Exam 3 - Reproductive

Question 1

What are the 4 androgen meds?

Answer 1

• testosterone
• testosterone esters
• dihydrotestosterone
• methyltestosterone

Question 2

Testosterone

Answer 2

• primarily made by Leydig cells
• rapidly metabolized by liver
• highly bound in plasma to sex hormone binding globulin(SHBG) and albumin

Question 3

Testosterone Esters

Answer 3

• more lipophilic than testosterone

- can be administered in oil suspension IM for prolonged release

Question 4

Dihydrotestosterone (DHT)

Answer 4

• converted from testosterone by 5a reductase

- major male sex hormone in skin, prostate, seminal vesicles, and epididymis

Question 5

methyl testosterone (android)

Answer 5

• synthetic analog
• hepatotoxic
• commonly used by athletes

Question 6

Androgens

Answer 6

Clinical Uses: androgen replacement therapy, anabolic agent, osteoporosis, delayed puberty
Adverse Effects:
women- hirsutism, acne, amenorrhea, clitoral enlargement, voice deepening. hepatic dysfunction, prostatic hyperplasia, urinary retention, azoospermia, cancer (hepatic adenomas/carcinomas), psych behavior
CONTRA: prego, men with breast/prostate carcinoma, renal/cardiac dz pts predisposed to edema

Question 7

What is an androgen antagonist med?

Answer 7

Flutamide (Eulexin)

Question 8

What is flutamide used for?

Answer 8

metastatic prostate cancer

• used in conjunction with GnRH
• not effective when used alone d/t reflex increase in LH secretion causing an increase in testosterone synthesis and release

Question 9

What are 3 smooth muscle relaxants used to treat BPH?

Answer 9

• alfuzosin (uroxatal)
• tamsulosin (flomax)
• silodosin (rapaflo)
• Have faster onset of action than 5a-reductase
• a1 adgrenergic receptor antagonist

Question 10

What are 2 5a-reductase inhibitors used to treat BPH?

Answer 10

-finasteride
-dutasteride
*Blocks the conversion of testosterone to dihydrotestosterone and interferes with the stimulatory effect on prostate gland enlargement
SE: impotence, gynecomastia

Question 11

Alfuzosin(Uroxatral)

Answer 11

Class: smooth muscle relaxant > a1 adrenergic receptor antagonist

• uroselective
• little CV effects at doses to treat BPH > d/t higher concentrations in the prostate than in the serum

Question 12

Tamsulosin (Flomax)

Answer 12

Class: smooth muscle relaxant (selective a1 adrenergic receptor antagonist)

• little effects on peripheral vascular resistance and hypotension
• ejaculatory dysfunction common

Question 13

Silodosin (Rapaflo)

Answer 13

Class: smooth muscle relaxant (selective a1 adrenergic receptor antagonist)

• little effects on peripheral vascular resistance and hypotension
• ejaculatory dysfunction common

Question 14

Finasteride (proscar)

Answer 14

inhibits type II 5a-reductase

*also used to treat male pattern baldness

Question 15

Dutasteride (avodart)

Answer 15

inhibitors Type I & II 5a-reductase

Question 16

What are the 4 drugs used to treat ED?

Answer 16

• sildenafil (viagra)
• vardenafil (levitra)
• tadalafil (cialis)
• avanafil (stendra)

Question 17

ED drugs

Answer 17

MOA: Inhibit PDE5
*they will not work in the absence of parasympathetic activity
SE: vasodilation
>HA, flushing, dyspepsia, nasal congestion, abnormal vision

Question 18

Silenafil (viagra) & Vardenafil (levitra)

Answer 18

Class: ED drug
MOA: PDE5 inhibitor
onset: 30-60 min
duration: 4-5hrs
*high fat and alcohol reduces absorption. recommended to take on empty stomach

Question 19

Tadalafil (cialis)

Answer 19

Class: ED drug
MOA: PDEF inhibitor
onset: 30-60min
duration: up to 36 hrs
taken without regard to food

Question 20

Avanafil (standra)

Answer 20

Class: ED drug
MOA: PDEF inhibitor
onset: 15-30 min
duration: 4-5 hrs
taken without regard to food