Male Reproductive

Question 1

Testosterone

Class MOA

Answer 1

Androgenic hormone

Alters gene transcription

Question 2

Testosterone side effects

Answer 2

Males: acne, baldness, gynecomastia, priapism, increased BPH & prostate CA (both questionable), exacerbation of sleep apnea, reduced sperm count, infertility

Females: virilization (increased body/facial hair), acne, deepening of voice, clitoral enlargement, menstrual irregularities

Kids: abN rate of sexual maturation, diminished height d/t premature closing of growth plates

Athletes: different liver abN, gynecomastia, breast cysts, cystic acne, premature epiphyseal plate closure, increased aggression

AbN lipid levels
Fluid retention, edema
Polycythemia -> increased ischemia risk

Question 3

Testosterone Characterisitics

Answer 3

I: Post-pubertal hypogonadism, bone marrow stimulation/anemia, severe osteoporosis, hormone therapy for trans*, athletes/body builders, “anti-aging”

Routes: IM (dose 1-2 weeks), oral, buccal, sublingual, skin patches/gels (daily)
Oral/buccal no longer recommended d/t increased hepatitis & hepatic carcinoma

Question 4

Anabolic steroids
 class and characteristics

Answer 4

Synthetic derivatives of testosterone

I: refractory anemia, severe osteoporosis, AIDS, CA

Widespread abuse d/t muscle-building capacity

Question 5

Leuprolide

(Lupron)

Class
moa

Answer 5

Anti-androgenic hormone, anti-estrogenic hormone

Synthetic analog of GnRH – interrupts production of testosterone & estrogen

Question 6

Leuprolide

(Lupron) side effects and charcteristics

Answer 6

Decreased libido, impotence, N/V, hot flashes, night sweats, arthralgia, myalgia, osteoporosis

I: Prostate CA, precocious puberty, endometriosis, uterine fibroids, sometimes in IVF protocol

SQ, IM – different prep have different ½ lives

Question 7

Finasteride

Proscar/Propecia
CLass
MOA

Answer 7

Anti-androgen

Inhibits type II 5-alpha-reductase, limits conversion of testosterone to DHT

Question 8

Finasteride

(Proscar/Propecia)

side effects

Answer 8

Decreased libido, ED, impotency, depression, breast swelling/tenderness

Question 9

Finasteride

(Proscar/Propecia) characterisitis

Answer 9

I: BPH, male-pattern baldness (low dose), prostate CA (high dose)

PO – 1x/day – no blood donation while taking drug

CI: Current/potential pregnancy – don’t handle crushed or broken tabs d/t birth defects

Question 10

*Doxazosin 
Cardura
*Terazosin 
Hytrin
*Tamsulosin 
Flomax, 
Urimax
*Silodosin
Urief

1. class
2. MOA

Answer 10

Alpha blocker

Relaxes smooth muscle in prostate & bladder neck, decreasing blockage of urine flow

Question 11

*Doxazosin 
Cardura
*Terazosin 
Hytrin
*Tamsulosin 
Flomax, 
Urimax
*Silodosin
Urief
side effects

Characteristics

Answer 11

All 5 drugs have different SE profiles

Weakness, orthostatic hypotension (monitor BP carefully b/c old men often have this anyways), nasal congestion

I: BPH

Question 12

Sildenafil citrate

(Viagra)

1. class
2. Moa

Answer 12

1. PDE-5 inhibitor
2. Blocks degradative action of PDE-5 on cyclic GMP in smooth muscle relaxation vasodilation blood remains in corpus cavernosum

Question 13

Sildenafil citrate

(Viagra)

SIde effectrs

Answer 13

HA, flushing, dyspepsia, nasal congestion, impaired vision (photophobia, blurred vision, cyanopesia = everything tinted blue)

Rare but serious: increased intraocular pressure, acute closed angle glaucoma, ventricular arrthymia, severe hypotension, MI, stroke, priapism

Question 14

Sildenafil citrate

Viagra

Characterisitics

Answer 14

I: ED, pulmonary hypertension (dilation of lung blood vessels)

Dose: 25, 50, 100 mg tablets – take 30 min to 4 hours before sex, no more than 1 tab/day

CI: nitric oxide donors, organic nitrites/nitrates – can hypotension; CVD risk factors (recent stroke or MI), severe liver or renal impairment, hypotension, hereditary degenerative retinal disorders