Repoductive Meds Flashcards
Androgen prototype
Testosterone (Duratest, Testoderm)
Indications for testosterone
hypogonadism, breast cancer, prevention of ovulation to treat endometriosis
Phosphodiesterase type 5 recptors (PDE5) inhibitors
Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra)
Indications for PDE5 inhibitors
Treatment of penile erectile dysfunction
Tx of pulmonary arterial HTN
Actions of PDE5 inhibitors
Selectively inhibit phosphodiesterase type 5 receptors (PDE5)-> increase nitrous oxide levels, which activates cGMP, a second messenger molecule, to cause a prolonged smooth muscle relaxation-> increased flow of blood into the corpus cavernosum
Cautions with PDE5 inhibitors/ Sildenafil
CAD, Hypotension or severe HTN
Bleeding issues
D2D with PDE5 inhibitors/ viagra
ketoconozole, nitrates, e-mycin, cimetidine (tegument), ritonavir & grapefruit juice, alpha blockers
Actions of androgens / testosterone
- Increase the retention of nitrogen, sodium, potassium
- Decrease the urinary excretion of calcium (hypercalcemia)
- Increase protein anabolism – holding on to protein and water.
- Decrease protein catabolism
- Increase the production of red blood cells
Adverse effects of androgens/ testosterone
Dizziness, headache, sleep disorders,
fatigue, rash, androgenic effects (acne, deepening
voice, oily skin), hypoestrogenic effects (fl ushing,
sweating, vaginitis), polycythemia, nausea,
hepatocellular carcinoma.
Advrese effects for PDE5 inhibitor/ Sildenafil
HA, vision issues, flushing, dyspepsia, UTI, rash
Anabolic Steroids
Oxandrolone (oxadrin)
Indications for anabolic steroids Oxandrolone
- treat anemia, certain cancers, and angioedema,
- promote weight gain and tissue repair (help weight gain)
- Protein anabolism (construction of molecules) if the body is eating its own protein,
Side effects of anabolic steroids
- hepatotoxicity= Watch liver enzymes
- CV risk of worsening ASD (increase LDL and decreased HDL)
- Virilism effects- females deeper voice, loss of hair, growth of facial hair, changes in mense, acne. Males acne, gyncomastia, impotence, priapism
Warn- cardiomyopathy, hepatic CA, personality changes, sexual dysfunction.
Estrogen
Estradiol
Actions of estradiol
- protects the heart from artherosclerosis
- retains Ca+ in the bones
- maintains the secondary female sex characteristics, labia stays plum, vagina is moist
Indications for estradiol
- hormone replacement therapy
- palliative and preventive therapy during menopause
- endometerosis and dysfunctional uterine bleeding
- contraception
- TREATMENT OF PROSTATE CANCER
Contraindications for estradiol
allergy, pregnancy, idiopathic (unk cause) bleeding, breast CA, estrogen dependent CA, and thromboembolic disorders.
Caution - no smoking
Adverse effects for estradiol
Break through bleeding, dysmenorrhea, anemorrhea, libido changes, photo-sensitivity, abd cramps
D2D for estradiol
drugs that increase hepatic metabolism, corticosteroids, grapefruit juice, CNS drugs (phenytoin & Barbituates), antibiotics.
Estrogen Receptor Modulators
Raloxifene
Actions for Raloxifene
modulating effects on estrogen receptors, used to stimulate specific estrogen receptors to increase bone mineral density.
Indications for raloxifene
postmenopausal osteoporosis
Contraindications for raloxifene
pts with a history of venous thrombosis and smoking
Adverse effects of raloxifene
GI upset, changes in fluid balance: HA, dizzy, visual changes. Hot flashes, skin rash, edema, and vaginal bleeding.
