Endocrine

Question 1

finasteride

Answer 1

Propecia, Proscar

5-alpha reductase inhibitor

-NIOSH: do not handle if pregnant
-will not regrow hair, but can prevent additional loss
-when used for benign prostatic hyperplasia (BPH), not rapidly effective and may take 6+ months to shrink enlarged prostate and reduce symptoms; better if used in combo with alpha blocker (e.g. tadalafil) to reduct symptoms and prevent/delay need for surgical intervention
-can take with/without food

Question 2

isotretinoin

Answer 2

Accutane, Claravis, Zenatane

retinoid

-follow REMS system for dispensing and counseling
-teratogenic category X, major risks in pregnancy
-adverse lipid effects such as increased TG
-possible psychiatric effects such as increased suicidality
-acne may get worse before improving
-indicated for treatment of severe recalcitrant acne, retinoid derivative of vitamin A
-avoid alcohol, can lead to inflammation of liver
-avoid vitamin A supplements
-take with food; high-fat foods increase drug absorption

Question 3

testosterone

Answer 3

AndroGel

androgen

-use as directed on opper arm/shoulder (not genitals)
-women and children should avoid contact
-men with BPH may get worse
-indicated in treatment of hypogonadism, breast cancer in women, vasomotor symptoms of menopause

Question 4

metformin

Answer 4

Glucophage

biguanide antihyperglycemic

-may cuase GI upset and diarrhea
-best if titrated to minimize symptoms
-may lead to B12 deficiency related neuropathy
-usually used in conjunction with diet and exercise for glycemic control in type II diabetes mellitus
-used off-label for insulin resistance in polycystic ovary syndrom (PCOS)
-lowers blood glucose concentrations, insulin sensitizer and decreases insulin resistance
-can result in modest weight loss
-avoid alcohol, take with food to reduce irritation