pharm and mens health Flashcards
name some structures of the male repro system
- two testes
- vas deferens
- prostate gland
- penis
- urethra
- hormone that stimulates and maintains structure is testosterone
describe androgens
- testosterone, androstenedione, dehydropiandrosterone (DHEA)
- male sex hormones secreted by the testes
- synthesized by cholesterol
- leydig cells in testes -> stimulated by LH to secrete testosterone
describe androgen deficiency
- lack of testosterone
- can be primary (failure of testes) or secondary (prob with the hormones)
describe erectile dysfunction
difficulty initiating or maintaining an erection
describe BPH
enlargement of the prostate
androgens as drug therapy
give an example of an androgen for drug therapy
testosterone
androgens as drug therapy
describe the actions of androgens
- growth and development of male sex organs and sex characteristics
- increase protein anabolism and decreases protein catabolism
androgens as drug therapy
what are some uses of androgens
- replacement therapy to treat hypogonadism and other conditions due to androgen deficiency
- establish secondary sex characteristics
- treat endometriosis and fibrocystic breast
androgens as drug therapy
what are some adverse effects of androgens
- skin/hair effects (acne and hair loss)
- reproductive effects (increased sex drive but decreased sperm count)
- GI effects
- female adverse effects (develop masculine features)
androgens as drug therapy
what are some contraindications of androgens
- pregnancy or lactating
- liver disease
androgens as drug therapy
what are some nursing implications for androgens
- androgens may increase effect of cyclosporin and warfarin
- avoid taking with sulfonylureas (can cause hypoglycemia)
- IM injection every 2-4 wks
- gels and patches available
androgens as drug therapy
describe patient education for androgens
- keep track of weight gain weekly
- practice healthy skin care
- keep med out of reach of children
- wash hands after gel application
- rotate patch site
what are some abusive uses of androgens/anabolic steroids
- enhance athletic performance
- ergogenic
- enhance muscle development/strength
- achieve more masculine appearance
what are some serious adverse effects of androgen/anabolic steroid abuse
- CV effects (HTN and increased cholesterol)
- liver disorders
- CNS disorders (agitation and aggression)
- reproductive disorders (tiny ass testes and reduced function)
- metabolic disorders
- dermatologic disorders (severe acne)
give an example of a phosphodiesterase type 5 inhibitor
sildenafil
viagra
describe the pharmacokinetics of phosphodiesterase type 5 inhibitors
- absorbed rapidly
- onset 15-20 minutes with a duration of 4 hours
describe the action of phosphodiesterase type 5 inhibitors
causes vasodilatory effect on the smooth muscle of the corpus cavernosum to allow a harder and longer lasting erection
what are some uses of phosphodiesterase type 5 inhibitors
- treatment of ED in healthy males
- treatment of pulmonary hypertension
what are some adverse effects of phosphodiesterase type 5 inhibitors
- headache
- facial flushing
- dizziness
- priapism (painful and persistent erection)
what are some contraindications of phosphodiesterase type 5 inhibitors
- not healthy enough for sexual activity
- cardiac conditions medicated with nitrates
- anatomical obstruction
- penile implants
- women
what are some nursing considerations for phosphodiesterase type 5 inhibitors
- BP meds increase risk of hypotension
- avoid nitrates
describe patient education for phosphodiesterase type 5 inhibitors
- do not take with nitrates
- do not take more than 1 daily
- seek medical attention for erection lasting more than 4 hours
when would adjuvant meds be used to treat ED
used if insuffiient response or adverse effect from PDE5 inhibitors
give an example of an adjuvant med for ED
alprostadil
describe the pharmacokinetics of alprostadil
- injected intracavernosal (right into the dick)
- works immediately
describe the action of alprostadil
- relaxation of cavernosal smooth muscle
- causes arterial dilation
what are some adverse effects of alprostadil
- burning
- prolonged erection
- fibrosis from frequent injections
name a 5-alpha reductase inhibitor
finasteride
describe the pharmacokinetics of 5-alpha reductase inhibitors
may take 6-12 months for max effect
describe the action of 5-alpha reductase inhibitors
- inhibits enzyme that converts testosterone to 5 alpha DHT
- inhibits metabolism of testosterone
- decreases proliferation of prostatic cells reducing enlargment of prostate
what are some uses of 5-alpha reductase inhibitors
- primarily for treatment of BPH
- male pattern baldness (in smaller doses)
what are some adverse effects of 5-alpha reductase inhibitors
- sexual effects
- gynecomastia
- decreased sperm production
what are some contraindications of 5-alpha reductase inhibitors
- pregnant women should not handle the med if broken
- women
- children
what are some nursing implications for 5-alpha reductase inhibitors
- testosterone reduces effects of both drugs
- do not handle this med if pregnant
- keep track of voiding
describe patient education for 5-alpha reductase inhibitors
- may take 6-12 months for max benefit
- seek medical attention if unable to void
- use barrier contraceptive
- do not handle medication if pregnant
give an example of an alpha1-adrenergic blocker
tamsulosin
first line for BPH
describe the actions of alpha1-adrenergic blockers
- relaxes smooth muscle of prostate and bladder neck
- decreases contraction of vascular smooth muscle
what are some uses of alpha1-adrenergic blockers
increases urination and reduces complications of BPH
what are some adverse effects of alpha1-adrenergic blockers
- orthostatic hypotension
- CNS effects
- sexual effects
what are some contraindications of alpha1-adrenergic blockers
- pregnancy/lactation
- hypotension
what are some nursing implications for alpha1-adrenergic blockers
- give after meals
- do not open or crush capsule
- avoid giving with other BP meds
- keep track of voiding pattern
- fall risk
describe patient education for alpha1-adrenergic blockers
- take 30mins after meal
- do not crush or chew
- use caution with position changes
- take at bedtime to reduce adverse effects
- do not drive until you know how drug affects you
four patients in an endocrine clinic are ordered to begin andogen therapy. the nurse reviews each patient’s current meds and identifies which of the following as ABLE to begin androgen therapy without a drug interaction?
1) taking cyclosporin
2) taking warfarin
3) taking sulfonylureas
4) taking heparin
4) taking heparin
androgens increase the effect of cyclosporin and warfarin. sulfonylureas should be avoided in combo with testosterone therapy. there is no drug to drug interactions with heparin
in which of the following patients would the use of sildenafil be contraindicated?
1) 52yo with type 1 DM
2) 58yo with unstable angina
3) 69yo with asthma
4) 74yo with cirrhosis
2) 58yo with unstable angina
unstable angina may require the use of nitroglycerin, a nitrate. nitrates are contraindicated with sildenafil d/t risk of hypotension
