Androgens, anti-androgens and anabolic steroids Flashcards
What do androgens cause and what are they used for?
Cause masculinisation; they may be used as replacement therapy in castrated adults and in those who are hypogonadal due to either pituitary or testicular disease.
What effect does the administration of androgens on normal males have?
Inhibit pituitary gonadotrophin secretion and depress spermatogenesis. Androgens also have an anabolic action which led to the development of anabolic steroids.
When can androgens be used as a treatment of impotence and impaired spermatogenesis?
Only after the hypogonadism has been properly investigated and treatment should be under expert supervision.
What is the effect of giving androgens to patients with hypopituitarism? what can it not achieve?
Can lead to normal sexual development and potency but not to fertility. If fertility is desired, the usual treatment is with gonadotrophins or pulsatile gonadotrophin releasing hormone which will stimulate spermatogenesis as well as androgen production.
If fertility is desired in a patient with hypopituitarism what is the usual treatment? Why is not androgens?
Androgens will lead to normal sexual development and potency but not to fertility. Treatment with gonadotrophins or pulsatile gonadotrophin releasing hormone will stimulate spermatogensis as well as androgen production.
What form of administration is preferred for testosterone replacement therapy?
IM depot preparations.
Testosterone enantate, propionate or undecanoate alternatively Sustanon (longer duration of action) can be used.
What is the benefit of using Sustanon, which is a mixture of different testosterone esters, in treatment?
Longer duration of action.
What is cyproterone acetate?
Anti-androgen used in the treatment of severe hypersexuality and sexual deviation in the male.
It inhibits spermatogenesis and produces reversible infertility (but is not a male contraceptive) ; abnormal sperm forms are produced.
Who can cyproterone acetate be used in and to treat what? (2)
Males for severe hypersexuality and sexual deviation.
NOT a male contraceptive - despite inhibiting spermatogenesis and reversible infertility.
Also licensed for use alone in patient with metastatic prostate cancer refractory to gonadorelin analogue therapy and has been used as an adjunct in prostatic cancer and in the treatment of acne and hirsutism in women.
What are the risks with using cyproterone acetate?
It has caused hepatic tumours in animal studies.
What can cyproterone acetate be used to treat in women?
Acne and hirsutism (excessive hair growth)
Dustateride and finasteride are alternatives to alpha-blockers in what group of men?
Those with a significantly enlarged prostate.
Finasteride is also licensed for use with doxazosin in the management of benign prostatic hyperplasia.
Finasteride is also licensed for use in the management of benigen prostatic hyperplasia in conjunction with what?
Doxazosin.
Low-strength finasteride can be used to treat what?
male-pattern baldness in men.
Anabolic steroids have some androgenic activity but cause less _______ than androgens in women.
Virilisation.
