reproductive heatlh 2

Question 1

routes of admin for testosterone

Answer 1

generally topical gels or patches
IM
oral usually ineffective- inactivated by 1st pass- but sublingual preparations are more effective
takes 1-72hrs for effect

Question 2

adverse effects of testosterone

in males

Answer 2

mostly seen from DHT
*inc risk of prostatic hyperplasia & prostatic CA
also- gynecomastia, priapism, baldness, acne, exacerbation of sleep apnea, infertility(negative feedback)

Question 3

adverse effects of testosterone

in females

Answer 3

virilization- excess body & facial hair, acne, deepening of voice, clitoral enlargement, menstrual irregularities

Question 4

additional adverse effects of testosterone

Answer 4

abN lipid levels
inc LDL
dec HDL
=inc risk of atherosclerosis & CAD
fluid retention & edema, inc blood viscosity

Question 5

testosterone

Answer 5

androgenic hormone
for testosterone replacement, both androgenic &/or anabolic effects
IM, patch, SL lozenges

Question 6

leuprolide/lupron

Answer 6

anti-androgenic hormone & anti-estrogenic hormone
for prostatic CA, precocious puberty, endometriosis, uterine fibroids, IVF
MOA- synthetic analog of GnRH. interrupts production of both estrogen & testosterone= dec FSH & LH, reduces receptor sites of GnRH
SQ, IM
SE-dec libido, impotence, N/V, hto flashes, night sweats, arthralgias, myalgias, osteoporosis

Question 7

finasteride/ proscar

Answer 7

anti-androgen
for BPH- lower doses for male pattern baldness, higher doses for prostetic CA
MOA- limits conversion of testosterone to DHT- inhibits type II 5-alpha reductase- limits/diminishes the bioactive amounts of DHT

Question 8

alpha blockers

Answer 8

for management of BPH- usu initial therapy
relax the SM of the prostate & the bladder neck= dec block of the flow of urine
doxazosin/Cardura
terazosin/hytrin
TAMSULOSIN/FLOMAX/URIMAX
silodosin/urief
SE- muscle weakness, orthostatic hypotension, nasal congestion

Question 9

phosphodiesterase type 5 inhibitors

PDE5

Answer 9

block the degradative action of enzyme phosphodiesterase type 5 on cyclic GMP in SM lining blood vessels- in the corpus cavernosum of the penis & AA of the lung
sildenafil citrate/Viagra
for erectile dysfunction & pulmonary hypertension

Question 10

CI to PDE5 inhibitors

Answer 10

• pts on nitric oxide donors, nitrities, nitrates,
• for men & women who sexual intercourse is CI
• severe liver or renal impairment
• hypotension
• *hereditary degenerative retinal disorders

Question 11

adverse effects of PDE5

Answer 11

inc intraocular pressure
acute angle closure glaucoma
ventricular arrhythmias
severe hypotension
MI
stroke
priapism