Beyond the Blue Pill: Pharmacologic & Whole Person Care Strategies to Treat ED

Credit

Handouts/Brochure

Speaker

Lara Zakaria, PharmD, MS, CNS, CDN, IFMCP Related seminars and products

---

Dr. Zakaria is a pharmacist and nutritionist with a focus in implementing solutions for functional medicine and personalized nutrition. A graduate of the Ernest Mario School of Pharmacy at Rutgers University (BSpharm) and the University of Colorado Skaggs College of Pharmacy (PharmD), she spent 20 years in community pharmacy practice. After developing an interest in nutrition, she earned a MS in nutrition from the University of Bridgeport and subsequently qualified as a Certified Nutrition Specialist (CNS) as well as an Institute for Functional Medicine Certified Practitioner (IFMCP). Dr. Zakaria’s practice focused on a multi-disciplinary approach working both one-on-one with patients as well as creating implementation tools and systems for scale. She is also faculty at the Integrative Medicine program at George Washington University, as well as guest instructor for Functional Medicine at LECOM College of Pharmacy. Lara is passionate about gut health and the prevention and reversal of metabolic, allergic, and autoimmune disease. There’s power in community, working with pharmacy professionals, nutritionists, and other clinicians to leverage their unique expertise to amplify the message of personalized nutrition and FxMed.

 

Speaker Disclosures:
Financial: Lara Zakaria maintains a private practice and has employment relationships with Emerson Ecologics, Kuara Health, Functional Medicine CE, and George Washington University. She previously received compensation from Gaia Herbs. She receives a speaking honorarium from PESI, Inc.
Non-financial: Lara Zakaria has no relevant non-financial relationships.

Additional Info

Access never expires for this product.

For a more detailed outline that includes times or durations of time, if needed, please contact cepesi@pesi.com

Visit our FAQ page at www.pesi.com/faq or contact us at www.pesi.com/info

Objectives

1. Evaluate the pathophysiology of erectile dysfunction and its role as an early indicator of cardiovascular and metabolic disease risk.
2. Apply evidence-based pharmacologic and integrative treatment strategies for erectile dysfunction, considering both patient safety and long-term health outcomes.

Outline

• ED as a predictor of vascular and metabolic disease: Cardiovascular disease, hypertension, type 2 diabetes, and chronic kidney disease
• Early marker for endothelial dysfunction and systemic inflammation
• Psychological and hormonal considerations
  • Anxiety, depression, and stress-related contributors
  • The role of testosterone and when to investigate hypogonadism

• Vascular causes: Atherosclerosis, endothelial dysfunction, impaired nitric oxide production
• Neurogenic causes: Diabetes-related neuropathy, spinal cord injury, post-surgical complications
• Endocrine causes: Testosterone deficiency, metabolic syndrome, thyroid dysfunction
• Psychogenic ED: Stress, anxiety, performance-related concerns
• Medication-induced ED: Common culprits (SSRIs, beta-blockers, thiazide diuretics, opioids, etc.)

• PDE-5 Inhibitors: Sildenafil, tadalafil, vardenafil, avanafil
  • Mechanism of action, efficacy, and duration differences
  • Safety considerations (CF risks, contraindications with nitrates, hypotension risk)
  • Common side effects and patient counseling points
• Testosterone therapy: When (and When NOT) to prescribe
  • Indications for TRT: Diagnosing hypogonadism vs. age-related testosterone decline
  • Risks: Polycythemia, prostate cancer concerns, CV risk controversy
  • Monitoring guidelines: hematocrit, PSA, lipid panels, symptom improvement
• Alternative pharmacologic options
  • Intracavernosal injections (alprostadil)
  • Vacuum erection devices
  • Off-label options (e.g., dopamine agonists, centrally acting agents)

• Dietary & lifestyle strategies for ED prevention & management
  • Mediterranean diet & endothelial health
  • Physical activity: Benefits of resistance training& cardiovascular exercise
  • Smoking cessation & alcohol moderation
  • Sleep optimization for hormonal balance
• Herbal & nutraceutical considerations
  • L-arginine & nitric oxide production
  • Panax ginseng & adaptogens for stress-related ED
  • Yohimbine: Risks vs. benefits
  • Omega-3s, flavonoids, and polyphenols for vascular support
• Stress management & psychosocial interventions
  • Cognitive Behavioral Therapy
  • Mindfulness-based approaches

• Patient Case: 56-year old male with ED, prediabetes, mild hypertension
  • Initial assessment: Ruling out secondary causes
  • Prescribing decision: PDE-5 inhibitor vs. testosterone testing
  • Integrative counseling: Cardiometabolic risk reduction, lifestyle modifications

Target Audience

• NPs
• APRNs
• PAs
• PharmDs
• MDs
• DOs