Transcript Mens_HealthDrugs

Pharmacology in Nursing
Men’s Health Drugs
Androgens

Testosterone
◦ 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)
Several synthetic derivatives of
testosterone
 Long-term dosage forms can last from 2
to 3 days to 2 to 4 weeks
 Oral forms have a high first-pass effect
 Transdermal forms available
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◦ Patches and gel
Androgens (cont’d)
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Anabolic steroids
◦ Anabolic activity: synthesis of tissue and
increasing tissue formation
◦ Schedule III, great potential for misuse by
athletes
oxymetholone
stanozolol
oxandrolone
nandrolone
Androgens:
Mechanism 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 Inhibitors
5-α-reductase inhibitors
 α1-adrenergic blockers
 Androgen receptor blockers
 Gonadotropin-releasing hormone (GnRH) analogs
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Androgen Inhibitors (cont’d)
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5-α-reductase inhibitors: finasteride (Proscar) and
dutasteride (Avodart)
Block the effects of endogenous androgens
Used to treat benign prostatic hypertrophy (BPH)
Results in alleviation of symptoms of BPH
◦ Easier passage of urine
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May also be used for treatment of male-pattern
baldness
BPH
α1-Adrenergic Blockers
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Used for symptomatic relief of
obstruction due to BPH
◦ doxazosin (Cardura)
◦ tamsulosin (Flomax)
◦ terazosin (Hytrin)
Androgen Receptor Blockers
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Block the activity of androgen hormones
at the target tissue (prostate) receptors
◦ flutamide
◦ nilutamide
◦ bicalutamide
Gn-RH Analogs
Gonadotropin-releasing hormone analogs
 Used to treat prostate cancer
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◦ goserelin
◦ leuprolide
◦ triptorelin
Drugs to Treat Erectile Dysfunction
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sildenafil (Viagra)
◦ First oral drug for treatment of ED
vardenafil (Levitra)
 tadalafil (Cialis)
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Remember to be very sensitive,
respectful, and non judgmental.
Sex is a health part of every
persons life and relationship
Men’s Health Drugs: Indications
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Primary use: hormone replacement
therapy
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Other uses vary with the specific drug
Men’s Health Drugs:
Adverse Effects
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Androgens cause fluid retention
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Anabolic steroids
◦ Peliosis of the liver, other severe hepatic effects
◦ “Roid rage”
Men’s Health Drugs:
Adverse Effects (cont’d)
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5-α-reductase inhibitors
◦ Loss of libido, loss of erection, ejaculatory
dysfunction, other effects
Men’s Health Drugs:
Adverse Effects (cont’d)
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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:
Adverse Effects (cont’d)
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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 Implications
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Assessment should include complete
history, including medication history, urinary
elimination problems, potential
contraindications
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Obtain baseline vital signs, weight, height,
serum electrolyte levels
Nursing Implications (cont’d)
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Assess renal and liver function
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Assess PSA level before beginning any drugs
for treatment of prostate disease
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Assess current medications for potential
interactions
Nursing Implications (cont’d)
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IM testosterone should be given deeply—choose
landmarks carefully
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Follow exact instructions for SL, buccal, and PO forms
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Transdermal Testoderm patches are applied to the
scrotal skin
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Transdermal Androderm patches are applied to the skin
on the body, never to scrotal skin
Nursing Implications (cont’d)
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Pregnant women should not handle crushed
or broken finasteride tablets
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Educate patient on proper administration
techniques for each drug
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Monitor for therapeutic responses
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Monitor for adverse effects