Men's Health Flashcards
What route of administration is preferred for a patient who needs testosterone treatment?
transdermal
List 4 monitoring parameters that must be followed in a patient on testosterone therapy.
free testosterone, prostate-specific antigen (PSA), hematocrit and hgb, liver function, lipid panel
What schedule are testosterone medications and how does this impact their prescribing?
schedule 3:
90 day supply with up to 5 refills
Describe the mechanism of action of phosphodiesterase-5 inhibitors and list the medications from this class.
inhibits conversion of cGMP to GMP
-avanafil, sildenafil, tadalafil, vardenafil
Describe “tachyphylaxis”. Is this common with PDE-5 inhibitors?
tolerance build up to a medication over time
uncommon
Name phosphodiesterase-5 inhibitors
Avanafil (Stendra) Sildenafil (Viagra) Tadalafil (Cialis) Vardenafil (Levitra)
Which PDE-5 inhibitor has the longest duration of action?
Tadalafil (Cialis) has a DOA of 36 hrs
PDE-5 inhibitors are CONTRAINDICATED with which class of medications? What is the reason for this?
-Contraindicated in pts taking any form of nitrate -Can result in FATAL HYPOTENSION -Nitrates should be avoided for 24 hrs after last dose of sildenafil & vardenafil, 48 hrs for tadalafil
Alpha-1 antagonists are considered 1st line for BPH. Describe their mechanism of action.
-Relax smooth muscle in the prostate & bladder neck -NOTE: do NOT reduce prostate size
What is the difference between 2nd and 3rd generation alpha-1 antagonists
2nd generation: non-uroselevtive
3rd generation: prostate specific
Describe the mechanism of action of the 5-alpha reductase inhibitors.
Reduce prostate size by inhibiting conversion of testosterone to dihydrotestosterone
What is the onset of action of the 5-alpha reductase inhibitors?
up to 6 months
What are common adverse effects associated with the 5-alpha reductase inhibitors?
Decreased libido, ED & ejaculation disorders
Which PDE-5 inhibitor is indicated for BOTH erectile dysfunction and benign prostatic hyperplasia (BPH)?
Tadalafil
