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Pharm > Men's Health > Flashcards

Men's Health Flashcards

1
Q

What is the principal endogenous androgen in both males and females?

A

Testosterone

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2
Q

Main reason
/indication why androgens/testosterone is prescribed?

What does this term mean?

A

Male hypogonadism- this is when boys have delayed puberty. Without androgens, puberty can’t happen.

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3
Q

How is male hypogonadism treated?

A

With injections of testosterone- IM injects every 2-4 weeks for 3-4 years

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4
Q

Male hypogonadism is the main

A

reason for why testosterone is prescribed

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5
Q

Besides male hypogonadism, what are three other reasons why testosterone would be prescribed?

A
  1. Off-label replacement therapy for menopausal women (to see if it would increase libido; off-label means not approved by FDA)
  2. Alleviates wasting/cachexia in patients with AIDS and replenishes muscle mass (when testosterone decreases, skeletal wasting risk increases)
  3. Anemia- because it stimulates the synthesis of erythropoietin and ultimately increases RBCs
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6
Q

Adverse effects of testosterone (1):

  1. __________ (____enhancing) in women and girls and boys - in women can cause acne, ____ voice, male _____ _______, increased libido,_______ _______ and ______ ________.
  2. _________ ________ ______: bone _____, basically. If testosterone is used in children, monitor bone growth!

3.__________: (Cholestatic ______or ____ cancer): Monitor LFTs. This only occurs with 17-alpha-alkylated androgens, which should not be used long term

A
  1. Virilization (male enhancing) in women and girls and boys - in women can cause acne, deep voice, male pattern baldness, increased ibido, clitoral enlargement and menstrual irregularities.
  2. Premature epiphyseal closure: bone fusing, basically. If testosterone is used in children, monitor bone growth!
  3. Hepatotoxicity: (Cholestatic hepatitis or liver cancer); Monitor LFTs. This only occurs with 17-alpha-alkylated androgens, which should not be used long-term.
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7
Q

Cholesterol adverse effect of testosterone

A

decreased HDL and increased LDL

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8
Q

Testosterone is what pregnancy risk category

A

Category X (v important)

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9
Q

Other adverse effects of testosterone:

Can ______ ______ ______ in men (it does not ____ it , just ______growth)

_____ - androgen-induced _______ of ___and ____

_____________

A

Can accelerate prostate cancer in men (it does not cause it, just promotes growth)

Edema - androgen induced retention of salt and water

Gynecomastia (enlargement in men’s breasts)

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10
Q

Testosterone has ____ potential for _____ ____.

It is a..

A

Testosterone has abuse potential for athletic performance

It is a SCHEDULE THREE CONTROLLED SUBSTANCE

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11
Q

Abuse potential of testosterone by athletes- nandrolone and stanozolol can cause ______ since they’re 17-alpha alkylated compounds

Significant risks of androgen abuse:

  • Hypertension, ________ of ___ and ____release –> testicular ______, _____, _______, acne, reduction in HDL and increase in LDL
  • _____damage
  • Could intensify ______
A

-can cause hepatotoxicity

  • Hypertension, suppression of LH and FSH release –> testicular shrinkage, sterility, gynecomastia, acne, reduction in HDL and increase in LDL
  • Renal damage
  • Could intensify aggression
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12
Q

How do PDE-5 inhibitors help erectile dysfunction?

They take the med (PDE-5), as well as having a _____ _____. ____________ nervous system is stimulated and impacts ____

Know that the result is..

A

They take the med (PDE-5), as well as having a sexual stimulus/arousal. Parasympathetic nervous system is stimulated and impacts cGMP.

Know that the result is vasodilatation of the arteries in the penis (arterial engorgement), in addition to reduced venous outflow- resulting in penis engorged with blood = erection

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13
Q

PDE5 breaks down

A

cGMP

  • again, causes arteries to vasodilate and the sinusoid cavities become filled w blood
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14
Q

Sildenafil (Viagra) is a ..

A

Phosphodiesterase type 5 (PDE5) inhibitor 1

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15
Q

Phosphodiesterase type 5 (PDE5) inhibitor 1- Sildenafil (Viagra)

  • It only enhances normal erectile response in the presence of _____
  • No significant impact on men who do not have __
A

stimuli

ED

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16
Q

Sildenafil adverse effects

  1. ____________ - when combined with other medications, it can ____ it too ____ where they can die
  • Dizziness, dyspepsia, flushing, nasal congestion, diarrhea, rash
  1. _______ - ____-lasting, _____ erection - if it lasts more than __ hours, you need to go to emergency room. If it doesn’t go down, it can literally cause ischemia!
  2. Rare: ______ changes, sudden ______ _____, _____
A
  1. Hypotension - when combined with other medications, it can drop it too low where they can die
  • Dizziness, dyspepsia, flushing, nasal congestion, diarrhea, rash
  1. Priapism - long-lasting, painful erection - if it lasts more than 4 hours, you need to go to emergency room. If it doesn’t go down, it can literally cause ischemia!
  2. Rare: vision changes, sudden hearing loss, vertigo
17
Q

Priapism is a painful erection lasting over __ hours- for ALL PDE5s- by 4 hrs go to ED because it can damage penile tissue, causing permanent loss of _____

Need to have blood aspirated from corpus cavernosum and ______ w a _________

A

Priapism is a painful erection lasting over 6 hours- for ALL PDE5s- by 4 hrs go to ED because it can damage penile tissue, causing permanent loss of potency.

Need to have blood aspirated from corpus cavernosum and irrigation w a vasoconstrictor

18
Q

Contraindicated drugs for PDE-5 inhibitors

A

Nitroglycerin/Nitrates- ABSOLUTELY CONTRAINDICATED FOR MEN TAKING NITRATES- need at least 24 hrs in between these meds for safety, and longer if using a CYP3A4 inhibitor or hepatic or renal pathology

Alpha-blockers (dilate arterioles which lead to hypotension)

Inhibitors of cytochrome P450 (CYP3A4)- grapefruit juice

19
Q

Two classes of drugs used for management of benign prostatic hyperplasia (BPH)

A

Alpha-blockers/Alpha 1 antagonists

5-alpha reductase inhibitors

20
Q

5-alpha reductase inhibitors name and what’s it for

A

-asteride

For a very large obstruction, mechanical obstruction (with BPH)

21
Q

Alpha-blockers/Alpha 1 antagonists name and

are for

A

-osin
Are for smaller prostates (dynamic obstruction)

22
Q

MOA of Alpha-blockers/Alpha 1 antagonists

A
  • Relaxation of the smooth muscle surrounding the prostate gland
  • Reduces dynamic obstruct of urthera (opening is larger)- they DO NOT reduce prostate size
23
Q

Adverse effects of Alpha-blockers/Alpha-1 antagonists

A

Selective blockers: Can cause abnormal ejaculation

Nonselective blockers:

Increased risk for floppy-iris syndrome with cataract surgery (tell ophthalmologist and postpone alpha-blocker therapy until after)

24
Q

MOA of 5-alpha reductase inhibitors

-_______ the growth of the ______ and causes ____ of the enlarged prostate tissue by _______ a hormone

-Promotes _______ of prostate epithelial tissue (decreases mechanical obstrux)

-Inhibits 5-alpha reductase found ONLY in ________ ________

A

-Delays the growth of the prostate and causes shrinkage of the enlarged prostate tissue by blocking a hormone

-Promotes regression of prostate epithelial tissue (decreases mechanical obstrux)

-Inhibits 5-alpha reductase found ONLY in reproductive tissues

25
Q

Adverse effects of 5-alpha reductase inhibitors (-asteride)

A

Finasteride/Dutasteride:

  • Decreases ejaculate volume and libido
    -Gynecomastia
    -Decreases PSA (prostate-specific antigen)
  • FDA pregnancy risk category X- preg. women should not touch pill
26
Q

Pt teaching for 5-alpha reductase inhibitor (-asteride); particularly Dutasteride

A

extremely long half life (5 weeks)- takes months to clear after stopping

27
Q

With Dutasteride…

A

men should not donate blood for 6 months due to long half life

28
Q

Review the use of the drug propecia

A

5-alpha reductase inhibitor (-asteride) that is sold at lower dosages as “Propecia” for male pattern baldness- it promotes hair groth

29
Q

Reminder: -osin is

A

Alpha 1 inhibitor/blocker

30
Q
A

Pharm (9 decks)

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