3 - Men's Health

Question 1

What is an androgen?

Answer 1

A male sex hormone, but do not occur only in men

Question 2

Where are androgens produced?

Answer 2

Ovaries

Testes

Adrenal Cortex

Question 3

The principal endogenous androgen in both males and females is:

Answer 3

testosterone

Question 4

Testosterone is made by ____ cells in the testes

Answer 4

Leydig

Question 5

Which hormones promote testosterone synthesis?

Answer 5

LH and FSH

Question 6

Which has greater androgenic activity: testosterone from the testes or from the adrenal cortex?

Answer 6

Adrenal production is pretty inconsequential, at least in men

Question 7

How is testosterone made in women?

Answer 7

The precursors (pre-androgens) are secreted by the adrenal cortex and ovaries, then converted into testosterone in the peripheral tissues

Question 8

How does testosterone exert its effects?

Answer 8

Much like steroid hormones in general:

Binds with receptors in the cytoplasm, then the complex migrates to the nucleus and promotes mRNA synthesis for specific proteins

Question 9

What is virilization?

Answer 9

development of male physical characteristics

Question 10

Is the net effect of testosterone anabolic or catabolic?

Answer 10

Anabolic

promotes growth of skeletal muscle

Question 11

Why do men have a higher Hct than women?

Answer 11

Because testosterone is erythropoietic

Question 12

What are therapeutic uses of androgens, other than replacement therapy in males?

Answer 12

1. Alleviation of decreased libido in menopausal women
2. Cachexia from AIDS or severe trauma
3. Anemia (especially aplastic)

Question 13

Why is testosterone associated with thromboembolic events?

Answer 13

Because of its erythropoietic effects

Question 14

What are some AEs of androgens?

Answer 14

Virilization

Premature epiphyseal closure, causing short stature

hepatotoxicity (rare)

prostate CA

edema

Clots

Question 15

What effect does testosterone have on lipid levels?

Answer 15

can lower HDL and elevate LDL

Question 16

Why aren’t oral androgens considered first line treatment?

Answer 16

Their androgenic effects are erratic and they carry a higher risk for hepatotoxicity

Question 17

Testosterone gels carry a black box warning for:

Answer 17

Secondary exposure causing virilization in children

This is why its so important to wash hands after applying and to ensure the gel has dried before allowing clothing to touch it

Question 18

If androgens are male sex hormones, why does taking large dose steroids for gainz cause sterility and testicle shrinkage?

Answer 18

Because all that excess testosterone in the blood stream is suppressing FSH and LH, reducing testicular production of testosterone

Question 19

What’s the difference between milrinone and sildenafil in terms of MOA?

Answer 19

Both are phosphodiesterase inhibitors

Milrinone inhibits PDE-3, increasing cAMP levels

Sildenafil inhibits PDE-5, increasing cGMP levels

Question 20

Which drugs should not be taken with sildenafil?

Answer 20

CYP3A4 inhibitors

Grapefruit juice

Alpha blockers

Nitrates

Question 21

Which men should not receive sildenafil?

Answer 21

If they have signs that sexual activity may be unsafe:

1. MI or stroke in the last 6 months
2. Resting hypo or hypertension
3. heart failure
4. unstable angina

Question 22

All PDE-5 inhibitors drugs are called:

Answer 22

“-afil”

Question 23

Which neurotransmitters delay ejactulation?

Answer 23

Serotonin

Question 24

Which neurotransmitters stimulate ejaculation?

Answer 24

Oxytocin and dopamine

Question 25

There are four classes of drugs used to treat BPH:

Answer 25

1. 5 - alpha - reductase inhibitors
2. Nonselective alpha 1 blockers
3. Selective Alpha 1a blockers
4. PDE-5 inhibitors

Question 26

5-ALPHA-REDUCTASE INHIBITORS

MOA & DRUG LIST

Answer 26

Finasteride (Proscar)

reduces dihydrotestosterone production, causing shrinkage of the prostate and relieving obstruction

takes weeks to start working

Question 27

SELECTIVE ALPHA 1a BLOCKERS

MOA & DRUG LIST

Answer 27

Tamsulosin (Flomax)

Blockade of these receptors relaxes smooth mm in the bladder neck, prostate capsule, and prostatic urethra

Works rapidly

Question 28

NONSELECTIVE ALPHA 1 BLOCKERS

MOA & DRUG LIST

Answer 28

Alfuzosin, Doxazosin, Terazosin

Same as selective, but obviously have greater risk of hypotension, fainting, somnolence, and nasal congestion

Question 29

PDE-5 INHIBITORS (BPH)

MOA & DRUG LIST

Answer 29

Tadalafil (Cialis)

smooth muscle relaxation in bladder, prostate and urethra