Unit 2 - Pharmacology Guiding Questions ch. 30 Flashcards
androgens
male hormones such as testosterone
source of androgens
-Testosterone is synthesized by Leydig cells
-regulated by the pituitary gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
physiological effect of androgens
involved in development of the sexual characteristics in males and in the stimulation of spermatogenesis
when in androgen replacement therapy used?
when endogenous production of testosterone is impaired (removal of testes, testicular failure, and problems in endocrine regulation)
primary concern of androgen replacement therapy
can increase prostate growth and perhaps increase the risk of prostate cancer in older men.
androgens for breast cancer
used to treat hormone-sensitive tumors.
why can androgens be used to treat anemia
they are potent stimulators of erythropoietin synthesis from the kidneys, which stimulates production of red blood cell synthesis in bone marrow
why can androgens be used to treat hereditary angioedema
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
adverse effects of clinical androgen use
-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
what are antiandrogens used to treat
-helpful in illnesses such as prostate cancer and other conditions aggravated by excessive androgen production
what is androgen abuse
when anabolic steroids are taken to increase muscle size and strength
androgens effect on athletic performance
-athletic men taking androgens during strength training may experience greater increments in lean body mass and muscle strength than athletes training without androgens
adverse effects of androgen abuse
liver damage, cardiovascular disease, abnormal bone metabolism, mood swings/aggression, altered sexual function
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?
-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.)
two primary forms of female hormones
estrogen and progesterone
the principle hormone that initiates the growth and development of the female reproductive system during puberty
estrogen
less important in sexual maturation and is involved to a great extent in facilitating and maintaining pregnancy
progesterone
primary function of the menstrual cycle
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
most frequent and prevalent use of the female hormones
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)
clinical conditions that may be resolves by estrogen and progesterone
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
what is female hormone replacement therapy used for
-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
primary risk factor during estrogen and progesterone therapy
cardiovascular disease
adverse effects of estrogen and progesterone
-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
other drugs that affect estrogen and progesterone activity
-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
adverse effects of hormonal contraceptives
-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
special concerns for PT patients on hormones
-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
