A.8- androgens, anti androgens Flashcards

1
Q

function of testosterone

A
  1. male reproductive development
  2. maintains fertility, libido
  3. cause male hair baldness
  4. anabolic effects–> ↑ muscle mass and strength, ↑ RBC’s production
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2
Q

synthetic analogues of testosterone

A

Nandrolone, Oxandrolone

Testosterone undecanoate

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3
Q

how is Nandrolone given?

A

parenteral

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4
Q

how is testosterone given?

A

transdermal, buccal, subcutaneous implant

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5
Q

indications of androgens (Testosterone, Nandrolone)

A
hypogonadism in boys
hormone replacement therapy in men
weight gain in patients with 'wasting syndrome'
anemias- stimulate RBC production  
illicit use in athletes
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6
Q

SE of testosterone

A

females- virilization (hirsutism, enlarged clitoris, deepened voice), menstrual irregularity
males- feminization and gynecomastia (due to feedback inhibition of the pituitary)
↑ libido and aggression
prostate pathology
both- cholestatic jaundice, ↑ of liver enzymes

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7
Q

contraindications for testosterone

A

pregnancy
prostate/ breast cancer
CHF

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8
Q

types of antiandrogens

A

receptor inhibitors
5𝝰 reductase inhibitors
GnRH analogs and antagonists
synthesis inhibitors

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9
Q

agents affecting sexual activity- non hormonal

A

PDE- 5 inhibitors (e.g- sildenafil, alprostadil)

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10
Q

drugs causing sexual disturbances

A

𝝰1 blockers- prolonged ejaculation
antidepressants
antipsychotics

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11
Q

mechanism of PDE-5 inhibitors

A

phosphodiesterase inhibition–> cGMP ↑–> vasodilation

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12
Q

how is sildenafil given?

A

oral

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13
Q

how is alprostadil given?

A

intracavernosal injection (into the corpus cavernosum of the penis)

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14
Q

indications for sildenafil (“viagra” )

A

erectile dysfunction
pulmonary hypertension
BPH

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15
Q

SE in sildenafil

A

severe hypotension when combined with nitrates
priapism (prolonged erection)
blue tinted vision

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16
Q

list receptor inhibitors (antiandrogens)

A

Bicalutamide
flutamide
spironolactone
cyproterone

17
Q

what is bicalutamide?

A

competitive inhibitor of androgen receptors

18
Q

how is bicalutamide given?

A

orally

19
Q

indications for bicalutamide and flutamide

A

prostate cancer

precocious puberty

20
Q

SE of bicalutamide

A

gynecomastia, hot flushes, impotence, hepatotoxicity

21
Q

what is the mechanism of 5𝝰- reductase inhibitor

A

conversion of testosterone into dihydrotestosterone (DHT) in prostate, hair follicles

22
Q

example of 5𝝰- reductase inhibitor

A

Finasteride

“Fine im bald..”

23
Q

indictions of finasteride

A

BPH

prevent male baldness!

24
Q

what is ketoconazole used for?

A

prostate cancer (if resistant to 1st line anti-androgens)