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Endocrine Module > Men's Health > Flashcards

Men's Health Flashcards

1
Q

The production of nitrous oxide occurs in what nervous system?

A

Parasympathetic

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2
Q

What is the first line treatment for ED?

A

PDE5

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3
Q

What is the mechanism of NO?

A

Nitrous oxide diffuses across the membrane of smooth muscle = increase GTP –> cGMP will cause cascade –> decrease intracellular calcium = relaxation = vasodilation = blood flows IN = erection

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4
Q

Why is PDE 5 Enzyme a target for ED?

A

Because it degrades cGMP
Inhibit clearance = increase cGMP = decreases Ca2+

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5
Q

Where is PDE 5 found?

A

Penis

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6
Q

PDE 5 Inhibitors can cause what?

A

Drop in BP due to relaxation of vascular smooth muscle

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7
Q

What are the adverse effects of PDE4 Inhibitors?

A

HA, Flushing, Dyspepsia, Nasal Congestion, and others

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8
Q

Which PDE 5 has the highest incidence of HA and Flushing?

A

Vardenafil

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9
Q

What is another A/E of Silfenafil?

A

Visual: BLUE hue, blurred vision, light sensitvity

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10
Q

What is another A/E of Vardenafil?

A

Prolonged QT Interval

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11
Q

What is another A/E of Tadalafil?

A

Back pain, myalgia, pain in limbs

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12
Q

Sildenafil has the most effect in what tissue target?

A

Rods/Cones in Eyes

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13
Q

Vardenafil has the most effect in what tissue target?

A

Vascular/Cardiac

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14
Q

Tadalafil has the most effect in what tissue target?

A

Skeletal Muscle

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15
Q

Avanafil has the most effect in what tissue target?

A

Vascular/Cardiac

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16
Q

Nitrates and PDE 5 Inhibitors used together causes what?

A

Significant and Serious drop in BP

17
Q

What is Priapism and is it an A/E of PDE 5?

A

Sustained erection >4hrs and YES

18
Q

What is Non-Arteritis Anterior Ischemic Optic Neuropathy and is it an A/E of PDE 5?

A

Temporary or permeant blindness
YES

19
Q

In what scenario would a PDE 5 inhibitor NOT work?

A

If there was a decrease in the ability to produce NO

20
Q

What is Alprostadil and its MOA?

A

PGE1, increase cAMP = decrease Ca2+

21
Q

Is Alprostadil independent or dependent on NO?

A

INDEPENDENT

22
Q

What is Phentoalmine?

A

Alpha Adrenergic Antagonist

23
Q

What is Papaverine?

A

Nonspecific PDE Inhibitor

24
Q

Are Phentoalmine and Papaverine independent or dependent on NO?

A

INDEPENDENT

25
Q

What are the A/Es of Alprastodil, Phentoalmine, and Papaverine?

A
  1. Priaprism
  2. Pain of Injection
  3. Fibrosis w/Long term use
  4. Non-Penile Vasodilation
26
Q

Where is testosterone produced?

A

Leydig Cells = men
Corpus Luteum and Adrenal Cortex = women

27
Q

When is the time of highest diurnal release of testosterone?

A

At waking

28
Q

What has a 5x affinity for androgen receptors compared to testosterone?

A

Dihydrotestosterone DHT

29
Q

What are the Androgen effects?

A
  1. Sexual differentiation and maturation
  2. Increases muscle mass
  3. Bone growth
  4. Erythropoiesis
  5. Sexual drive
  6. Male pattern baldness
  7. Prostatic hyperplasia
30
Q

What are the side effects of androgen replacement therapy?

A
  1. Priapism
  2. Prostatic Hyperplasia
  3. Prostate Cancer
  4. Gynecomastia
31
Q

When would you want to block androgens?

A

BPH or Prostate Cancer

32
Q

What are anti-androgens for BPH?

A

Finasteride and Dutasteride

33
Q

What is the MOA and A/E of finasteride and dutasteride?

A

5-a-reductase inhibition
Decreased libido, impotence, and gynecomastia

34
Q

What alpha-1 blockers are used for BPH and their MOA?

A

Tamsulosin, Silodosin, and Alfuzosin
Cause relaxation of smooth muscle and improve urine flow

35
Q

What are A/Es of alpha-1 blockers?

A
  1. Cardiovascular (less of a problem for alfuzosin)
  2. Orthostatic Hypotension
  3. Tachycardia
  4. Congestion
36
Q

What are Androgen Receptor Antagonists used as 2nd line option for prostate cancer?

A

Flutamide and Bicalutamide

Endocrine Module (16 decks)

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