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Pharmacology in Nursing Men’s Health Drugs 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 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 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 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 Androgen Inhibitors 5-α-reductase inhibitors α1-adrenergic blockers Androgen receptor blockers Gonadotropin-releasing hormone (GnRH) analogs 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 BPH α1-Adrenergic Blockers Used for symptomatic relief of obstruction due to BPH ◦ doxazosin (Cardura) ◦ tamsulosin (Flomax) ◦ terazosin (Hytrin) Androgen Receptor Blockers Block the activity of androgen hormones at the target tissue (prostate) receptors ◦ flutamide ◦ nilutamide ◦ bicalutamide Gn-RH Analogs Gonadotropin-releasing hormone analogs Used to treat prostate cancer ◦ goserelin ◦ leuprolide ◦ triptorelin Drugs to Treat Erectile Dysfunction sildenafil (Viagra) ◦ First oral drug for treatment of ED vardenafil (Levitra) tadalafil (Cialis) Remember to be very sensitive, respectful, and non judgmental. Sex is a health part of every persons life and relationship Men’s Health Drugs: Indications Primary use: hormone replacement therapy Other uses vary with the specific drug Men’s Health Drugs: Adverse Effects Androgens cause fluid retention Anabolic steroids ◦ Peliosis of the liver, other severe hepatic effects ◦ “Roid rage” Men’s Health Drugs: Adverse Effects (cont’d) 5-α-reductase inhibitors ◦ Loss of libido, loss of erection, ejaculatory dysfunction, other effects 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 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 Nursing Implications Assessment should include complete history, including medication history, urinary elimination problems, potential contraindications Obtain baseline vital signs, weight, height, serum electrolyte levels 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 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 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
