A patient who was recently diagnosed with hypertension and placed on propranolol (Inderal) is seen in the clinic for an unrelated issue

Question

When the nurse notes that his blood pressure is elevated, she asks if the patient has been taking his medication and he says he quit because "I didn't like how I felt when I took it." Based on this statement, what would be an appropriate response?

1. "Many male patients experience side effects of this drug, which include altered libido and impotence. This is common. Tell me how you felt when you took the drug."
2. "You shouldn't stop taking the drug without first talking to the doctor!"
3. Write a note in the patient's record but say nothing to the patient.
4. "I'm going to give you some information about this medication for you to take home and read. At your next visit, I'll have the doctor talk to you about it."

Answer 1

Correct Answer: 1
Antihypertensive drugs are a common cause of erectile dysfunction (ED) and loss of libido, and many men do not report the disorder. The side effects should be discussed at the time the prescription is given and reviewed at any follow-up visits. Offering an opening to discuss sexual dysfunction is relevant. Admonishing a patient for not taking medications and merely noting the issue in the patient's chart does not address the problem. Offering factual information is relevant but, in this case, the patient's hypertension remains untreated.