A 54-year-old diabetic patient has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease that required CABG 3 years ago, hypertension, and gout
The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil (Viagra). Which of the following home medications is contraindicated if taken concurrently with sildenafil?
A)
Diltiazem (Cardizem), a calcium channel blocker
B)
Cordarone (amiodarone), an antiarrhythmic
C)
Imdur (isosorbide mononitrate), a vasodilator
D)
Lasix (furosemide), a diuretic
Ans:
C
Feedback:
Sildenafil (Viagra) is a selective inhibitor of phosphodiesterase type 5 (PDE-5), the enzyme that inactivates cGMP. This acts by facilitating corporeal smooth muscle relaxation in response to sexual stimulation. The concomitant use of PDE-5 inhibitors and nitrates (Imdur) is absolutely contraindicated because of the risk of profound hypotension. The other medications listed are not nitrates and do not have this adverse reaction.
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