Pharmacology in NursingPharmacology in Nursing

Men’s Health DrugsMen’s Health Drugs

AndrogensAndrogensTestosterone

◦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)Androgens (cont’d)Several synthetic derivatives of

testosteroneLong-term dosage forms can last

from 2 to 3 days to 2 to 4 weeksOral forms have a high first-pass

effectTransdermal forms available

◦Patches and gel

Androgens (cont’d)Androgens (cont’d)Anabolic steroids

◦Anabolic activity: synthesis of tissue and increasing tissue formation

◦Schedule III, great potential for misuse by athletes

oxymetholone stanozololoxandrolonenandrolone

Androgens:Androgens:Mechanism of ActionMechanism 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 InhibitorsAndrogen Inhibitors

5-α-reductase inhibitorsα1-adrenergic blockersAndrogen receptor blockersGonadotropin-releasing hormone

(Gn-RH) analogs

Androgen InhibitorsAndrogen Inhibitors (cont’d)(cont’d)

5-α-reductase inhibitors: finasteride (Proscar) and dutasteride (Avodart)

Block the effects of endogenous androgensUsed to treat benign prostatic hypertrophy

(BPH)Results in alleviation of symptoms of BPH

◦ Easier passage of urineMay also be used for treatment of male-

pattern baldness

BPHBPH

αα11-Adrenergic Blockers-Adrenergic Blockers

Used for symptomatic relief of obstruction due to BPH◦doxazosin (Cardura)◦tamsulosin (Flomax)◦terazosin (Hytrin)

Androgen Receptor Androgen Receptor BlockersBlockersBlock the activity of androgen

hormones at the target tissue (prostate) receptors◦flutamide◦nilutamide◦bicalutamide

Gn-RH AnalogsGn-RH Analogs

Gonadotropin-releasing hormone analogs

Used to treat prostate cancer◦goserelin◦leuprolide◦triptorelin

Drugs to Treat Erectile Drugs to Treat Erectile DysfunctionDysfunction

sildenafil (Viagra)◦First oral drug for treatment of ED

vardenafil (Levitra)tadalafil (Cialis)

Remember to be very Remember to be very sensitive, respectful, and non sensitive, respectful, and non

judgmental.judgmental.

Sex is a health part of every Sex is a health part of every persons life and relationshippersons life and relationship

Men’s Health Drugs: Men’s Health Drugs: IndicationsIndicationsPrimary use: hormone

replacement therapy

Other uses vary with the specific drug

Men’s Health Drugs:Men’s Health Drugs:Adverse EffectsAdverse Effects

Androgens cause fluid retention

Anabolic steroids◦Peliosis of the liver, other severe

hepatic effects◦“Roid rage”

Men’s Health Drugs:Men’s Health Drugs:Adverse Effects (cont’d)Adverse Effects (cont’d)

5-α-reductase inhibitors◦Loss of libido, loss of erection,

ejaculatory dysfunction, other effects

Men’s Health Drugs:Men’s Health Drugs:Adverse Effects (cont’d)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:Men’s Health Drugs:Adverse Effects (cont’d)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 ImplicationsNursing ImplicationsAssessment should include

complete history, including medication history, urinary elimination problems, potential contraindications

Obtain baseline vital signs, weight, height, serum electrolyte levels

Nursing Implications Nursing Implications (cont’d)(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 Nursing Implications (cont’d)(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 Nursing Implications (cont’d)(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