Men's Health Med Chem Flashcards
Testosterone Aromatase
Estradiol E2
Increases bone density
DHEA
Weak androgen, testosterone precursor
Testosterone 5a-reductase
Dihydrotestosterone (DHT)
More potent metabolite
Differentiates genitalia, puberty
Inactive testosterone metabolites
Androsterone
Etiocholanolone
Primary hypogonadism
Two or more X chromosomes
Klinefelter 47XXY eunuch limbs
Too much iron
Aging
Tx: testosterone replacement therapy
Pituitary hormone for adults
Erectile dysfunction
Heart disease
Atherosclerosis
High Blood pressure
Depression
Erection: NO release, smooth muscle relaxation and blood flow
Tx: phosphodiesterase PDE5 inhibitors
Inhibited cGMP breakdown
Prostaglandin: alprostadil increase cAMP, smooth muscle relaxation
Cialis longer half life
Need brain stimulation, NO pathway
Benign prostatic hyperplasia
Excess prostrate tissue growth
43% of men >65
Laser surgery
Alpha1 blockers: tamsulosin, terazosin longer half life than prazosin
5a-reductase inhibitor, decrease DHT and prostate size
Anticholinergic drugs
Stabilize bladder by inhibiting detrusor contraction
Propantheline bromide
Prostate cancer
Prostate specific antigen (PSA) good market for cancer from baseline
Painful urination, sexual dysfunction
Tx: hormone therapy to decrease testosterone production
1) GnRH antagonist: degarelix
2) continuous GnRH agonist
3) androgen synthesis inhibitor: ketoconazole, aminoglutemide
4) antiandrogens compete with AR
Androgen receptor antagonists (FNB)
Flutamide
Nitulamide
Bicalutamide
Compete and downregulate AR
Ketoconazole
Blocks 11Bhydroxylase and androgen synthesis
Intermittently androgen deprivation
Effective as continuous
Improves quality of life
Provege
Prostrate cancer immunotherapy vaccine
Antigen activated presenting cell
T Cells attack Prostate cancer cells
