Androgens

Question 1

Hypogonadism drugs

Answer 1

Methyltestosterone (oral) - liver tox, hepatic cancer
Testosterone enanthate (IM) - HRT
Testosterone (topical)

Question 2

AE Androgen therapy/abuse

Answer 2

Premature epiphyseal closure/muscle tendon injury
Hepatic dysfunction
HTN, renal dysfunction
Polycythemia/Mental disturbances

Question 3

MOA Androgen Receptor Antagonist

Answer 3

Flutamide, Bicalutamide, Enzalutamide
Prior to GnRH analog to prevent testosterone surge
Treat prostate cancer
Enzalutamide also acts on nuclear level

Question 4

MOA GnRH Agonist

Answer 4

Leuprolide, Goserelin
increased receptor affinity - increases LH/testosterone production
Down-regulation of GnRH on Pituitary gonadotropes

Question 5

AE Androgen Antagonist

Answer 5

gynecomastia, liver toxicity

Question 6

AE GnRH Agonist

Answer 6

Sexual dysfunction, bone density loss, anemia, fatigue, prostate cancer

Question 7

MOA GnRH Antagonist

Answer 7

Degarelix

Faster onset, no LH surge, reduced LH/FSH release, decrease testosterone production

Question 8

MOA Androgen Biosynthetic Inhibitor

Answer 8

Abiraterone
Used for metastatic prostate cancer
AE - adrenal insufficiency, hepatic toxicity, HTN, hypokalemia, fluid retention

Question 9

MOA 5a-reductase inhibitors

Answer 9

Finasteride, Dusteride
Treat BPH
AE - reduced DHT = abnormalities, impotence, gynecomastia

Question 10

Androgenic Alopecia TX

Answer 10

DHT thought to be causative agent

Finasteride*

Question 11

ED Drugs MOA

Answer 11

PDE5 inhibitors - also treat BPH
Sildenafil, Vardenafil, Tadalafil, Avanafil
AE - dyspepsia, low BP, cardiac effects, priapism
Avoid nitrates/nitrites