Priapism Priapism is a very uncommon adverse event; however, due to its serious consequences of corporal scarring and possible irreversible damage, the patient is instructed to seek immediate medical attention for a painful erection lasting longer than 4 hours. Pharmacologic reversal of a prolonged erection less than 24 hours duration may be accomplished with phenylephrine solution, a vasoconstricting agent. An intermittent injection of 200 mcg/mL phenylephrine is administered to the side of the shaft of the penis every 10 minutes or until the erection has subsided (maximum of 10 injections). According to an impotent diabetes patient, another method to treat priapism is to use a nasal decongestant such as Neo-Synephrine. The …
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Pharmacologic Agents Pharmacologic treatment using vasoactive agents is now coming to the forefront as one of the most effective means of treating impotence. These agents, directly administered into the corpora cavernosum, mimic the vascular phenomenon of erection, eliciting a response within 5–10 minutes that lasts 30 minutes to one hour. The dose of the drug varies depending on the cause of the impotence, therefore a careful evaluation should be obtained before instituting treatment. Patients with arterial insufficiency, neurological or psychological erectile dysfunction generally respond to lower doses than those with veno-occlusive disease. It is important that both the patient and his partner be included in discussion and instruction regarding erectile dysfunction …
[ Continue Reading... ]Etiology of Impotence Vascular: The most common cause of erectile dysfunction is vascular — an impaired blood flow into (arterial insufficiency) or excess blood flow out of (veno-occlusive disease) the penis. Hypertension, hyperlipidemias, diabetes and excessive cigarette smoking are factors known to contribute to vascular impotency (Table 1). Table 1. Causes of Impotence Vascular Neurological Hormonal Psychological Trauma/Surgery Medication Neurological: Nerve impulses travel from the brain down the spinal cord through the lower back and sacrum to the genital region. Nerve signals cause substances such as nitric oxide and prostaglandins to be released into the blood stream; these substances stimulate the smooth muscle in the cavernosa to relax and an erection …
[ Continue Reading... ]Pharmacists can have a significant impact on the quality of life of men who suffer from erectile dysfunction. To impact the care of these patients one must first recognize that there is a potential problem and then develop sensitive communication skills to stimulate discussion with the patient and/or his significant other. This approach can help the patient understand the various treatment options that can be utilized to overcome impotence. Since pharmacists see patients more than any other health-care provider and are respected and trusted by patients, pharmacists can impact the patient’s life in a very positive way. With the baby-boomer generation reaching their middle years, erectile dysfunction (ED) will be a …
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