pharmacology in nursing men’s health drugs. androgens testosterone ◦ responsible for normal...
TRANSCRIPT
AndrogensAndrogensTestosterone
◦Responsible for normal development and maintenance of the primary and secondary male sex characteristics
◦Development of bone and muscle tissue
◦Inhibition of protein catabolism (metabolic breakdown)
◦Retention of various electrolytes
Androgens (cont’d)Androgens (cont’d)Several synthetic derivatives of
testosteroneLong-term dosage forms can last
from 2 to 3 days to 2 to 4 weeksOral forms have a high first-pass
effectTransdermal forms available
◦Patches and gel
Androgens (cont’d)Androgens (cont’d)Anabolic steroids
◦Anabolic activity: synthesis of tissue and increasing tissue formation
◦Schedule III, great potential for misuse by athletes
oxymetholone stanozololoxandrolonenandrolone
Androgens:Androgens:Mechanism of ActionMechanism of Action
Effects are similar to the body’s endogenous androgens◦Stimulation of normal growth and
development of the male sex organs◦Development and maintenance of
male secondary sex characteristics◦Stimulate increased synthesis of body
proteins, aiding in the formation of muscular and skeletal proteins
Androgen InhibitorsAndrogen Inhibitors
5-α-reductase inhibitorsα1-adrenergic blockersAndrogen receptor blockersGonadotropin-releasing hormone
(Gn-RH) analogs
Androgen InhibitorsAndrogen Inhibitors (cont’d)(cont’d)
5-α-reductase inhibitors: finasteride (Proscar) and dutasteride (Avodart)
Block the effects of endogenous androgensUsed to treat benign prostatic hypertrophy
(BPH)Results in alleviation of symptoms of BPH
◦ Easier passage of urineMay also be used for treatment of male-
pattern baldness
αα11-Adrenergic Blockers-Adrenergic Blockers
Used for symptomatic relief of obstruction due to BPH◦doxazosin (Cardura)◦tamsulosin (Flomax)◦terazosin (Hytrin)
Androgen Receptor Androgen Receptor BlockersBlockersBlock the activity of androgen
hormones at the target tissue (prostate) receptors◦flutamide◦nilutamide◦bicalutamide
Gn-RH AnalogsGn-RH Analogs
Gonadotropin-releasing hormone analogs
Used to treat prostate cancer◦goserelin◦leuprolide◦triptorelin
Drugs to Treat Erectile Drugs to Treat Erectile DysfunctionDysfunction
sildenafil (Viagra)◦First oral drug for treatment of ED
vardenafil (Levitra)tadalafil (Cialis)
Remember to be very Remember to be very sensitive, respectful, and non sensitive, respectful, and non
judgmental.judgmental.
Sex is a health part of every Sex is a health part of every persons life and relationshippersons life and relationship
Men’s Health Drugs: Men’s Health Drugs: IndicationsIndicationsPrimary use: hormone
replacement therapy
Other uses vary with the specific drug
Men’s Health Drugs:Men’s Health Drugs:Adverse EffectsAdverse Effects
Androgens cause fluid retention
Anabolic steroids◦Peliosis of the liver, other severe
hepatic effects◦“Roid rage”
Men’s Health Drugs:Men’s Health Drugs:Adverse Effects (cont’d)Adverse Effects (cont’d)
5-α-reductase inhibitors◦Loss of libido, loss of erection,
ejaculatory dysfunction, other effects
Men’s Health Drugs:Men’s Health Drugs:Adverse Effects (cont’d)Adverse Effects (cont’d)
minoxidil◦Oral form: tachycardia, dizziness,
angina, severe fluid retention◦Topical form: same but less severe
adverse effects, local irritation, itching, dryness, redness
Men’s Health Drugs:Men’s Health Drugs:Adverse Effects (cont’d)Adverse Effects (cont’d)
Drugs for erectile dysfunction◦Headache, flushing, dyspepsia, nasal
congestion, chest pain hyper/hypotension
◦Priapism, unexplained visual loss◦In men with preexisting cardiovascular
disease, especially those taking nitrates Lower BP substantially May cause serious adverse effects
Nursing ImplicationsNursing ImplicationsAssessment should include
complete history, including medication history, urinary elimination problems, potential contraindications
Obtain baseline vital signs, weight, height, serum electrolyte levels
Nursing Implications Nursing Implications (cont’d)(cont’d)
Assess renal and liver function
Assess PSA level before beginning any drugs for treatment of prostate disease
Assess current medications for potential interactions
Nursing Implications Nursing Implications (cont’d)(cont’d) IM testosterone should be given deeply—
choose landmarks carefully
Follow exact instructions for SL, buccal, and PO forms
Transdermal Testoderm patches are applied to the scrotal skin
Transdermal Androderm patches are applied to the skin on the body, never to scrotal skin