionals  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1148577629
ER  -