Drugs for male GU disorders and Urinary Incontinence - (Martin) SRS Flashcards
Tell me what the Gonadotropin-releasing hormone analogs are. one bold
- Leuprolide (prototype)
- Gonadorelin, goserelin, histrelin, nafarelin, triptorelin
What do the Gonadotropin-releasing hormone antagonists end in?
- relix
1. Abarelix, cetrorelix, degarelix, ganirelix
What are the two categories of
What are the Androgen receptor inhibitors We need to know?
one prototype
- Cyproterone
- Flutamide
- Bicalutamide
- Nilutamide
- Spironolactone
What are the 5α-reductase inhibitors we need to know? 2 both bold
- Finasteride
- Dutasteride
What categories of drugs are used for BPH?
- 5α-reductase inhibitors (see above)
- α-adrenergic antagonists
- Saw palmetto
What are the alpha adrenergic antagonists used for BPH? 6, all bold
- Prazosin (prototype α1-selective antagonist)
- Terazosin
- Doxazosin
- Alfuzosin
- Tamsulosin
- Silodosin
What are the two categories of drugs used for ED?
- PDE-5 inhibitors
- Alprostadil
What are the PDE-5 inhibitors used in the tx of ED? 2 bold five tots
- Sildenafil [Viagra]
- Tadalafil [Cialis]
- Vardenafil [Levitra, Staxyn]
- Avanafil [Stendra]
What are the drugs used to urinary incontinence? one bold and 5 otherss
- Darifenacin
- Fesoterodine
- Oxybutynin
- Solifenacin
- Tolterodine
- Trospium
In Leydig cells, the 11 and 21 hydroxylases (present in adrenal cortex) are absent but what is present?
CYP17 (17 -hydroxylase)
- Conversion of testosterone to estradiol by aromatase occurs primarily in the liver and adipose tissue and is executed by what enzyme?
- CYP19 P450 aromatase
ADRs of androgens include masculinizing actions (most noticeable in women and prepubertal children) although rare, sodium retention and edema are more common in patients with heart and kidney disease. What impact may they have on the liver?
- Many synthetic androgens cause hepatic dysfunction
- Often occurs early in the course of treatment (degree is proportional to the dose)
- Bilirubin levels may increase until clinical jaundice is evident
- Cholestatic jaundice is reversible upon cessation of therapy
- Prostatic hyperplasia may develop in older males, causing urinary retention
- Hepatic adenomas and carcinomas
When used for hormone replacement in men, androgens may cause acne, sleep apnea, erythrocytosis, gynecomastia, and azoospermia. What do supraphysiologic doses do?
Is/are these/this thing(s) reversible?
Azoospermia and decreased testicular size
Reversible possible months after discontinuation
What types of cancers have been noted with androgen use?
Hepatic adenomas and carcinomas
What type of behavioral effects have been reported with androgen use? 3
- psychologic dependence
- increased aggressiveness
- psychotic symptoms
Are androgens CI in pregnant women?
Yes, and in those who may become pregnant during therapy
What cancer scenarios could men have that would be CI for androgen use?
Carinoma of the prostate or breast
Androgens should not be used in infants and young kids. What should be used instead?
Somatropin
If used in a patient with renal or cardiac disease, what should these patients be warned of before beginning androgen therapy?
Edema (use diuretics if this develops)