Pharm-Male repro-Dr. Dewitt

Question 1

Clinical manifestation of Low Testosterone

Answer 1

• Adults:
  
  • infertility
  • impaired production of gonadal steroids
  • reduced spermatogenesis
• Adolescents:
  
  • Impaired production of gonadal steroids
  • reduced spermatogenesis
  • failure to develop secondary sex characteristics at normal time of puberty (sexual infantilism) or delayed puberty
  • associated with ambiguous external genitalia at birth

Question 2

GnRH

Answer 2

• single dose
• assess appropriate anterior pituitary response

Question 3

GnRH Agonists

Answer 3

• Drugs:
  
  • Gonadorelin
  • Leuprolide
• used to diagnose LH responsiveness
  
  • help to determine if low testosterone is due to
    
    • constitutional delay
      
      • dealys in puberty
    • hypogonadotropic hypogonadism
      
      • adults or adolescents

Question 4

Gonadorelin

Answer 4

• GnRH agonist
• Admin: Pulse
• initiate LH surgery and spermatogenesis
• requires portable battery-powered pump and tubing
• Tx: delayed puberty
• takes 3-6 months of infusion before effective

Question 5

hMG

Answer 5

LH & FSH isolated from urine of postmenopausal women

Question 6

hCG then hMG

Answer 6

• 1st line agent
• Tx: Hypogonadism

Question 7

Androgen replacement/augmentation

Answer 7

• Used in adults excpet when spermatogenesis is desired for fertility
• for infertility cases, additional agents and/or approaches may be required
• Androgens
  
  • long-acting testosterone agent
  • used in adolescents
  • used at time of desired puberbty to achieve growth spurt and secondary sex characteristics
  • doses increased until maturation is complete
    
    • then patient is maintained on adult dose