repro / mens health (exam 2)

Question 1

androgen is the umbrella term for ____, ____, and _____

Answer 1

testosterone, androstenedione, dehydroepiandrosterone (DHEA)

Question 2

male sex hormones secreted by _____

Answer 2

testes

Question 3

what is stimulated by LH to secrete testosterone

Answer 3

leydig cells in testes

Question 4

what is primary androgen deficiency?

Answer 4

failure of testes

Question 5

what is secondary androgen deficiency?

Answer 5

problem w/ hormones (pituitary/hypothalamus)

Question 6

what is difficulty initiating or maintaining erection

Answer 6

erectile dysfunction

Question 7

what is enlargement of the prostate?

Answer 7

BPH

Question 8

what are the uses for androgens

Answer 8

-replacement therapy to treat hypogonadism and other androgen deficiencies
-establish secondary sex characteristics
-treat endometriosis and fibrocystic breast

Question 9

adverse effects of androgens

Answer 9

-skin/hair acne/hair loss
-repro effects (inc. sex drive, dec. sperm)
-females grow facial hair and deeper voice

Question 10

contraindications of androgens

Answer 10

P/L and liver disease

Question 11

androgens increase the effect of ______ and ______

Answer 11

cyclosporin and warfarin

Question 12

avoid taking androgens with _____

Answer 12

sulfonyureas

Question 13

patients on androgen should track _____

Answer 13

weight

Question 14

adverse effects of androgens / anabolic steroids

Answer 14

-CV effects
-CNS disorders
-repro disorders (small testicles)

Question 15

what meds are used to treat ED and enhance erection?

Answer 15

phosphodiesterase type 5 inhibitor
“fils”

Question 16

example phosphodiesterase type 5 inhibitor?

Answer 16

sildenafil (viagara)

Question 17

pharmacokinetics of sildenafil?

Answer 17

-rapidly absorbed
-onset 20-40 mins with 4 hr duration

Question 18

what meds have a vasodilatory effect on smooth muscle of corpus cavernosum to allow a harder and longer-lasting erection

Answer 18

phosphodiesterase type 5 inhibitor (sildenafil)

Question 19

what is sildenafil used for

Answer 19

-ED treatment
-pulmonary hypertension

Question 20

adverse effects of sildenafil

Answer 20

HA
priapism

Question 21

Contraindications of sildenafil

Answer 21

-not healthy for sexual activity
-cardiac conditions medicated with nitrates

Question 22

considerations for sildenafil

Answer 22

-BP meds inc. chance of hypotension
-avoid nitrates

Question 23

education for sildenafil

Answer 23

-no nitrates
-don’t take more than 1 daily
-seek med attention if longer than 4 hours

Question 24

what meds are used if insufficient response or adverse effect from PDE5 inhibitors

Answer 24

adjuvant medication for ED

Question 25

what is an adjuvant medication for ED

Answer 25

alprostadil

Question 26

administration of alprostadil

Answer 26

injected intracavernosal into penis

Question 27

how long does it take for alprostadil to work

Answer 27

immediately

Question 28

effect of alprostadil

Answer 28

-relaxes cavernosal smooth muscle -causes arterial dilation

Question 29

adverse reaction of alprostadil

Answer 29

-burning at injection -prolonged erection -fibrosis

Question 30

what meds are used to treat BPH

Answer 30

5-alpha reductase inhibitor (finasteride)

Question 31

what is an example of 5-alpha reductase inhibitor

Answer 31

finasteride

Question 32

how long does it take for finasteride full effect

Answer 32

6-12 months

Question 33

what med inhibits metabolism of testosterone

Answer 33

finasteride

Question 34

what med decreases proliferation of prostatic cells reducing enlargement of prostate

Answer 34

finasteride

Question 35

uses of finasteride?

Answer 35

-primary BPH treatment -male pattern baldness (small doses)

Question 36

adverse effects of finasteride

Answer 36

-sexual effects -gynecomastia -dec. sperm

Question 37

contraindication of finasteride

Answer 37

pregnant women should not handle

Question 38

what should be monitered while on finasteride?

Answer 38

voiding (to see if BPH improves)

Question 39

what is used for the initial monotherapy of BPH

Answer 39

alpha1-adrenergic blockers (tamsulosin)

Question 40

what is the action of tamsulosin

Answer 40

-relax smooth muscle of prostate and bladder -decreases contraction of vascular smooth muscle

Question 41

what med increases urination and reduces complications of BPH works right away

Answer 41

tamsulosin

Question 42

adverse effect of tamsulosin

Answer 42

orthostatic hypotension

Question 43

contraindications of tamsulosin

Answer 43

P/L hypotension

Question 44

give tamsulosin ____ meals

Answer 44

after

Question 45

can you crush tamsulosin

Answer 45

no

Question 46

take tamsulosin _____ mins after meal

Answer 46

30

Question 47

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

Answer 47

taking heparin androgens increase effect of cyclosporin and warfarin, sulfonylureas should be avoided in combo with testosterone.

Question 48

which of the following pts. has sildenafil contraindicated? -52 yr. t1 DM -58 unstable angina -69 asthma -74 cirrhosis

Answer 48

58 unstable angina