Pharm-Male repro-Dr. Dewitt Flashcards Preview

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Flashcards in Pharm-Male repro-Dr. Dewitt Deck (7)
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1

Clinical manifestation of Low Testosterone

  • Adults:
    • infertility
    • impaired production of gonadal steroids 
    • reduced spermatogenesis
  • Adolescents:
    • Impaired production of gonadal steroids
    • reduced spermatogenesis
    • failure to develop secondary sex characteristics at normal time of puberty (sexual infantilism) or delayed puberty
    • associated with ambiguous external genitalia at birth

2

GnRH

  • single dose
  • assess appropriate anterior pituitary response

3

GnRH Agonists

  • Drugs:
    • Gonadorelin
    • Leuprolide
  • used to diagnose LH responsiveness
    • help to determine if low testosterone is due to
      • constitutional delay 
        • dealys in puberty
      • hypogonadotropic hypogonadism
        • adults or adolescents

4

Gonadorelin

  • GnRH agonist
  • Admin: Pulse
  • initiate LH surgery and spermatogenesis
  • requires portable battery-powered pump and tubing
  • Tx: delayed puberty
  • takes 3-6 months of infusion before effective

5

hMG

LH & FSH isolated from urine of postmenopausal women

6

hCG then hMG

  • 1st line agent
  • Tx: Hypogonadism

7

Androgen replacement/augmentation

  • Used in adults excpet when spermatogenesis is desired for fertility
  • for infertility cases, additional agents and/or approaches may be required
  • Androgens
    • long-acting testosterone agent
    • used in adolescents
    • used at time of desired puberbty to achieve growth spurt and secondary sex characteristics
    • doses increased until maturation is complete
      • then patient is maintained on adult dose