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Name /bks_53161_deglins_md_disk/testosteronecypionate 03/17/2014 11:01AM 1 Plate # 0-Composite pg 1 # 1 Use Cautiously in: Benign prostatic hyperplasia; Hypercalcemia; Geriatric patients (qrisk of prostatic hyperplasia/carcinoma); Males ⬍12 yr (safety and effectiveness not established). testosterone cypionate (tess-toss-te-rone sip-eye-oh-nate) Adverse Reactions/Side Effects EENT: deepening of voice. CV: edema. GI: cholestatic jaundice, drug-induced hepatitis, liver function test elevation, nausea, vomiting. GU: change in libido, erectile dysfunction, priapism, prostatic enlargement. Endo: gynecomastia, hirsutism, oligospermia, hypercholesterolemia. F and E: hypercalcemia, hyperkalemia, hyperphosphatemia. Derm: male pattern baldness. Local: pain at injection site. Depo-Testosterone Classification Therapeutic: hormones Pharmacologic: androgens Schedule III Pregnancy Category X Interactions Drug-Drug: Mayqaction of warfarin, oral hypoglycemic agents, andinsulin. Indications Concurrent use with corticosteroids mayqrisk of edema formation. Hypogonadism in androgen-deficient men. Route/Dosage Action IM (Adults): Replacement therapy— 50– 400 mg every 2– 4 wk. Responsible for the normal growth and development of male sex organs. Maintenance of male secondary sex characteristics: Growth and maturation of the prostate, seminal vesicles, penis, scrotum, Development of male hair distribution, Vocal cord thickening, Alterations in body musculature and fat distribution. Therapeutic Effects: Correction of hormone deficiency in male hypogonadism. NURSING IMPLICATIONS Assessment Pharmacokinetics Absorption: Well absorbed from IM sites; absorbed slowly. Distribution: Crosses the placenta. Protein Binding: 98%. Metabolism and Excretion: Metabolized by the liver; 90% eliminated in urine as metabolites. Half-life: 8 days. TIME/ACTION PROFILE (androgenic effects†) ROUTE ONSET PEAK IM unknown unknown †Response is highly variable among individuals; may take months with breast or prostate cancer; Severe liver, renal, or cardiac disease; Patients with known hypersensitivity to benzyl alcohol. ⫽ Genetic Implication. for edema. Report significant changes indicative of fluid retention. ● Men: Monitor for precocious puberty in boys (acne, darkening of skin, develop- ● ● DURATION 2–4 wk Contraindications/Precautions Contraindicated in: Hypersensitivity; OB: Pregnancy and lactation; Male patients ⫽ Canadian drug name. ● Monitor intake and output ratios, weigh patient twice weekly, and assess patient ● ● ● ment of male secondary sex characteristics— increase in penis size, frequent erections, growth of body hair). Bone age determinations should be measured every 6 mo to determine rate of bone maturation and effects on epiphyseal closure. Monitor for breast enlargement, persistent erections, and increased urge to urinate in men. Monitor for difficulty urinating in elderly men, because prostate enlargement may occur. Lab Test Considerations: Monitor hemoglobin and hematocrit periodically during therapy; may cause polycythemia. Monitor hepatic function tests and serum cholesterol levels periodically during therapy. Mayqserum AST, ALT, and bilirubin,qcholesterol levels, and suppress clotting factors II, V, VII, and X. Monitor blood glucose closely in patients with diabetes who are receiving oral hypoglycemic agents or insulin. Monitor serum sodium, chloride, potassium, and phosphate concentrations (may beq). CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued. PDF Page #1 Name /bks_53161_deglins_md_disk/testosteronecypionate 03/17/2014 11:01AM Plate # 0-Composite pg 2 # 2 2 PDF Page #2 Potential Nursing Diagnoses Sexual dysfunction (Indications) (Side Effects) Implementation ● Range-of-motion exercises should be done with all bedridden patients to prevent mobilization of calcium from the bone. ● IM: Administer IM deep into gluteal muscle. Crystals may form when vials are stored at low temperatures; warming and shaking the vial will redissolve crystals. Use of a wet syringe or needle may cause solution to become cloudy but will not affect its potency. Patient/Family Teaching ● Advise patient to report the following signs and symptoms promptly: priapism ● ● ● ● (sustained and often painful erections), difficulty urinating, gynecomastia, edema (unexpected weight gain, swelling of feet), hepatitis (yellowing of skin or eyes and abdominal pain), or unusual bleeding or bruising. Explain rationale for prohibiting use of testosterone for increasing athletic performance. Testosterone is neither safe nor effective for this use and has a potential risk of serious side effects. Advise diabetic patients to monitor blood closely for alterations in blood glucose concentrations. Emphasize the importance of regular follow-up physical exams, lab tests, and x-ray exams to monitor progress. Radiologic bone age determinations should be evaluated every 6 mo in prepubertal children to determine rate of bone maturation and effects on epiphyseal centers. Evaluation/Desired Outcomes ● Resolution of the signs of androgen deficiency without side effects. Therapy is usu- ally limited to 3– 6 mo followed by bone growth or maturation determinations. Why was this drug prescribed for your patient? 䉷 2015 F.A. Davis Company