Question

pharmacology

Assignments, Chapter 41, Drugs Affecting the Male Reproductive System Learning Objective(s) Written Assignments 1. Identify why a patient would be prescribed androgens. Describe the effects of testosterone and androgens on the male body. What are the adverse effects? 2. Develop a chart that identifies the therapeutic actions, indications, pharmacokinetics, contraindications, common adverse reactions, and drug-drug interactions for testosterone, oxandrolone, and sildenafil. Learning Objective(s) Group Assignments 1. Discuss nursing concerns and nursing measures for use of testosterone, oxandrolone, and sildenafil for a child, an adult, and an older adult. 2. A 20-year-old patient is seeking information about the use of anabolic steroids. Role-play a health care provider and patient discussing the similarities and differences among oxandrolone and other anabolic steroids, and the appropriate use of this class of drug.

Answer 1

1. Androgens are hormones responsible for the male features and reproduction. Some are naturally produced in the body, and if the body doesn't make them properly, they can be obtained through prescription medication. Androgens are responsible for sexual development in males and are produced by the testes.

#. Affects of androgens and testosterone on male body :-

Primary characters of male fetus - epididymus, vas deferens, seminal vesicles

Puberty = growth of scrotum, seminal vesicles, larynx, skeleton,

facial, pubic and axillary hair

increased muscle mass

Anabolic = increase muscle mass and lean body mass, increase RBC count

Post-pubertal = maintains secondary characters, fertility, libido, maintains bone density via E2 metabolite, acne, male pattern baldness, prostate enlargement (DHT metabolite)

#. Adverse effects of testosterone are :-

- Gyanecomastia , excessive frequency and duration of penile erection , decreased ejaculatory volumes , oligospermia, hypercholestremia , polycythemia ,edema , premature epiphyseal closure

2. Testosterone Pharmacotherapeutics

Replacement therapy for hypogonadism associated with low or no endogenous testosterone.

- Testosterone Pharmacokinetics

This drug has a high first-pass effect and is not used orally. It is also highly protein bound. The conjugates and metabolites of testosterone are eliminated in the urine and feces.

- Testosterone Pharmacodynamics

The effects of exogenous testosterone in males are the same as effects of endogenous testosterone. In females, the drug causes masculinization. It also slows the growth of advanced breast cancers.

- Testosterone Contraindications and Precautions

Serious cardiac, hepatic, or renal disease

- Testosterone Adverse Effects

Gynecomastia, excessive frequency and duration of penile erections, decreased ejaculatory volumes, and oligospermia; Hypercholesterolemia; Polycythemia, edema from salt and water retention; Premature epiphyseal closure

- Testosterone Drug Interactions

Anticoagulants, fluoxymesterone, insulin, and methyltestosterone; Any hepatotoxic medications could increase risk of hepatotoxicity

#. Indications of oxandrolone

adjunctive therapy to promote weight gain after weight loss associated with extensive surgery, chronic infections, or trauma; to offset protein catabolism associated with prolonged corticosteroid use; orphan drug uses; short-stature syndrome; HIV-related cachexia and wasting

Actions of oxandrolone

testosterone with androgenic and anabolic activity, promotes tissue building, reverses catabolic processes, increases red blood cell mass

Adverse effects

excitation,

insomnia

virilization

hepatitis

liver cell tumors

blood lipid changes

retention of sodium, water and chloride

acne

masculinization of females

inhibition of testicular function

priapism

baldness

loss of libido in post pubertal males

Contraindications and cautions

any known allergy

pregnancy and lactation

presence of liver dysfunction

coronary disease (hyperlipidemia)

prostate or breast cancer

Pharmacokinetics

PH

well absorbed and widely distributed throughout the body

metabolized in the liver and excreted in the urine

Drug to drug interactions

potential for interaction with oral anticoagulants and a potentially decreased need for antidiabetic agents, which may not be metabolized normally

#. Sildenafil :-

Class:-

Phosphodiesterase (PDE) inhibitors

Action :-

Facilitates erections; enhances blood flow to penile organ

Therapeutic :-

Treat erectile dysfunction

SE :-

Ab symptoms; diarrhea, heartburn, upset stomach

Interactions :-

Drug; Nitrates- decreases BP

Food; Grapefruit increases PDE-5 inhibitor- increases side effects

1. Nursing consideration and measure :-

#. Androgens

Monitor input and output

Weight regularly

Monitor the cholesterol levels

Reconstitute the drug according to manufacturer directions

Remove an old dermal system before applying new

Follow instructions for topical testosterone

Monitor liver function

#. Anabolic steroids

Adm with food if GI effects are severe

Monitor endocrine function, hepatic, serum electrolytes before and periodically during therapy.

Arrange for radiographs of the long bones of children every 3 to 6 months.