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Men's Health

Major endogenous androgen testosterone
Principle adverse effect of androgen virilization and hepatoxicity
Testosterone effects on women clitoral growth
Overproduction of androgens virilization
Therapeutic uses of Androgens male hypogonadism, HRT, delayed puberty, HRT in menopausal women, wasting in AIDS pts, anemias
Virilization development of male characteristics
Adverse effects of Androgens virilization, premature epiphyseal closure, hepatoxicity, effects cholesterol, use in pregnancy, prostate CA, edema, abuse potential
17-alpha-alylated adrogens Fluoxymestrone, Methyltestposterone, Oxandrolone
Major AE of 17-alpha-alylated adrogens hepatoxicity
Risk with Anabolic Steroids HTN, supression of LH and FSH, testicular shrinkage, sterility, gynecomastia, acne, decrease HDL, increased LDL, hepatoxicity, renal damage, psychologic effects (aggression)
Phosphodiesterase type 5 (PDE5) inhibitors used to treat ED
Oral PDE5 inhibitors Sildenafil, Vardenafil, Tadalafil
Non-oral PDE5 inhibitors Papaverine plus phentolamine, alprostadil
Sildenafil (Viagra) PDE5 inhibitor, well tolerated, caution use with vasodilators (alpha blockers, nitrates)
Adverse Effects of Sildenafil hypotension, priapism, HA, dyspepsia, flushing, nasal congestion, diarrhea, rash, dizziness, mild visual disturbances, intensification of obstructive sleep apnea
Sildenafil caution with Nitrates 24hrs between doses to prevent severe hypotension
Sildenafil interaction with alpha blockers symptomatic postural hypotension
Sildenafil interaction with inhibitors of CYP34A these drugs can suppress the metabolism of Sildenafil
Caution of use of Sildenafil with.... MI, stroke, life-threatening dysrhythmias within past 6 mos., resting hypotension, resting hypertension, heart failure, unstable angina
Vardenafil drug for ED, similar to sildenafil except it prolongs the QT interval
Tadalafil drug for ED, similar to sildenafil except its effects last 36hrs
Avanafil drug for ED, similar to sildenafil except it has the fasted onset of action
Papaverine + Phentalomine Smooth muscle relaxant and alpha-adrenergic blocker used for ED....causes priapism
Alprostadil prostagladin E1, given IV, used for ED....causes priapism
Alprostadil Pellets used for ED, given transurethral.....does not cause priapism or penile fibrosis
Finasteride (Proscar) 5-alpha-reductase inhibitor used to tx BPH
Propecia low dose Finasteride used to tx male pattern baldness
Adverse effects of Finasteride decrease ejaculate volume and libido, gynecomastia, decrease levels of PSA
Dutasteride (Adovert) similar to Finasteride except causes more completed reduction in DHT, harmful to developing male fetuses, has an extreme long half-life (5 weeks)
Alpha-Adrenergic Antagonist use in BPH blockade of alpha recpetors relaxes smooth muscle in the bladder neck (trigone and sphincter)
Alpha Antagonist Drugs used in BPH Terazosin, Doxazosin, Tamsulosin, alfuzosin, Sildosin
Tamsulosin (Flomax) and Alfuzosin effect on BP selective for Alpha blockage in prostate, no real effect on BP
Terazosin and Doxazosin effect on BP & side effects non-selective for alpha blockage, promotes vasodilation, causes hypotension, fainting, dizziness, somnolence, and nasal congestion
Tamsulosin (Flomax) side effect can cause abnormal ejaculation
Drug interactions for alpha blockers meds that lower BP, organic nitrates, PDE5 inhibitors, CYP3A4 inhibitors, caution with cataract sx: "floppy iris syndrome"
Created by: julzbanks