Term | Definition |
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" |