L 11 androgens

Question 1

testosterone

Answer 1

-Most important androgen secreted by the testis
Binds to the androgen receptor and alters the rate of transcription

Question 2

In men, ~8 mg of testosterone is produced daily

Answer 2

-95% by the Leydig cells in the testis
-5% by the adrenal glands

Question 2

Plasma levels of testosterone

Answer 2

-In men, 0.6 μg/dL after puberty; decreases after age 50
-In women, 0.03 μg/d

Question 3

circulating testosterone

Answer 3

-Bound to sex hormone-binding globulin (SHBG) (65%)
-Bound to albumin (33%)
-Free (2%

Question 4

GnRH

Answer 4

gonadrotropin-releasing hormone

Question 5

LH

Answer 5

luteinizing hormone

Question 6

FSH

Answer 6

follicle stimulating hormone

Question 7

excretion of testosterone

Answer 7

-occurs in the liver
-inactivated and conjugated, then excreted to the urine

Question 8

adrenal androgens

Answer 8

-Intermediates of the testosterone synthesis pathway
-Produced in significant amounts, largely in the adrenal glands.
-Weak androgen effects
-Physiological functions are not known
-androstenedione, DHEA, DHEAS

Question 9

physiologic effects of testosterone

Answer 9

-Responsible for many changes at puberty
-Growth-promoting properties
-Stimulation and maintenance of sexual function
-Stimulation of erythrocyte production
-Decrease in HDL levels

Question 10

growth promoting properties

Answer 10

-Penile and scrotal growth
-Change in the skin (thicker and oilier)
-pubic, axillary, and beard hair
-Deepening of the voice
-Skeletal growth followed by epiphyseal closure
-Increase in lean body mass  positive nitrogen balance

Question 11

androgen replacement therapy in men

Answer 11

-Male hypogonadism (testosterone deficiency)
-Hypopituitarism

Question 12

gynecological disorders

Answer 12

-Must be used with great caution due to adverse effects
-Endometriosis (danazol)
-In combination with estrogens for replacement therapy in the postmenopausal period (controversial)
-Eliminates the endometrial bleeding.
-Enhances libido

Question 13

protein anabolic agents

Answer 13

Reverses protein loss after trauma, surgery, or prolonged immobilization in conjunction with dietary measures and exercises

Question 14

clinical uses of androgens

Answer 14

-andropause
-protein anabolic agents
-gynecologic disorders
-androgen replacement therapy in men

Question 15

synthetic androgens

Answer 15

-When administered orally, testosterone is readily absorbed but inactivated largely.
-17-alkyl forms (ex. methyltestosterone) are more active orally.
-Ester forms (ex. propionate, enanthate, cypionate) have prolonged absorption time
and greater activity for intramuscular administration

Question 16

anabolic steroids in sports

Answer 16

-Used in doses 10 – 200 times larger than the daily normal production to increase
strength and aggressiveness.
-Such effects have been proven only in women
-Large doses of anabolic steroids suppress the secretion of gonadotropins. –> testicular atrophy

Question 17

significant health risks by long term use of anabolic steroids

Answer 17

-Harmful changes in cholesterol levels (Low HDL and high LDL)
-Acne
-High blood pressure
-Hepatic dysfunction in case of 17-alkyl steroid

Question 18

adverse effects of androgen in women

Answer 18

-Hirsutism
-Acne
-Amenorrhea
-Clitoral enlargement
-Deepening of the voice
-should not be used in infants or pregnant women because there is significant disturbances in sexual development

Question 19

adverse effects of androgens in men

Answer 19

-Acne
-Sleep apnea
-Gynecomastia
-Azoospermia and testicular atrophy
-Increased aggressiveness and psychotic symptom

Question 20

antiandrogens

Answer 20

-5a reductase inhibitor
-androgen receptor antagonist

Question 21

5a reductase inhibitors

Answer 21

-block the conversion from testosterone to 5a dihydrotestosterone
-Finasteride (Proscar ®, Propecia® )
-Dutasteride (Avodart®

Question 22

synthetic androgens

Answer 22

-Methyltestosterone (Android®, Metandren®, Testred®)
-testosterone enanthate (Delatestryl®)
-testosterone cypionate (Depo-Testosterone®

Question 23

androgen receptor antagonist

Answer 23

-Block the binding of endogenous androgens to the receptor or inhibit the activation of the receptors
-Steroidal inhibitors
-Non-steroidal inhibitors

Question 24

finasteride

Answer 24

-Benign prostatic hyperplasia (Proscar®)
-Male pattern baldness (Propecia ®)
-Hirsutism in women

Question 25

dutasteride

Answer 25

-Benign prostatic hyperplasia
-Male pattern baldnes

Question 26

cyproterone acetate

Answer 26

-Hirsutism in women
-Excessive sexual drive in men

Question 27

spironolactone

Answer 27

-Hirsutism in women
-Acne

Question 28

steroidal androgen receptor antagonist

Answer 28

Cyproterone acetate (Androcur®)
 Spironolactone (Aldactone®)

Question 29

flutamide

Answer 29

-Non-steroidal antiandrogen
-Prostate cancer

Question 30

enzalutamide

Answer 30

-Non-steroidal antiandrogen
-Metastatic castration-resistant prostate cancer

Question 31

nonsteroidal androgen receptor antagonist

Answer 31

flutamide (Eulexin®)
 Enzalutamide (Xtandi®)