Unit 4: Pharm: Chapter 41

Question 1

Drugs Affecting Male Reproductive System: Children

Answer 1

Anabolic steroids/androgens may be used in children as replacement therapy and to increase red blood cell production in renal failure. D/T effects of these hormones on epiphyseal closure, children should be closely monitored with hand and wrist radiographs pretreatment and every 6 months.
Puberty occurs, the drug should be stopped.
Adolescents who are prescribed androgens should be alerted to the potential for increased acne and other effects.
Adolescent athletes need constant education about the risks associated with the use of anabolic steroids to improve athletic prowess.

Question 2

Drugs Affecting Male Reproductive System: Older Adults

Answer 2

may have problems because of underlying conditions that are aggravated by the drug effects.
Hypertension, heart failure, and coronary artery disease may be aggravated by the fluid retention associated with these drugs.
Benign prostatic hypertrophy, a common problem in older males, may be aggravated by androgenic effects that may enlarge the prostate further,

Question 3

Androgens

Answer 3

male sex hormones and include testosterone, which is produced in the testes, and androgens, which are produced in the adrenal glands.

Question 4

Hypogonadism

Answer 4

Treated with androgens for underdeveloped testes and certain breast cancers.

Question 5

Androgens Actions

Answer 5

Forms of testosterone, responsible for the growth and development of male sex organs and the maintenance of secondary male sex characteristics.
Increase the retention of nitrogen, sodium, potassium, and phosphorus and to decrease the urinary excretion of calcium.
Testosterones increase protein anabolism and decrease protein catabolism (breakdown).
They also increase the production of red blood cells.

Question 6

Anabolic Steroids

Answer 6

promote the processes of body tissue building, reverse catabolic or tissue-destroying processes, and increase hemoglobin and red blood cell mass.
Indications for particular anabolic steroids vary with the drug.
Used to treat anemias, certain cancers, and angioedema and to promote weight gain and tissue repair in debilitated patients and protein anabolism in patients who are receiving long-term corticosteroid therapy.

Question 7

Androgens Contraindications

Answer 7

Effects on neonate
Aggravated prostate cancer
Caution with liver and CV disease as disorder can be exacerbated
Wear gloves with topical testosterone

Question 8

Androgens Advese Effects

Answer 8

include acne, edema, hirsutism (hair distribution associated with male secondary sex characteristics), deepening of the voice, oily skin and hair, weight gain, decrease in breast size, penile enlargement, and testicular atrophy.
In prepubescent males, adverse effects include virilization

Question 9

Androgens Drug to Drug Interactions

Answer 9

there may be decreased thyroid function as well as increased creatinine and creatinine clearance, results that are not associated with disease states. These effects can last up to 2 weeks after discontinuation of therapy. Androgens can alter effects of oral anticoagulants, insulin, and oral antidiabetic medications.

Question 10

Bee Pollen

Answer 10

Reported to contain amino acids and other minerals and enzymes and to improve athletic stamina. There is no clear evidence regarding its effectiveness. Serious allergic reactions have been reported with the use of this product.

Question 11

Creatine

Answer 11

Contains a substance that is found in muscle and naturally occurs in red meats and other dietary sources. There is mixed evidence regarding whether it can enhance performance. The strongest evidence is that it could help increase strength for resistance training. Short-term use is probably safe, but safety is not clear with long-term use.
Drink plenty of water

Question 12

Damiana

Answer 12

Used to increase muscle strength, as an aphrodisiac, and to boost mental health. It can cause liver toxicity. It interferes with antidiabetic agents and causes elevated blood sugar concentrations. Users should report muscle spasms or hallucinations.

Question 13

Spirulina

Answer 13

Used to increase energy and boost metabolism. It may contain toxic metals and can cause serious reactions in children and pets. It interferes with vitamin B12 absorption. No scientific studies validate the claims of its effectiveness.

Question 14

Wild Yam

Answer 14

estrogenlike effects, this herb is used to increase athletic performance because it may contain a constituent of dehydroepiandrosterone used to slow the aging process and to improve energy and stamina.
Preparations interact with disulfiram and metronidazole because they contain alcohol. It is known to be toxic to the liver. Users may experience estrogenlike effects, including breast pain.
Users should be monitored closely and urged to report any adverse effects.

Question 15

Danazol

Answer 15

Androgens
100-1600 mg PO
Treatment of endometriosis amenable to hormal management
Decreasing pain with fibocystic breast disease that is not treated with other measures
Prevention of angioedema attacks

Question 16

Ozandrolone

Answer 16

Androgens
2.5 po 2-4 PRN max 20 mg, peds < 0.1 mg/kg/d PO
Promotion of weight gain in debilitated patients
Treatment of certain cancers
Relief of bone pain of osteoporosis
Promotion of catabolism with prolonged corticosteroid use

Question 17

Oxymetholone

Answer 17

Androgens
1-5 mg PO
Treatment of anemias cause by deficit in RBC production

Question 18

Testerosterone

Answer 18

Androgens
Dose vary
Replacement therapy in Hypogonadism
Treatment of delayed puberty in male patients ands certain breast cancers in post menopausal patients
Prevention of postpartum breast engorgement

Question 19

Methylterstosterone

Answer 19

Androgens
Males 10-50 mg po, females 50-20 mg PO
Replacement therapy in Hypogonadism Treatment
Treatment of delayed puberty in males
Treatment of certain breast in post menopausal.

Question 20

Low Testosterone Syndrome

Answer 20

an be associated with many chronic diseases, such as chronic obstructive pulmonary disease (COPD), obesity in males, anemia, renal failure, or diabetes mellitus.
Testosterone levels can be measured, and often testosterone replacement therapy can raise levels and relieve symptoms. When therapy is used appropriately, the treatment does not seem to increase risk of prostate cancer or cardiovascular events.

Question 21

Androgens Nursing Conclusions

Answer 21

Altered body image perception related to androgenic effects
•Impaired comfort related to need for injections
•Altered sexual function related to androgenic effects
•Knowledge deficit regarding drug therapy

Question 22

Penile Erectile Dysfunction

Answer 22

is a condition in which the corpus cavernosum does not fill with blood to allow for penile erection.
result from the aging process and in vascular and neurological conditions.
Drugs: prostaglandin alprostadil (Caverject, Muse, and others) and the phosphodiesterase type 5 (PDE5) receptor inhibitors avanafil (Stendra), sildenafil (Viagra).

Question 23

Alprostadil

Answer 23

Penile Erectile Dysfuntion

When injected directly into the cavernosum, alprostadil acts locally to relax the vascular smooth muscle and allow filling of the corpus cavernosum, causing penile erection. Alprostadil (Muse) is a urethral suppository.

Question 24

PDE5

Answer 24

The PDE5 inhibitors are taken orally and act to increase nitrous oxide levels in the corpus cavernosum. Nitrous oxide activates the enzyme cGMP, which causes smooth muscle relaxation, allowing the flow of blood into the corpus cavernosum. They prevent the breakdown of cGMP by phosphodiesterase, leading to increased cGMP levels and prolonged smooth muscle relaxation, thus promoting the flow of blood into the corpus cavernosum, resulting in penile erection.

Question 25

Penile Erectile Dysfunction Pharmacokinetics

Answer 25

After injection, alprostadil is metabolized to inactive compounds in the lungs and excreted in the urine. The PDE5 inhibitors are well absorbed from the GI tract, undergo metabolism in the liver, and are excreted in the feces. The differences among the three PDE5 inhibitors lie in their onsets and durations of action.

Question 26

Penile Erectile Dysfuntion Contraindications

Answer 26

With anatomic obstruction or predispose the patient to priapism Cannot be used with penile implants Caution with bleeding disorders

Question 27

PDE5 Drug to Drug Interactions

Answer 27

cannot be taken in combination with any organic nitrates (nitroglycerin or isosorbide dinitrate) or alpha-adrenergic blockers, drugs that cause a drop in blood pressure; serious cardiovascular effects including death due to severe hypotension have occurred. There is also a possibility of increased levels and effects of PDE5 inhibitors if taken with moderate or potent CYP3A4 inhibitors such as ketoconazole, itraconazole, or erythromycin; monitor the patient and reduce the dose as needed.