Chapter 22: Drugs Affecting the Reproductive System
Know the pharmacodynamics, pharmacotherapeutics, clinical use, drug interactions, and ADRs
... [Show More] 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]