Drugs for Men's Health and Reproductive Disorders Flashcards
male sex hormones, affect sexual processes, accessory sexual organs, cellular
metabolism, and bone and muscle growth.
androgens
the main androgen, is synthesized
primarily in the testes and to a lesser extent in the adrenal cortex.
testosterone
normal plasma concentrations of testosterone in men
250 - 1000 mg/dl
occurs when there is insufficient testosterone production by the testes. Hypogonadism can be
primary, reflecting testicular abnormality, or secondary, reflecting hypothalamic or pituitary
failure
(indication of androgen therapy)
hypogonadism
occurs when there is insufficient testosterone production by the testes. Hypogonadism can be
primary, reflecting testicular abnormality, or secondary, reflecting hypothalamic or pituitary
failure
hypogonadism
Artificial induction of puberty is undertaken after boys reach 15 to 17 years of age.
Hypothalamic and pituitary function is assessed. A 4- to 6-month trial of androgen therapy is
implemented, followed by a period of rest for reevaluation. If prolonged therapy is required, what medication is given?
transdermal patches
testosterone cypionate or testosterone enanthate
starting - 100 mg IM every
2 weeks for 6-12 months
increase to 200 mg every 2 weeks.
delay of bone growth
The cause may be a deficiency of growth hormone, which can be associated with androgen
deficiency, or it may be solely androgen deficiency. Treatment is not initiated before the age of
14 years. Therapy for 3 to 6 months or less before epiphyseal closure may result in linear growth
without adverse permanent effects on hypothalamic, pituitary, or gonadal maturation. It is not
known whether treatment has an effect on final adult height.
Constitutional Growth Delay
const. growth delay treatment
an orally
active testosterone analog, is effective for treating boys. stimulates the onset of
puberty. It is classified as an anabolic steroid and is regulated as such.
Oxandrolone
0.1mg/kg
Other uses of androgens include treatment of
— in men and
women, the geriditary autosomal clotting disorder angioneurotic edema, tissue wasting
associated with severe or chronic illness, advanced carcinoma of the breast in women, and
endometriosis.
refractory anemias
side effects of androgen therapy
abdominal pain, nausea, insomnia, diarrhea or
constipation, hives or redness at the injection site, increased salivation, mouth soreness, and
increased or decreased sexual desire.
contraindications of androgen therapy
pregnancy
individuals with nephrosis or nephrotic phase of nephritis
hypercalcemia
pituitary insufficiency, hepatic dysfunction,
benign prostatic hypertrophy
prostate cancer
history of myocardial infarction
androgen drug interactions
potentiates the effects of oral anticoagulants
antagonize calcitonin and parathyroid hormones
decrease blood glucose in clients with diabetes
Barbiturates, phenytoin, and phenylbutazone
decrease the effects of androgens.
decreases the effects of androgen
Barbiturates, phenytoin, and phenylbutazone
are synthetic derivatives of testosterone developed to maximize the anabolic
effects of androgens and to minimize their androgenic effects. Testosterone precursors available
as
supplements
include
androstenediol,
androstenedione,
and
dehydroepiandrosterone (DHEA). A
Anabolic Steroids
effects of anabolic steroids
Anabolic steroids increase strength and power, and
artificially enhanced strength and power can lead to changes in performance. Sudden dramatic
increase in weight gain and body size, increased acne, and changes in mood and behavior can
be signs of anabolic steroid use. Individuals using anabolic steroids may become more
aggressive and physical.
side effects of anabolic steroids
Side effects include water retention, which overloads the kidneys, and
cardiovascular damage such as cardiomyopathy and stroke. There can also be hapatic
problems, because anabolic steroids tend to lower HDL (good) cholesterol.
two other steroids
human chorionic gonadotropin (hCG,
Pregnyl, Novarel, Ovidrel)
tetrahydrogestrinone (THG).
a
hormone used to treat infertility; it also stimulates testosterone production.
hcg
a potent androgen developed to escape urine detection;
not approved by the FDA and not legally marketed
tetrahydrogestrinone
or androgen antagonists, block the synthesis or action of androgens. These
drugs may be useful in the management of benign prostatic hypertrophy and carcinoma of the
prostate. They have been used to treat male-pattern baldness, acne, hirsutism, virilisation
syndrome in women, and precocious puberty in boys, although their effectiveness is not well
established.
antiandrogens
is the most
effective inhibitor of testosterone synthesis.
Gonadotropin-releasing hormone
leuprolide
an antimycotic, is used for treatment of prostatic
carcinoma because of its inhibition of adrenal and gonadal steroid synthesis.
ketoconazole
Two types of drugs have been developed to block testosterone action
androgen-receptor antagonist
dihydrotestosterone
an orally active progesterone, is a potent androgen
antagonist. It also suppresses LH and FSH secretion and has progestational qualities
cyproterone acetate
is a nonsteroidal drug that competes with androgens and androgen
receptor sites. Men receiving this show elevations in plasma LH and testosterone levels.
Flutamide (Eulexin)
Finasteride, a steroid, inhibits conversion of testosterone to dihydrotestosterone. This orally active agent decreases the concentration of dihydrotestosterone in plasma and in the prostate without elevated plasma concentrations of LH or testosterone. Finasteride is used to treat benign prostatic hypertrophy (BPH). Women of childbearing potential should not be exposed
Finasteride
primary treatment is orchidopexy (surgical placement of the testicle into the scrotum), which is
usually performed by the time the child is 18 months old.
orchidopexy
a deficiency in thyroid hormone, can be the result of insufficient thyroid
hormone production or resistance to its effects at the target organs.
hypothyroidism
inadequate pituitary function can result in hypogonadism
1 ampoule of __
which contains 75IU each of LH and FSH, can stimulate testosterone production when injected
IM three times a week over a period of years. Menotropin is indicated when bothe LH and FSH
levels are low. It is given concomitantly with hCG 2000 IU IM twice a week for at least 3 months.
Menotropins
disease, there is a deficit of both cortisol and
mineralocorticoid aldosterone.
Addison’s disease
(persistent inability to attain or maintain an erection satisfactory for sexual
performance) may be caused by psychoemotional prob lems, diabetes, hypertension, lower
urinary tract symptoms, and history of pelvic surgery, vascular insufficiency, neurologic
disorders, androgen deficiency or resistance, or diseases of the penis.
erectile dysfunction
(impaired ejection of seminal fluid from the urethra of the male)
ejaculatory dysfunction
(reduction of penile swelling) is most commonly caused by penile diseases or systemic disease.
detumescence
Erectile dysfunction caused by vascular insufficiency treatment
vasoactive drugs, including papaverine, phentolamine,
prostaglandin E, nitroglycerin, or yohimbine.
facilitate erections by
enhancing blood flow to the penis.
Phosphodiesterase (PDE) inhibitors
such as:
Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
For men who do not respond to oral medications or in whom medications are contraindicated,
drugs for both intracavernous and other routes of administration are available.
Sublingual apomorphine (Uprima)
Phentolamine (Vasomax)
