WEEK 5 NR 568 FINAL QUESTIONS WITH COMPLETE
SOLUTIONS
Testosterone gels (AndroGel, Testim, Vogelxo)
(1) cause less local irritation, (2) cannot fall off, and (3) produce
more consistent testosterone levels.
The principal disadvantage of the gels is that testosterone can be
transferred to others by skin-to-skin contact.
This is possible because only 10% of an applied dose is
absorbed; the other 90% remains on the skin after the gel dries.
Erectile Dysfunction (ED)
Patient Teaching
high-fat meal will delay absorption of avanafil, sildenafil, or
vardenafil (but not tadalafil)
grapefruit juice should be avoided because this can raise PDE-5
inhibitor levels
in men who experience cardiac symptoms (e.g., anginal pain,
lightheadedness) during sex to refrain from further sexual
activity and discuss the event with their prescriber.
seek immediate medical attention if an erection lasts more
than 4 h. Prolonged priapism can cause permanent damage.
stop their PDE-5 inhibitor and seek immediate medical attention
if they experience sudden loss of vision in one or both eyes or if
hearing loss develops.
,avoid nitrates for at least 12 h after taking avanafil, for at least
24 h after taking sildenafil or vardenafil, and for at least 48 h
after taking tadalafil.
Medication Classes used to treat ED
PDE-5 Inhibitors (Viagra, Cialis)
Prostaglandin E1 (Alprostadil)
Vasodilator + A-adrenergic antagonist (Papaverine with
phentolamine)
Vasodilators
provide tumescence (engorgement due to vascular congestion)
when injected directly into the corpus cavernosum. Erection
develops within 10 minutes and lasts 2 to 4 hours
PGE1
Relaxation of smooth muscle (arterial, venous, and trabecular),
causes a rapid inflow of arterial blood. Pressure from the
engorged penis helps block venous outflow to promote
maintenance of the erect state.
Treatment of BPH
Know examples of drugs in each major drug class
5-α-Reductase Inhibitor (Finasteride)
α-Adrenergic Antagonist (Tamsulosin)
Adverse effects of common BPH therapies
5-α-Reductase Inhibitors: Decreased ejaculate volume and
libido. Teratogenic to the male fetus.
, α1 Blockers: Abnormal ejaculation (ejaculation failure, reduced
ejaculate volume, or retrograde ejaculation). Risk of floppy-iris
syndrome during cataract surgery.
Phosphodiesterase-5 Inhibitor: Hypotension, priapism
α1a Blocker/5-α-Reductase Inhibitor: Decreased libido and
abnormal ejaculation (ejaculation failure, reduced ejaculate
volume, retrograde ejaculation)
What teaching needs to be done for OCs
Take pill around the same time daily
Among women of higher weight, efficacy is somewhat reduced.
Report leg tenderness/pain/redness, SOB, headaches/migraines,
sudden chest pains, visual changes.
If a mini pill is missed by more than 3 hours, take it immediately
and use backup for at least 2 days
If one or more pills are missed in the first week, take one pill as
soon as possible and then continue with the pack. Use an
additional form of contraception for 7 days.
If one or two pills are missed during the second or third week,
take one pill as soon as possible and then continue with the
active pills in the pack but skip the placebo pills and go straight
to a new pack once all the active pills have been taken.
If three or more pills are missed during the second or third week,
follow the same instructions given for missing one or two pills
but use an additional form of contraception for 7 days.
Baseline data for OCs
SOLUTIONS
Testosterone gels (AndroGel, Testim, Vogelxo)
(1) cause less local irritation, (2) cannot fall off, and (3) produce
more consistent testosterone levels.
The principal disadvantage of the gels is that testosterone can be
transferred to others by skin-to-skin contact.
This is possible because only 10% of an applied dose is
absorbed; the other 90% remains on the skin after the gel dries.
Erectile Dysfunction (ED)
Patient Teaching
high-fat meal will delay absorption of avanafil, sildenafil, or
vardenafil (but not tadalafil)
grapefruit juice should be avoided because this can raise PDE-5
inhibitor levels
in men who experience cardiac symptoms (e.g., anginal pain,
lightheadedness) during sex to refrain from further sexual
activity and discuss the event with their prescriber.
seek immediate medical attention if an erection lasts more
than 4 h. Prolonged priapism can cause permanent damage.
stop their PDE-5 inhibitor and seek immediate medical attention
if they experience sudden loss of vision in one or both eyes or if
hearing loss develops.
,avoid nitrates for at least 12 h after taking avanafil, for at least
24 h after taking sildenafil or vardenafil, and for at least 48 h
after taking tadalafil.
Medication Classes used to treat ED
PDE-5 Inhibitors (Viagra, Cialis)
Prostaglandin E1 (Alprostadil)
Vasodilator + A-adrenergic antagonist (Papaverine with
phentolamine)
Vasodilators
provide tumescence (engorgement due to vascular congestion)
when injected directly into the corpus cavernosum. Erection
develops within 10 minutes and lasts 2 to 4 hours
PGE1
Relaxation of smooth muscle (arterial, venous, and trabecular),
causes a rapid inflow of arterial blood. Pressure from the
engorged penis helps block venous outflow to promote
maintenance of the erect state.
Treatment of BPH
Know examples of drugs in each major drug class
5-α-Reductase Inhibitor (Finasteride)
α-Adrenergic Antagonist (Tamsulosin)
Adverse effects of common BPH therapies
5-α-Reductase Inhibitors: Decreased ejaculate volume and
libido. Teratogenic to the male fetus.
, α1 Blockers: Abnormal ejaculation (ejaculation failure, reduced
ejaculate volume, or retrograde ejaculation). Risk of floppy-iris
syndrome during cataract surgery.
Phosphodiesterase-5 Inhibitor: Hypotension, priapism
α1a Blocker/5-α-Reductase Inhibitor: Decreased libido and
abnormal ejaculation (ejaculation failure, reduced ejaculate
volume, retrograde ejaculation)
What teaching needs to be done for OCs
Take pill around the same time daily
Among women of higher weight, efficacy is somewhat reduced.
Report leg tenderness/pain/redness, SOB, headaches/migraines,
sudden chest pains, visual changes.
If a mini pill is missed by more than 3 hours, take it immediately
and use backup for at least 2 days
If one or more pills are missed in the first week, take one pill as
soon as possible and then continue with the pack. Use an
additional form of contraception for 7 days.
If one or two pills are missed during the second or third week,
take one pill as soon as possible and then continue with the
active pills in the pack but skip the placebo pills and go straight
to a new pack once all the active pills have been taken.
If three or more pills are missed during the second or third week,
follow the same instructions given for missing one or two pills
but use an additional form of contraception for 7 days.
Baseline data for OCs
