05-19-2008, 08:52 AM
A 60-year-old African-American male presents to the clinic for an annual physical examination. He has hypertension and hyperlipidemia and takes medications for the last 3 years. He has no history of coronary artery disease (CAD) or stroke. He smokes half a packet of cigarettes a day and has been trying to quit. He denies having chest pain, shortness of breath, nocturia, frequency, or poor stream. He has been having erectile dysfunction (ED) for the last 3 months. His blood pressure (BP) in the office is 170/90 mm Hg and his pulse rate is 72 beats per minute. He is currently on beta blockers and angiotensin-converting enzyme (ACE) inhibitors. He has seen the advertisements for medications for ED and asks the physician™s opinion about trying one of them. What should the physician recommend to the patient?
. He needs cardiac evaluation with exercise stress testing for CAD prior to initiating treatment with phosphodiesterase (PDE) 5 inhibitors
B. Initiate treatment for ED after controlling his BP
C. Initiate treatment with low dose PDE 5 inhibitors as his hypertension is uncontrolled
D. Initiate treatment with PDE5 inhibitors
E. PDE 5 inhibitors are contraindicated in patients taking beta blockers
. He needs cardiac evaluation with exercise stress testing for CAD prior to initiating treatment with phosphodiesterase (PDE) 5 inhibitors
B. Initiate treatment for ED after controlling his BP
C. Initiate treatment with low dose PDE 5 inhibitors as his hypertension is uncontrolled
D. Initiate treatment with PDE5 inhibitors
E. PDE 5 inhibitors are contraindicated in patients taking beta blockers