3 - Endocrine System Disorders & Pharmacotherapy

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Created by
Danika Francesca

Cards (49)

  • FSH - necessary for sperm production (spermatogenesis).
  • LH - stimulates the production of testosterone, which is necessary to continue the process of spermatogenesis
  • Testosterone - important in the development of male characteristics, including muscle mass and strength, fat distribution, bone mass and sex drive.
  • Erectile Dysfunction - Inability to develop and maintain an erection for satisfactory sexual intercourse or activity.
  • REFLEX ERECTION - achieved by directly touching the penile shaft. Involves the peripheral nerves and the lower parts of the spinal cord
  • PSYCHOGENIC ERECTION - achieved by erotic or emotional stimuli.
    Involves the limbic system of the brain.
  • Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), 🡪 relaxation of the smooth muscles of the corpora cavernosa (the main erectile tissue of the penis), and 🡪 penile erection.
  • Nitric Oxide - a natural chemical the body produces that relaxes muscles in the penis. This increases blood flow and allows one to get an erection in response to sexual stimulation.
  • DRUGS THAT ENHANCE EFFECTS OF NITRIC OXIDE
    1. Sildenafil (Viagra)
    2. Tadalafil (Adcirca, Cialis)
    3. Vardenafil (Levitra, Staxyn)
    4. Avanafil (Stendra)
  • SERIOUS SIDE EFFECTS OF DRUGS THAT ENHANCE EFFECTS OF NITRIC OXIDE
    1. Anaphylaxis: skin rash, itchy, swollen, blistered or peeling skin, wheezing, tightness in the chest, DOB, swelling of the face, mouth, lips, tongue or throat
    2. AV block
    3. Postural hypotension
    4. Tremor
    5. Herpes simplex
    6. Angina pectoris
    7. Cardiac arrest
    8. Depression
    9. Rectal hemorrhage
    10. Photosensitivity
    11. Deafness
  • DRUGS THAT ENHANCE NITRIC OXIDE does not work in the absence of sexual stimulation. Limit use to once per day.
  • Nitrates - can't be taken with drugs that enhance nitric oxide since it can cause serious and fatal complications
  • Alpha blockers - should not be taken with drugs that enhance nitric oxide within 4 hours
  • DRUGS THAT ENHANCE NITRIC OXIDE
    Take this drug 30 minutes to 4 hours before anticipated sexual activity. The usual timing is 1 hour. The drug will have no effect in the absence of sexual stimulation.
  • ALPROSTADIL SELF-INJECTION - Using a fine needle to inject the drug into the base or side of the penis. Each injection is dosed to create an erection lasting no longer than an hour. pain and period cramps
  • ALPROSTADIL SELF-INJECTION
    1. Caverject
    2. Edex
  • ALPROSTADIL SELF-INJECTION SIDE EFFECTS
    1. Mild bleeding from the injection site
    2. Prolonged erection (priapism)
    3. Formation of fibrous tissue at the injection site
    4. Fever
    5. Seizure
    6. Lethargy
    7. Flushing
    8. Bradycardia or tachycardia
    9. Syncope
    10. Ventricular fibrillation shock
    11. Diarrhea
    12. Gastric regurgitation
    13. Disseminated intravascular coagulation (DIC)
    14. Thrombocytopenia
    15. Oliguria
    16. Anuria
    17. Penile pain; penile rash, penile edema
  • Warfarin - where alprostadil self-injection interacts with and may increase anticoagulant properties
  • Antihypertensive drugs - where alprostadil self-injection may interact with and increase the risk of hypotension
  • Arterial blood gases and arterial blood pH - lab tests that should be monitored regularly when using Alprostadil self-injection
  • ALPROSTADIL SELF-INJECTION
    Advise patient to seek immediate medical attention if an erection persists longer that 6 hours.
  • ALPROSTADIL URETHRAL SUPPOSITORY - Involves placing a tiny alprostadil suppository inside the penis in the penile urethra.
  • ALPROSTADIL URETHRAL SUPPOSITORY - Using a special applicator to insert the suppository into the penile urethra.
  • ALPROSTADIL URETHRAL SUPPOSITORY
    The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes.
  • ALPROSTADIL URETHRAL SUPPOSITORY
    Sit or stand upright for 10 minutes after taking the medicine. Do not lie down.
  • ALPROSTADIL URETHRAL SUPPOSITORY
    Educate patient that this medication usually works within 5 to 10 minutes and produces an erection that lasts for about 30 to 60 minutes.
  • ALPROSTADIL URETHRAL SUPPOSITORY
    Tell patient to report if he had a painful erection or an erection for more than 4 hours, seek medical care right away.
  • TESTOSTERONE REPLACEMENT SIDE EFFECTS
    1. Worsening sleep apnea
    2. Acne
    3. Benign prostatic hyperplasia
    4. Enlarging breasts
    5. Limiting sperm production or causing testicles to shrink
    6. Stimulating RBC production – increase risk of forming blood clots
    7. Hoarseness
    8. Deepening of voice
    9. Pain at injection site
    10. Tiredness
    11. Mood swings
  • CONTRAINDICATIONS OF TESTOSTERONE REPLACEMENT
    1. hypersensitivity to androgens
    2. serious cardiac, liver, or kidney disease
    3. hypercalcemia
    4. BPH with obstruction
  • Androgenic therapy is usually terminated if serum calcium rises above 14 mg/dL.
  • Infertility - Disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.
  • MALE AND FEMALE FERTILITY PILLS - increase the amount of bioavailable testosterone and decrease the amount of estradiol (a form of estrogen).
  • CLOMIPHENE/CLOMID - in males, it increases testosterone and strength, reduced fatigue, and improved erectile function among men who have hypoandrogenism.
  • CLOMIPHENE/CLOMID - in females, it stimulates pituitary release of luteinizing hormone (LH), follicle stimulating hormone (FSH), and gonadotropins, leading to ovarian stimulation.
  • ANASTROZOLE - reduce male hyperandrogenism symptoms such as low energy, reduced muscle mass, low libido, and erectile dysfunction.
  • ANASTROZOLE - It has also been shown to improve sperm production and sperm recovery rates in men who are azoospermic or have a low sperm count.
  • RARE BUT SERIOUS SIDE EFFECTS OF THE MALE FERTILITY PILL
    1. Blood clots
    2. Cataracts
    3. Steven-Johnson Syndrome
  • MALE FERTILITY PILLS
    1. Give on an empty stomach, 1 hour before or 2 hours after meals, because food affects extent of absorption.
  • HCG - in males, it increases testosterone levels in men who suffer from symptoms of low testosterone or hypogonadism.
  • HCG - in females, it causes maturation of the ovarian follicle and triggers ovulation.