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pharm and mens health Flashcards

1
Q

name some structures of the male repro system

A
  • two testes
  • vas deferens
  • prostate gland
  • penis
  • urethra
  • hormone that stimulates and maintains structure is testosterone
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2
Q

describe androgens

A
  • testosterone, androstenedione, dehydropiandrosterone (DHEA)
  • male sex hormones secreted by the testes
  • synthesized by cholesterol
  • leydig cells in testes -> stimulated by LH to secrete testosterone
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3
Q

describe androgen deficiency

A
  • lack of testosterone
  • can be primary (failure of testes) or secondary (prob with the hormones)
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4
Q

describe erectile dysfunction

A

difficulty initiating or maintaining an erection

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5
Q

describe BPH

A

enlargement of the prostate

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6
Q

androgens as drug therapy

give an example of an androgen for drug therapy

A

testosterone

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7
Q

androgens as drug therapy

describe the actions of androgens

A
  • growth and development of male sex organs and sex characteristics
  • increase protein anabolism and decreases protein catabolism
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8
Q

androgens as drug therapy

what are some uses of androgens

A
  • replacement therapy to treat hypogonadism and other conditions due to androgen deficiency
  • establish secondary sex characteristics
  • treat endometriosis and fibrocystic breast
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9
Q

androgens as drug therapy

what are some adverse effects of androgens

A
  • skin/hair effects (acne and hair loss)
  • reproductive effects (increased sex drive but decreased sperm count)
  • GI effects
  • female adverse effects (develop masculine features)
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10
Q

androgens as drug therapy

what are some contraindications of androgens

A
  • pregnancy or lactating
  • liver disease
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11
Q

androgens as drug therapy

what are some nursing implications for androgens

A
  • 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
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12
Q

androgens as drug therapy

describe patient education for androgens

A
  • 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
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13
Q

what are some abusive uses of androgens/anabolic steroids

A
  • enhance athletic performance
  • ergogenic
  • enhance muscle development/strength
  • achieve more masculine appearance
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14
Q

what are some serious adverse effects of androgen/anabolic steroid abuse

A
  • 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)
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15
Q

give an example of a phosphodiesterase type 5 inhibitor

A

sildenafil

viagra

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16
Q

describe the pharmacokinetics of phosphodiesterase type 5 inhibitors

A
  • absorbed rapidly
  • onset 15-20 minutes with a duration of 4 hours
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17
Q

describe the action of phosphodiesterase type 5 inhibitors

A

causes vasodilatory effect on the smooth muscle of the corpus cavernosum to allow a harder and longer lasting erection

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18
Q

what are some uses of phosphodiesterase type 5 inhibitors

A
  • treatment of ED in healthy males
  • treatment of pulmonary hypertension
19
Q

what are some adverse effects of phosphodiesterase type 5 inhibitors

A
  • headache
  • facial flushing
  • dizziness
  • priapism (painful and persistent erection)
20
Q

what are some contraindications of phosphodiesterase type 5 inhibitors

A
  • not healthy enough for sexual activity
  • cardiac conditions medicated with nitrates
  • anatomical obstruction
  • penile implants
  • women
21
Q

what are some nursing considerations for phosphodiesterase type 5 inhibitors

A
  • BP meds increase risk of hypotension
  • avoid nitrates
22
Q

describe patient education for phosphodiesterase type 5 inhibitors

A
  • do not take with nitrates
  • do not take more than 1 daily
  • seek medical attention for erection lasting more than 4 hours
23
Q

when would adjuvant meds be used to treat ED

A

used if insuffiient response or adverse effect from PDE5 inhibitors

24
Q

give an example of an adjuvant med for ED

A

alprostadil

25
describe the pharmacokinetics of alprostadil
- injected intracavernosal (right into the dick) - works immediately
26
describe the action of alprostadil
- relaxation of cavernosal smooth muscle - causes arterial dilation
27
what are some adverse effects of alprostadil
- burning - prolonged erection - fibrosis from frequent injections
28
name a 5-alpha reductase inhibitor
finasteride
29
describe the pharmacokinetics of 5-alpha reductase inhibitors
may take 6-12 months for max effect
30
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**
31
what are some uses of 5-alpha reductase inhibitors
- primarily for treatment of BPH - male pattern baldness (in smaller doses)
32
what are some adverse effects of 5-alpha reductase inhibitors
- sexual effects - gynecomastia - decreased sperm production
33
what are some contraindications of 5-alpha reductase inhibitors
- **pregnant women should not handle the med if broken** - women - children
34
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
35
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
36
give an example of an alpha1-adrenergic blocker
tamsulosin | first line for BPH
37
describe the actions of alpha1-adrenergic blockers
- relaxes smooth muscle of prostate and bladder neck - decreases contraction of vascular smooth muscle
38
what are some uses of alpha1-adrenergic blockers
increases urination and reduces complications of BPH
39
what are some adverse effects of alpha1-adrenergic blockers
- **orthostatic hypotension** - CNS effects - sexual effects
40
what are some contraindications of alpha1-adrenergic blockers
- pregnancy/lactation - hypotension
41
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
42
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
43
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*
44
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*

Pharm 2 (34 decks)

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