NR 566 Week 6 Study Guide {2020}

NR 566 Week 6 Study Guide {2020} – Chamberlain College of Nursing NR 566 Week 6 Study Guide Chapter 22: Drugs Affecting the Reproductive System • Know the pharmacodynamics, pharmacotherapeutics, clinical use, drug interactions, and ADRs for: Erectile dysfunction (ED) drugs, Estrogens and Progesterone, and Antiandrogen drugs • Androgen drugs o Testosterone is the primary male androgen o Responsible for:  Growth, maturation, and maintenance of male sex organs and secondary sexual characteristics  Skeletal growth spurt in adolescence and termination of linear growth by fusion of the epiphyseal growth plate  Activation of sebaceous glands (acne during puberty)  Enhances production of erythropoietic stimulating factor, increased RBCs production  Libido o Androgen Drugs: testosterone propionate (in oil, DepoTesterone), testosterone enanthate (in oil, Delatestryl), testosterone cypionate (in oil, Depo-Testosterone), methyltestosterone (Android, Methitest, Testred, Virilon), testosterone gel (AndroGel 1%, AndroGel 1.62%, Axiron, Testium), fluoxymesterone, TD testosterone (Testoderm, Androderm), and buccal testosterone (Striant)  Used to treat Indicated for the symptomatic Tx of • 1) deficiency states in males associated with hypogonadism and • 2) in both sexes for d/os such as CA and HIB, Tx libido, endometriosis, and postmenopausal symptoms in women, have been used illicitly to enhance athletic performance and increase muscle mass o Contraindicated: male breast CA, prostate CA, and Pregnancy (Category X), and lactation • Antiandrogens: several different categories o Androgen hormone inhibitors (5-alpha-reductase inhibitors)  Drugs: Finasteride (Propecia, Proscar) and dutasteride (Avodart)  MOA: Block conversation of testosterone to dihydrotesterone  Used to Tx BPH  PSA levels and digital prostate examination are required monitoring for men on these agents  Finasteride (Propecia, Proscar): • Extensive hepatic metabolism • BPH: 5mg/day, 6 to 12 months of therapy until therapeutic response o Regression of prostate size increased urinary flow, and improve BPH symptoms • Approved for Male pattern baldness: 1 mg/day, three months until results • Stopping the drugs reverses the effect within 12 months • ADRs: decreased libido, impotence (can occur at both doses)  Dutasteride (Avodart) • Inhibits both type 1 and 2 (5-alpha-reductase) • Peak clinical effect 6 to 12 months of therapy • Extensively metabolized in the liver (CYP3A4 and CYP3A5) • Used to Tx BPH  PSA levels and digital prostate examination are required monitoring for men on these agents  Finasteride (Propecia, Proscar): • Extensive hepatic metabolism • BPH: 5mg/day, 6 to 12 months of therapy until therapeutic response o Regression of prostate size increased urinary flow, and improve BPH symptoms • Approved for Male pattern baldness: 1 mg/day, three months until results • Stopping the drugs reverses the effect within 12 months • ADRs: decreased libido, impotence (can occur at both doses)  Dutasteride (Avodart) • Inhibits both type 1 and 2 (5-alpha-reductase) • Peak clinical effect 6 to 12 months of therapy • Extensively metabolized in the liver (CYP3A4 and CYP3A5) • Used to Tx BPH • Absorbed through the skin, women who are pregnant or may become pregnant should not handle dutasteride capsules r/t risk of fetal anomaly to a male fetus • ADR: decreased libido and impotence o Gonadotropin-releasing hormone analogue: luteinizing hormone-releasing hormone antagonist  Leuprolide acetate (Lupron)  Create a reversible chemical orchiectomy state in males and an oophorectomy state in females  Used to Tx: advanced prostatic CA and for management of endometriosis and uterine leiomyomata (fibroids)  1 mg SC daily or IM every 3 months (depot formulation)  Increased suppression when used with flutamide (direct antiandrogen)  Peds: Tx central precocious puberty  Women: reducing uterine fibroids, endometriosis, and PCOS (pain relief, regain fertility)