Patient/Family Teaching

• Caution patient to report priapism (erection lasting 6 hr or longer) to health care professional immediately. Priapism is a medical emergency that can result in penile tissue damage and permanent loss of potency if not treated promptly

» Caution patient that use of alprostadil offers no protection against sexually transmitted diseases (STDs). Injection of alprostadil may cause a small amount of bleeding at injection site, increasing risk of transmission of bloodborne diseases. Advise patient to use protective measures to prevent spread of STDs, including HIV

• Intracavernosal Injection: Instruct patient on correct technique for preparation, injection, and disposal of equipment. Caution patient not to reuse or share needle with other persons. Desirable dose is determined with first injection in physician's office. Advise patient not to increase dose without consulting physician. Injections should be administered no more than 3 times/wk, with 24 hr between injections. Advise patient to notify physician if nodules or hard tissue in the penis; redness, swelling, or tenderness; or curvature of the erect penis occurs

» Emphasize the importance of follow-up exams every 3 mo to assess efficacy and safety of therapy and to adjust dose as needed

• Intraurethral: Instruct patient on proper technique for administering before self-administration. Patient should urinate before insertion. Stretch penis lengthwise and press at top and bottom. Insert the delivery device into urethra, depress button to release suppository, and hold device upright and immobile for 5 sec to help dissolve suppository. Move penis and device as a unit from side to side to help dissolve suppository and remove device. If uncomfortable or pulling sensation occurs, remove device and repeat procedure if needed. After device is withdrawn, patient should roll penis between the hands for 10 sec to further distribute suppository within walls of urethra and decrease stinging sensation. Sitting, standing, or walking for 10 min while erection is developing promotes blood flow. Patient should not exceed 2 systems in 24 hr. An erection that lasts longer than desired may be relieved by the application of an icepack alternately to each inner thigh for a period no longer than 10 min

» Advise patient to use contraception if engaging in sexual intercourse with female of reproductive age. Use a condom if female is pregnant; effects on the fetus are unknown

alprostadil (intracavernosal, intraurethral) is a sample topic found in Davis's Drug Guide. All other sections of this record are viewable by clicking on the index in the left column, or by clicking on "Display all Sections" in the "Content Manager".

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