repro / mens health (exam 2) Flashcards
androgen is the umbrella term for ____, ____, and _____
testosterone, androstenedione, dehydroepiandrosterone (DHEA)
male sex hormones secreted by _____
testes
what is stimulated by LH to secrete testosterone
leydig cells in testes
what is primary androgen deficiency?
failure of testes
what is secondary androgen deficiency?
problem w/ hormones (pituitary/hypothalamus)
what is difficulty initiating or maintaining erection
erectile dysfunction
what is enlargement of the prostate?
BPH
what are the uses for androgens
-replacement therapy to treat hypogonadism and other androgen deficiencies
-establish secondary sex characteristics
-treat endometriosis and fibrocystic breast
adverse effects of androgens
-skin/hair acne/hair loss
-repro effects (inc. sex drive, dec. sperm)
-females grow facial hair and deeper voice
contraindications of androgens
P/L and liver disease
androgens increase the effect of ______ and ______
cyclosporin and warfarin
avoid taking androgens with _____
sulfonyureas
patients on androgen should track _____
weight
adverse effects of androgens / anabolic steroids
-CV effects
-CNS disorders
-repro disorders (small testicles)
what meds are used to treat ED and enhance erection?
phosphodiesterase type 5 inhibitor
“fils”
example phosphodiesterase type 5 inhibitor?
sildenafil (viagara)
pharmacokinetics of sildenafil?
-rapidly absorbed
-onset 20-40 mins with 4 hr duration
what meds have a vasodilatory effect on smooth muscle of corpus cavernosum to allow a harder and longer-lasting erection
phosphodiesterase type 5 inhibitor (sildenafil)
what is sildenafil used for
-ED treatment
-pulmonary hypertension
adverse effects of sildenafil
HA
priapism
Contraindications of sildenafil
-not healthy for sexual activity
-cardiac conditions medicated with nitrates
considerations for sildenafil
-BP meds inc. chance of hypotension
-avoid nitrates
education for sildenafil
-no nitrates
-don’t take more than 1 daily
-seek med attention if longer than 4 hours
what meds are used if insufficient response or adverse effect from PDE5 inhibitors
adjuvant medication for ED
what is an adjuvant medication for ED
alprostadil
administration of alprostadil
injected intracavernosal into penis
how long does it take for alprostadil to work
immediately
effect of alprostadil
-relaxes cavernosal smooth muscle
-causes arterial dilation
adverse reaction of alprostadil
-burning at injection
-prolonged erection
-fibrosis
what meds are used to treat BPH
5-alpha reductase inhibitor (finasteride)
what is an example of 5-alpha reductase inhibitor
finasteride
how long does it take for finasteride full effect
6-12 months
what med inhibits metabolism of testosterone
finasteride
what med decreases proliferation of prostatic cells reducing enlargement of prostate
finasteride
uses of finasteride?
-primary BPH treatment
-male pattern baldness (small doses)
adverse effects of finasteride
-sexual effects
-gynecomastia
-dec. sperm
contraindication of finasteride
pregnant women should not handle
what should be monitered while on finasteride?
voiding (to see if BPH improves)
what is used for the initial monotherapy of BPH
alpha1-adrenergic blockers (tamsulosin)
what is the action of tamsulosin
-relax smooth muscle of prostate and bladder
-decreases contraction of vascular smooth muscle
what med increases urination and reduces complications of BPH
works right away
tamsulosin
adverse effect of tamsulosin
orthostatic hypotension
contraindications of tamsulosin
P/L
hypotension
give tamsulosin ____ meals
after
can you crush tamsulosin
no
take tamsulosin _____ mins after meal
30
4 pts begin androgen therapy. nurse reviews each history and identifies which pts as able to start androgens
-taking cyclosporin
-taking warfarin
-taking sulfonylureas
-taking heparin
taking heparin
androgens increase effect of cyclosporin and warfarin, sulfonylureas should be avoided in combo with testosterone.
which of the following pts. has sildenafil contraindicated?
-52 yr. t1 DM
-58 unstable angina
-69 asthma
-74 cirrhosis
58 unstable angina
