Menopause And Andropause Drugs Flashcards
Andropuase
Male menopause
Dysuria
Painful urinarions
Menarche
Age of onset of first menstruation
Menopause
The cessation of menstruation, end of monthly cycles, referring to the fertility cycle of women
Neurogenic
Bladder impaired bladder function caused by a nervous system abnormality, typically an injury to the spinal cord
Nocturia
Voiding at night
Overactive bladder syndrome (OBS)
Conditions of urgency, frequency, and nocturia, with or without incontinence
Stress incontinence
Losing urine without meaning to during physical activity
Urge incontinence
Sting, sudden need to void because of bladder spasm or contraction
Uroselective
Anti adrenergic drug that is selective for alpha receptors in the urinary system and not generalized
Menopause symptoms
Hot flashes, night sweats, vaginal dryness, painful intercourse, mood changes and sleep problems, vaginal walls become thinner, shorter and lose elasticity, more susceptible to yeast infections, stress incontinence due to weakening pelvic floor muscles
Estrogen in postmenopausal women uses
Relief of moderate to severe symptoms of menopause (flushing and sweating), atrophic vaginitis, osteoporosis is postmenopausal women, palliative treatment of advanced prostatic carcinoma, selected cases of advanced breast carcinoma, uterine bleeding caused by hormonal imbalance. If uterus intact, also use progestin
Transdermal estradiol in post menopausal women uses
After removal of the ovaries in postmenopausal, and primary ovarian failure
Warning swith the administration of estrogen in postmenopausal women
Increased risk of endometrial cancer, gallbladder disease, hypertension, hepatic adenoma, cardiovascular disease, thromboembolic disease, and hypercalcemia in people with breast cancer and bone metases
selective estrogen receptor modulators aka SERMs MOA
May potentiate or block estrogen effects in different tissues
SERMs in aging women uses
Vaginal atrophy, osteoporosis prevention, breast cancer treatment
Tamoxifen use
Breast cancer
Tormifene use
Breast cancer
Raloxifene MOA
Works in the bone at the estrogen receptor and decreases resorption and increases mineral density
Ospemifene use
Painful intercourse caused by vaginal atrophy
SERMS side ffects
Hot flashes, vaginal discharge, muscle spasms and excessive sweating
SERMs interactions
estrogen based drugs increase risk of endometrial cancer
SERMs in menopausal women considerations
Increased risk of deep vein thrombosis (DVT), stroke and MI
Ospmifene contraindications
Breast cancer, hepatic disease, shouldn’t be given with estrogens, estrogen antagonists, fluconazole or rifampin
SERM contraindications
Pregnancy
Raloxifene interactions
Decreased effectiveness of cholestyramine and warfarin, and drug should be discontinued 72 hours before surgical procedures
Symptoms of overactive bladder syndrome
Urinary urgency, frequent urination throughout the day and night, and urge incontinence
Antipasmodics MOA
Cholinergic blocking, inhibit bladder contractions and delay the urge to void (act at the parasympathetic nerve receptors)
Flavoxate use
In men to relieve dysuria symptoms, urinary urgency, nocturia, suprapubic pain and frequency and urge incontinence
Mirabegron MOA
Beta 3 adrenergic receptor Agonist, relaxes the smooth muscle as the bladder fills with urine, allowing the bladder to hold a greater amount of urine
Antipasmodics use
Bladder instability, caused by a neurogenic bladder
Antipasmodics side effects
Dry mouth, drowsy, constipation, diarrhea, decreased tear production, decreased sweating, GI disturbances, dim vision, and urinary hesitancy, vomiting, nervousness, vertigo, headache, rash, mental confusion, discoloration of urine (dark orange to brown)
Antipasmodics administration
Consider extended release capsules to reduce side effects
Antipasmodics contraindications
Glaucoma, intestinal or gastric blockage, abdominal bleeding, myasthenia gravis, or urinary tract blockage
Antipasmodics precautions
GI infections, benign prostatic hypertrophy, urinary retention, hyperthyroidism, hepatic or renal disease, and hypertension, and pregnancy (cat C)
Antipasmodics interactions
Decreased effectiveness of antibiotics and antifungals, miperidine, flurazepam and phenothiazines and TCAs increase antipasmodics effect, decreased effectiveness of haloperidol, increased serum levels of digoxin
Benign prostatic hypertrophy signs
Difficulty in urination, retention of urine, and incontinence
Treatment for benign prostatic hypertrophy (BPH)
Monitoring, invasive procedures, drugs are used for mild to moderate symptoms
BPH Drugs : alpha adrenergics MOA
Exert their action of the smooth muscle of the prostate and the bladder neck, the block norepinephrine, allowing the muscles to relax and the urine to flow. Are uroselective
BPH Drugs: androgen hormone inhibitors (AHIs) MOA
Prevent the conversion of testosterone onto the androgen DHT, resulting in a decrease of the size of the prostate gland
BPH Drugs: alpha adrenergic blockers side effects
Weight gain, fatigue, dizzy, transient orthostatic hypotension
AHIs used for BPH side ffects
Impotence, decreased libido, and a decreased volume of ejaculate, changes to breast tissue (pain or tenderness, discharge or enlargement)
BPH Drugs: alpha adrenergic blockers precautions
Renal or hepatic disease, hypertension (symptoms may be increased)
AHIs precautions
Renal and hepatic disease
AHIs pregnancy cat
X
Discontinue AHIs if
Angina or heart like pain occurs
Discontinue alpha adrenergic blockers for BPH if
Angina or heart like pain occurs
Dutasteride restrictions
Can’t donate blood while taking or up to 6 months after discontinuing drug
BPH Drugs: alpha adrenergic blockers interactions
Decreased effectiveness of antibiotics and antifungals, and beta blockers and phosphodiesterase type 5 inhibitors increase hypotension
Phosphodiesterase 5 inhibitors MOA
Oral, facilitate the enzyme that allows blood flow to penis
Phosphodiesterase 5 inhibitors use
Erectile dysfunction
Tadalafil administration
Approved for daily use because it relieves urinary difficulties resulting from an enlarged prostate
PDE5 inhibitors side effects
Headache, flushing, GI upset, nausea, runny nose, congestion
PDE5 inhibitors contraindications
Men who use nitrates,
PDE 5 inhibitors precautions
Pre existing cardiac problems, esp those using drugs to lower blood pressure, renal or hepatic impairment, ocular problems can occur
PDE5 inhibitors interactions
Antiretrovirals increase effectiveness of PDE5 inhibitor, and increased effects of antihypertensives
Sildenafil administration
Work best when no taken immediately after food
Vardenafil administration
Work best when not taken immediately after food
Hormones for cancer treatment use
Not a curative measure, but are adjuvants and sometimes palliative
Hormones used as antineoplastics ex
Abiraterone, conjugate estrogen, megestrol, goserelin,
Finasteride pregnancy considerations
Pregnant women shouldn’t handle this drug (commonly used in men)
SERMs ex
Ospemifene, raloxifene
Antipasmodics ex
Darifenacin, fesoterodine, mirabegron, oxybutynin, solifenacin, tolterodine, trospium, flavoxate
BPH Drugs : peripherally acting antiadrenergics ex
Alfluzosin, doxazosin, silodosin, tamsulosin, terazosin
AHIs ex
Dutasteride, finasteride,
PDE5 inhibitors ex
Avanafil, sildenafil, tadalafil, vardenafil,
Adrenal steroid inhibitors ex
Aminoglutethimide
Gonadotropin releasing hormone antagonist ex
Degarelix
Gonadotropin releasing hormone analogs ex
Goserelin, histrelin, leuprolide, triptorelin
Antiandrogens ex
Abiraterone, bicalutamide, enzalutsmide, flutamide, nilutamide
Estrogen ex
Estramustine
Androgen ex
Testolactone
Aromtase inhibitors use
Breast cancer
Aromatase inhibitors ex
Anastrozole, exemestane, letrozole
Progestins for cancer ex
Medroxyprogesterone, megestrol
Antiestrogen ex
Fulvestrant (used for breast cancer)
Antiestrogen SERM ex
Tamoxifen, and toremifene (both used for breast cancer)
