Androgens

Question 1

Where are androgens synthesized?

Answer 1

95% testis (Leydig cells)

5% adrenal glands

Question 2

Androgens are synthesized by circulating____

Answer 2

cholesterol

Question 3

What are the metabolic effects of androgens?

Answer 3

Erythropoiesis
Decreased synthesis of clotting factors
Decrease HDL, increase LDL

Question 4

Therapeutic uses of androgens

Answer 4

HRT in primary or secondary hypogonadism
Induction of puberty in delayed matruation
Osteoporosis in males

Question 5

Testosterone enanthate/ Testosterone cypionate

Indication

Answer 5

Hypogonadism

Question 6

Testosterone enanthate/ Testosterone cypionate

MOA (i.e. effects on the body)

Answer 6

Growth/maturation of prostate, seminal vesicles, penis, scrotum
Development of male hair distribution
Laryngeal development
Vocal cord thickening
Alterations in body musculature
Fat distribution

Question 7

Testosterone enanthate/ Testosterone cypionate

Side Effects

Answer 7

Cholestatic jaundice syndrome
Liver carcinoma
Benign prostatic hyperplasia
Prostate cancer
Gynecomastia
Acne
Headache

Question 8

Testosterone enanthate/ Testosterone cypionate

Contraindications

Answer 8

Breast cancer in men
Prostate cancer
Pregnancy

Question 9

Testosterone enanthate/ Testosterone cypionate

Which route of administration is preferred?

Answer 9

Transdermal to prevent first pass hepatic metabolism

Question 10

Androgen Receptor Antagonists

Answer 10

Flutamide

Spironolactone

Question 11

Androgens used in HRT

Answer 11

Testosterone enanthate/ Testosterone cypionate

Question 12

Flutamide (androgen receptor antagonist) indication

Answer 12

Metastatic prostate cancer

BPH

Question 13

Flutamide (androgen receptor antagonist) MOA

Answer 13

Competitive inhibitor of DHT and T binding to receptor

Question 14

Flutamide (androgen receptor antagonist) Side Effects

Answer 14

Hepatotoxicity**
Hematopoietic disorders*
Diarrhea
Nausea
Rash
Hot flashes

Question 15

Flutamide (androgen receptor antagonist) Contraindication

Answer 15

Severe hepatic impairment

Question 16

Which is the best for the treatment of prostate cancer?
A. Leuprolide
B. DES
C. Flutamide

Answer 16

Flutamide

Question 17

Spironolactone (Androgen receptor antagonist) Indications

Answer 17

Hirsutism
Hypertension
Acne
Edema (CHF)
Cirrhosis /nephrotic syndrome
Hypokalemia

Question 18

Spironolactone (Androgen receptor antagonist) MOA

Answer 18

Competitive inhibition of DHT and T binding to receptor

Question 19

Spironolactone (Androgen receptor antagonist) Side Effects

Answer 19

Gastrointestinal hemorrhage
Hyperkalemic metabolic acidosis*
Agranulocytosis
SLE
Gynecomastia
Dyspepsia
Lethargy
Abnormal menstruation
Impotence
Rash

Question 20

Spironolactone (Androgen receptor antagonist) Contraindications

Answer 20

Anuria
Hyperkalemia
Acute renal insufficiency

Question 21

Spironolactone (Androgen receptor antagonist) Therapeutic consideration

Answer 21

An aldosterone receptor antagonist and also an androgen receptor antagonist

Question 22

Inhibitors of Peripheral Testosterone Conversion to DHT

Answer 22

Finasteride

Question 23

Finasteride (inhibitor of Peripheral Testosterone Conversion to DHT) Indication

Answer 23

BPH

Androgenic alopecia

Question 24

Finasteride (inhibitor of Peripheral Testosterone Conversion to DHT) MOA

Answer 24

Selective inhibition of type II 5-a reductase (converts T to DHT in prostate, liver, skin)

Question 25

Finasteride (inhibitor of Peripheral Testosterone Conversion to DHT) side effects

Answer 25

Breast tenderness Decreased libido Erectile dysfunction Ejaculatory disorder

Question 26

Finasteride (inhibitor of Peripheral Testosterone Conversion to DHT) Contraindication

Answer 26

Pregnancy | Women

Question 27

Finasteride (inhibitor of Peripheral Testosterone Conversion to DHT) therapeutic consideration

Answer 27

Improves urine flow Alternative to tranurethral resection of prostate (TURP) 25% reduction of prostate size Most effective on large prostates