Unit 2 - Pharmacology Guiding Questions ch. 30

Question 1

androgens

Answer 1

male hormones such as testosterone

Question 2

source of androgens

Answer 2

-Testosterone is synthesized by Leydig cells
-regulated by the pituitary gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH)

Question 3

physiological effect of androgens

Answer 3

involved in development of the sexual characteristics in males and in the stimulation of spermatogenesis

Question 4

when in androgen replacement therapy used?

Answer 4

when endogenous production of testosterone is impaired (removal of testes, testicular failure, and problems in endocrine regulation)

Question 5

primary concern of androgen replacement therapy

Answer 5

can increase prostate growth and perhaps increase the risk of prostate cancer in older men.

Question 6

androgens for breast cancer

Answer 6

used to treat hormone-sensitive tumors.

Question 7

why can androgens be used to treat anemia

Answer 7

they are potent stimulators of erythropoietin synthesis from the kidneys, which stimulates production of red blood cell synthesis in bone marrow

Question 8

why can androgens be used to treat hereditary angioedema

Answer 8

Certain androgens act on the liver to restore production of several clotting factors and to increase production of a glycoprotein, inhibiting the initial stages of the clotting sequence that leads to increased vascular permeability

Question 9

adverse effects of clinical androgen use

Answer 9

-masculinizing effects
-in women: can produce hirsutism, hoarseness or deepening of the voice, changes in the external genitalia (enlarged clitoris), Irregular menstrual periods and acne
-in men: may produce bladder irritation, breast swelling and soreness, and frequent or prolonged erections
-in children: may cause accelerated sexual maturation and impairment of normal bone development due to premature closure of epiphyseal plates
-may also increase the risk of prostate cancer
-liver damage and hepatic carcinoma
-hypertension

Question 10

what are antiandrogens used to treat

Answer 10

-helpful in illnesses such as prostate cancer and other conditions aggravated by excessive androgen production

Question 11

what is androgen abuse

Answer 11

when anabolic steroids are taken to increase muscle size and strength

Question 12

androgens effect on athletic performance

Answer 12

-athletic men taking androgens during strength training may experience greater increments in lean body mass and muscle strength than athletes training without androgens

Question 13

adverse effects of androgen abuse

Answer 13

liver damage, cardiovascular disease, abnormal bone metabolism, mood swings/aggression, altered sexual function

Question 14

You are treating a 17 y.o. boy for a knee strain from a football injury. You suspect he might be using anabolic steroids; he has neither admitted to nor denied abusing these drugs
What should you do?

Answer 14

-Educate him: health risks, concern for his safety
-Inform about legal issue: steroids are a Schedule III controlled substance; federal law… fine $250,000 &/or 3 yrs in prison (although state/local penalties may be less)
-If continued abuse… tell him you must notify primary care/referring physician
-He is a minor, but be careful about notifying parents b/c state laws vary re: disclosure about certain health issues (HIV testing, birth control, etc.)

Question 15

two primary forms of female hormones

Answer 15

estrogen and progesterone

Question 16

the principle hormone that initiates the growth and development of the female reproductive system during puberty

Answer 16

estrogen

Question 17

less important in sexual maturation and is involved to a great extent in facilitating and maintaining pregnancy

Answer 17

progesterone

Question 18

primary function of the menstrual cycle

Answer 18

to stimulate the ovaries to produce an ovum that is available for fertilization while simultaneously preparing the endometrium of the uterus for implantation of the ovum, should fertilization occur

Question 19

most frequent and prevalent use of the female hormones

Answer 19

contraceptive preparations (other: to replace endogenous hormone production and to moderate the effects of endogenous hormones on growth and function of reproductive and other tissues)

Question 20

clinical conditions that may be resolves by estrogen and progesterone

Answer 20

osteoporosis (can increase bone mineral density), hypogonadism (low ovarian function), failure of ovarian development, menstrual irregularities, endometriosis (growth of uterine-like tissue that can occur in various locations within the pelvic cavity), carcinoma

Question 21

what is female hormone replacement therapy used for

Answer 21

-controlling perimenopausal and postmenopausal symptoms
-might improve plasma lipid profile and possibly reduce the risk of cardiovascular disease in postmenopausal women
-may offer some protection against cognitive decline

Question 22

primary risk factor during estrogen and progesterone therapy

Answer 22

cardiovascular disease

Question 23

adverse effects of estrogen and progesterone

Answer 23

-cardiovascular disease
-MI, stroke, thromboembolism
-increased risk of certain cancers (breast cancer)
-nausea
-swelling of the feet and ankles

progesterone
-abnormal blood clotting, thrombophlebitis, pulmonary embolism, and cerebral infarction
-may alter normal menstrual cycle

Question 24

other drugs that affect estrogen and progesterone activity

Answer 24

-SERMs (selective estrogen receptor modulators): activate estrogen receptors on certain tissues while blocking the effects on others
-antiestrogens: block the effects of estrogen by occupying the estrogen receptor (treat infertility)
-antiprogestins: termination of pregnancy

Question 25

adverse effects of hormonal contraceptives

Answer 25

-cardiovascular problems (venous thrombosis, ischemic stroke, MI)
-impair normal hemostasis and can lead to venous thromboembolism and arterial thrombosis
-may lead to certain forms of cancer
-nausea, loss of appetite, abdominal cramping, headache, dizziness, weight gain, and fatigue

Question 26

special concerns for PT patients on hormones

Answer 26

-should routinely monitor blood pressure during administration of hormones
-hypertension
-pts play and important role in educating the pt about the dangers of androgen abuse
-should advice pts of potential side effects