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Pharmacology in Nursing Men’s Health Drugs

Pharmacology in Nursing Men’s Health Drugs

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Pharmacology in Nursing Men’s Health Drugs

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  1. Pharmacology in NursingMen’s Health Drugs

  2. 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

  3. 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 • Patches and gel

  4. Androgens (cont’d) • Anabolic steroids • Anabolic activity: synthesis of tissue and increasing tissue formation • Schedule III, great potential for misuse by athletes • oxymetholone • stanozolol • oxandrolone • nandrolone

  5. 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

  6. Androgen Inhibitors • 5-α-reductase inhibitors • α1-adrenergic blockers • Androgen receptor blockers • Gonadotropin-releasing hormone (Gn-RH) analogs

  7. Androgen Inhibitors(cont’d) • 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 • May also be used for treatment of male-pattern baldness

  8. BPH

  9. α1-Adrenergic Blockers • Used for symptomatic relief of obstruction due to BPH • doxazosin (Cardura) • tamsulosin (Flomax) • terazosin (Hytrin)

  10. Androgen Receptor Blockers • Block the activity of androgen hormones at the target tissue (prostate) receptors • flutamide • nilutamide • bicalutamide

  11. Gn-RH Analogs • Gonadotropin-releasing hormone analogs • Used to treat prostate cancer • goserelin • leuprolide • triptorelin

  12. Drugs to Treat Erectile Dysfunction • sildenafil (Viagra) • First oral drug for treatment of ED • vardenafil (Levitra) • tadalafil (Cialis)

  13. Remember to be very sensitive, respectful, and non judgmental.

  14. Sex is a health part of every persons life and relationship

  15. Men’s Health Drugs: Indications • Primary use: hormone replacement therapy • Other uses vary with the specific drug

  16. Men’s Health Drugs:Adverse Effects • Androgens cause fluid retention • Anabolic steroids • Peliosis of the liver, other severe hepatic effects • “Roid rage”

  17. Men’s Health Drugs:Adverse Effects (cont’d) • 5-α-reductase inhibitors • Loss of libido, loss of erection, ejaculatory dysfunction, other effects

  18. Men’s Health Drugs: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

  19. Men’s Health Drugs: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

  20. Nursing Implications • Assessment should include complete history, including medication history, urinary elimination problems, potential contraindications • Obtain baseline vital signs, weight, height, serum electrolyte levels

  21. Nursing Implications (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

  22. Nursing Implications (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

  23. Nursing Implications (cont’d) • Pregnant women should not handle crushed or broken finasteride tablets • Educate patient on proper administration techniques for each drug • Monitor for therapeutic responses • Monitor for adverse effects