NR 566 Week 6 Study Guide
Chapter 22: Drugs Affecting the Reproductive System
• Know the pharmacodynamics, pharmacotherapeutics, clinical use,
... [Show More] drug interactions, and ADRs for: Erectile dysfunction (ED) drugs, Estrogens and Progesterone, and Antiandrogen drugs
• Androgen drugs
o Testosterone is the primary male androgen
o Responsible for:
▪ Growth, maturation, and maintenance of male sex organs and secondary sexual characteristics
▪ Skeletal growth spurt in adolescence and termination of linear growth by fusion of the epiphyseal growth plate
▪ Activation of sebaceous glands (acne during puberty)
▪ Enhances production of erythropoietic stimulating factor, increased RBCs production
▪ Libido
o Androgen Drugs: testosterone propionate (in oil, DepoTesterone), testosterone enanthate (in oil, Delatestryl), testosterone cypionate (in oil, Depo-Testosterone), methyltestosterone (Android, Methitest, Testred, Virilon), testosterone gel (AndroGel 1%, AndroGel 1.62%, Axiron, Testium), fluoxymesterone, TD testosterone (Testoderm, Androderm), and buccal testosterone (Striant)
▪ Used to treat Indicated for the symptomatic Tx of
• 1) deficiency states in males associated with hypogonadism and
• 2) in both sexes for d/os such as CA and HIB, Tx libido, endometriosis, and postmenopausal symptoms in women, have been used illicitly to enhance athletic performance and increase muscle mass
o Contraindicated: male breast CA, prostate CA, and Pregnancy (Category X), and lactation
• Antiandrogens: several different categories
o Androgen hormone inhibitors (5-alpha-reductase inhibitors)
▪ Drugs: Finasteride (Propecia, Proscar) and dutasteride (Avodart)
▪ MOA: Block conversation of testosterone to dihydrotesterone
▪ Used to Tx BPH
▪ PSA levels and digital prostate examination are required monitoring for men on these agents
▪ Finasteride (Propecia, Proscar):
• Extensive hepatic metabolism
• BPH: 5mg/day, 6 to 12 months of therapy until therapeutic response
o Regression of prostate size increased urinary flow, and improve BPH symptoms
• Approved for Male pattern baldness: 1 mg/day, three months until results
• Stopping the drugs reverses the effect within 12 months
• ADRs: decreased libido, impotence (can occur at both doses)
▪ Dutasteride (Avodart)
• Inhibits both type 1 and 2 (5-alpha-reductase)
• Peak clinical effect 6 to 12 months of therapy
• Extensively metabolized in the liver (CYP3A4 and CYP3A5) [Show Less]