Exam 3 - Reproductive Flashcards
What are the 4 androgen meds?
- testosterone
- testosterone esters
- dihydrotestosterone
- methyltestosterone
Testosterone
- primarily made by Leydig cells
- rapidly metabolized by liver
- highly bound in plasma to sex hormone binding globulin(SHBG) and albumin
Testosterone Esters
- more lipophilic than testosterone
- can be administered in oil suspension IM for prolonged release
Dihydrotestosterone (DHT)
- converted from testosterone by 5a reductase
- major male sex hormone in skin, prostate, seminal vesicles, and epididymis
methyl testosterone (android)
- synthetic analog
- hepatotoxic
- commonly used by athletes
Androgens
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
What is an androgen antagonist med?
Flutamide (Eulexin)
What is flutamide used for?
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
What are 3 smooth muscle relaxants used to treat BPH?
- alfuzosin (uroxatal)
- tamsulosin (flomax)
- silodosin (rapaflo)
- Have faster onset of action than 5a-reductase
- a1 adgrenergic receptor antagonist
What are 2 5a-reductase inhibitors used to treat BPH?
-finasteride
-dutasteride
*Blocks the conversion of testosterone to dihydrotestosterone and interferes with the stimulatory effect on prostate gland enlargement
SE: impotence, gynecomastia
Alfuzosin(Uroxatral)
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
Tamsulosin (Flomax)
Class: smooth muscle relaxant (selective a1 adrenergic receptor antagonist)
- little effects on peripheral vascular resistance and hypotension
- ejaculatory dysfunction common
Silodosin (Rapaflo)
Class: smooth muscle relaxant (selective a1 adrenergic receptor antagonist)
- little effects on peripheral vascular resistance and hypotension
- ejaculatory dysfunction common
Finasteride (proscar)
inhibits type II 5a-reductase
*also used to treat male pattern baldness
Dutasteride (avodart)
inhibitors Type I & II 5a-reductase
What are the 4 drugs used to treat ED?
- sildenafil (viagra)
- vardenafil (levitra)
- tadalafil (cialis)
- avanafil (stendra)
ED drugs
MOA: Inhibit PDE5
*they will not work in the absence of parasympathetic activity
SE: vasodilation
>HA, flushing, dyspepsia, nasal congestion, abnormal vision
Silenafil (viagra) & Vardenafil (levitra)
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
Tadalafil (cialis)
Class: ED drug MOA: PDEF inhibitor onset: 30-60min duration: up to 36 hrs taken without regard to food
Avanafil (standra)
Class: ED drug MOA: PDEF inhibitor onset: 15-30 min duration: 4-5 hrs taken without regard to food
