Androgen, Anabolic Pharmacology Flashcards
An adult male has a low sperm count. Plasma testosterone is low and LH levels are high. What is the next test you should run? what is dx?
FSH levels- if normal = Leydig cell failure
Young athletes who abuse androgens should be made aware of the side effects of these drugs. Which one of the following is, however, not of concern and why?
Increased muscle mass Anemia due to bone marrow failure Overly aggressive behavior Decreased spermatogenesis Stunted growth
Anemia… androgens cause hematopoiesis
A week-old newborn male presents to clinic for a routine checkup. The parents are concerned because he does not seem to have male genital characteristics. Physical examination reveals female external genitalia seen without a scrotum or descended testicles. What androgen is the patient lacking that is the cause of his condition? (A) Androstenedione (B) Androsterone (C) Dehydroepiandrosterone (DHEA) (D) Dihydrotestosterone (DHT) (E) Testosterone
DHT
Primary sex chc - testosterone
external genitalia = DHT mediated
A 76-year-old man presents to the clinic for follow-up of his benign prostatic hyperplasia. He has been doing well with his symptoms since starting finasteride. He no longer has as much difficulty starting his stream and feels that he empties his bladder completely. What is the mechanism of action of finasteride?
(A) 5α-Reductase inhibitor (B) α1-Antagonist (C) GnRH agonist (D) GnRH antagonist (E) Nonsteroidal competitive inhibitor at the testosterone receptor
(A) 5α-Reductase inhibitor
A 17-year-old girl has never had a menstrual period. Physical examination shows a normal female body habitus, normal breast development, and normal appearing external genitalia. She has no axillary or pubic hair. The patient refuses to have a pelvic or rectal examination. Which of the following is the most likely explanation for the clinical presentation?
(A) Androgen insensitivity (B) Congenital adrenal hyperplasia (C) Ectodermal dysplasia (D) A psychiatric disorder (E) A sex chromosome mosaicism
Androgen insensitivity
Testosterone is responsible for
In a genetic male, Leydig cells support the development of what structure with what homo?
Androgens support Mesonephric ducts
mesonephric ducts (under influence of testosterone) develop into what structures in male? (5)
internal structures: “BEEDS”
Bladder trigone, Epididymus, Ejaculatory ducts, Ductus defeerens, Seminla vesicles,
DHT controls expression of what chc in males (2)
external genitalia before puberty
prostate
3 sites of Estrogen synthesis in females
ovaries, adrenals, peripheral conversion of DHEA
What is the only hormone that completes the loop of androgen synthesis with negative feedback? and how?
testosterone–> inhibits GnRH and LH/FSH production
What happens at puberty to increase testosterone produciton
LH produciton increases
What initiates spermatogenesis (cell and homo) and what maintains spermatogenesis?
FSH actiing on sertoli cell initiates it
maintianed by testosterone
If testis don’t drop what is the deficiency
DHT
In what 2 tissues in T not DHT the active steroid
hypothalamus and pituitary
DHT controls what aspects of reproductive development (and 3 examples)
differentiation of male accessory ducts and external genitalia:
prostate
penis
scrotum
T acts on what male reproductive tissues (4)
Seminiferous tubules, seminal vesicles, epididymus, vas deferens
17@ (typeB) or ring substiutions (type C) of T: are they metabolized to T?
no
17@ or ring substiutions of T: are they orally active
yes
methyltestosterone: orally active? what is the modification of T?
17@ (typeB) = orally active
mesterolone: orally active? what is the modification of T?
ring substiutions (type C) = orally active
ADEs (2) of 17@ (typeB) or ring substiutions (type C)
liver toxicity and cancer
Type A; enanthate or cypionate is what kind of change to T?
17B- esterification
Type A; enanthate or cypionate/ 17B-esterification: orally active? mtb to T?
not orally active
is mtb to T
all preparations of T have mixed anabolic and androgenic effects. What effect does the androgenic activity have on a person?
The androgenic effects blunt intrinsic testosterone production–> inhibition of spermatogenesis, etc
