Androgens and antiandrogens Flashcards
primary goal of testosterone therapy
restoring testosterone level
When do you draw testosterone level?
morning, between 8 and 10 am
Testosterone therapy effects start
within 3-6 months of starting therapy. bone density takes 24 months to improve
adverse effects of testosterone
acne, prostate disorders, sleep apnea, erythrocytosis (rise in hct).
testosterone forms
- Androgen, Testim, Fortesta (gel that comes in 50-100 mg daily).
- testosterone enanthate or cypionate (IM. 50-100 mg q week or 100-200 mg q2 weeks).
- SC infection and pellet.
education for testosterone topical administration
wash hands before applying, do not touch until med is dry. do not touch area for 5 hours after administered.
Testosterone contraindications
prostate cancer, male breast cancer, lower UTI, erythrocytosis (low hgb & hct), sleep apnea, uncontrolled CHF (testosterone causes sodium retention). do not use if hct is >50.
Testosterone drug interactions
anticoagulants (increases anticoagulant effects of warfarin), diabetic agents (risk for hypoglycemia), corticosteroids (fluid retention).
monitoring while on testosterone.
- check level 2-3 months after starting tx. once stable, check q 6-12 months.
- evaluate for prostate cancer at 3 months and one year after starting therapy
- check Hct (CBC) 3-6 months after starting tx and then annually.
5-Alpha Reductase Inhibitors
Finasteride (Proscar, Propecia)
antiandrogen
Finasteride (Proscar, Propecia) Indications
treats BPH and male pattern baldness.
at 5mg, it reduces risk for BPH but at higher risk for prostate cancer.
Finasteride (Proscar, Propecia) Pharmacodynamics
inhibits enzymes that convert testosterone to DHT (dihydrotestosterone). antiandrogen effects.
Finasteride (Proscar, Propecia) Caution/contraindications
prostate evaluation required for anyone on this medication with increase in PSA level
GnRH analogues
antiandrogen
Leuprolide (Lupron)
Leuprolide (Lupron) Pharmacodynamics
LH releasing hormone agonists. (blocking LH releasing hormone). creates reversible chemical orchiectomy state in males (used in prostate cancer). creates reversible chemical oophorectomy state in females.
