1. Drugs for Men’s Health and Reproductive Disorders
Chapter 57
Drugs for Men’s Health and Reproductive Disorders
Copyright © 2015, 2012, 2009, 2006, 2003, 2000, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

2. Substances Related to Male Reproductive Disorders
Androgens
Testosterone, main androgen 
Administration
IM, well-absorbed
Indications
Hypogonadism
Delayed puberty in adolescents
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3. Androgens Testosterone Drug interactions Lab interactions
Anticoagulants, barbiturates, phenytoin, corticosteroids
Lab interactions
Decreases blood glucose in diabetics; increases cholesterol, thyroid, liver function, hematocrit
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4. Androgens (Cont.) Testosterone Side effects Pripiasm Gynecomastia
Spermatogenesis halted
Oligospermia
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5. Androgens (Cont.) Adverse reactions Hypercalcemia Virilization
Teratogenic effects
Hepatic carcinoma
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6. Androgens (Cont.) Contraindications Pregnancy
Nephrosis or nephrotic phase of nephritis
Hypercalcemia
Pituitary insufficiency
Hepatic dysfunction
BPH
Prostate cancer
History of myocardial infarction
Men with breast cancer
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7. Androgens (Cont.) Caution Hypertension Hypercholesterolemia CAD
Renal disease
Seizure disorder
Infants
Prepubertal children
Older men
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8. Anabolic Steroids Also called anabolic-androgenic steroids (AAS)
Class of steroid hormones related to the hormone testosterone
They increase protein synthesis within cells, which results in the buildup of cellular tissue (anabolism), especially in muscles.
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9. Testosterone Precursors
Androstenediol
Androstenedione
Dehydroepiandrosterone (DHEA)
Available as nutritional supplements
Health risks from long-term use: increased LDL, decreased HDL, acne, high blood pressure, liver damage, and dangerous changes in the structure of the left ventricle of the heart
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10. Other Steroids Gonadotropin (hCG, Pregnyl, Novarel, Ovidrel)
Tetrahydrogestrinone (THG)
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11. Nursing Process: Androgens
Assessment
Nursing diagnoses
Planning
Nursing interventions
Patient teaching
Cultural considerations
Evaluation
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12. Antiandrogens Leuprolide, ketoconazole, flutamide (Eulexin)
Use: Treatment of benign prostatic hypertrophy, advanced prostatic cancer, and as hormonal therapy in the treatment of endometriosis
Other uses: Treatment of male pattern baldness, acne, hirsutism, virilization syndrome in women, and precocious puberty in boys
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13. Drugs Used in Other Male Reproductive Disorders
Developmental disorders
Undescended testes
Associated with infertility, testicular cancer
Delayed puberty
Given Gn-RH, LH, or FSH therapy
Pituitary, thyroid, adrenal disorders
Given LH or FSH therapy
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14. Drugs Used in Other Male Reproductive Disorders (Cont.)
Sexual dysfunction
Phosphodiesterase inhibitors
Sildenafil citrate (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
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15. Natural Products Herbs used for sexual performance Yohimbine Ginseng
Damiana
Ginkgo biloba
Saw palmetto
Muira puama
Tribulus terrestris
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16. Drugs for Treatment of BPH
5-alpha reductase inhibitors
Finasteride (Proscar, Propecia)
Dutasteride (Avodart, Duagen)
Alpha-adrenergic blocking agents
Tamsulosin (Flomax)
Doxazosin (Cardura)
Terazosin (Hytrin)
Alfuzosin (Uroxatrel)
Silodosin (Rapaflo)
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17. Practice Question #1
The nurse teaches a patient that sildenafil is contraindicated for patients taking which category of medications?
Sulfonylureas
Beta blockers
Nitrates
Proton pump inhibitors
Answer: C
Rationale: Nitroglycerin and other nitrate medications used to treat heart disease can cause a significant decrease in blood pressure when taken with PDE-5 inhibitors. Therefore, this class of drugs is contraindicated for use by any patient using organic nitrates in any form.
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18. Practice Question #2
A patient is receiving androgen therapy for hypogonadism. The nurse teaches the patient to observe for common side effects of the drug, including which of the following?
Abdominal pain and hives at injection site
Dry mouth and dizziness
Weight gain and blurred vision
Generalized rash
Answer: A
Rationale: Some side effects of androgen therapy include abdominal pain, nausea, insomnia, diarrhea or constipation, hives or redness at the injection site, increased salivation, mouth soreness, and increased or decreased sexual desire.
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19. Practice Question #3
The nurse should inform a woman undergoing androgen therapy that she may develop which symptom?
Impaired bone growth
Gynecomastia
Vocal changes
Priapism
Answer: C
Rationale: Vocal changes to a deeper voice may occur.
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20. Practice Question #4
Which drug used in the treatment of benign prostatic hypertrophy is most likely to cause postural hypotension?
Alfuzosin (Uroxatral)
Dutasteride (Avodart)
Finasteride (Propecia)
Tadalafil (Cialis)
Answer: A
Rationale: Alfuzosin is an alpha-adrenergic blocking agent, which is also used to control blood pressure and can cause postural hypotension.
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21. Practice Question #5
Before administering androgen therapy, it is most important for the nurse to assess the patient for
chronic obstructive pulmonary disease.
diabetes mellitus.
pregnancy.
a serum calcium of 8.0.
Answer: C
Rationale: Androgen therapy is contraindicated during pregnancy.
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