NURSING > Summary > NR 566 Week 6 Chapters 22, 31, 44 Notes (download to score A+) (All)

NR 566 Week 6 Chapters 22, 31, 44 Notes (download to score A+)

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NR 566 Week 6 Chapters 22, 31, 44 Notes (download to score A+) Chapter 22: Drugs Affecting the Reproductive System Chapter 31: Contraception Chapter 44: Sexually Transmitted Infections and Vaginitis Chapter 22: Drugs Affecting the Reproductive System Androgens • Testosteroneprimary male androgen • many tissues , it’s activity depends on reduction to dihydrotesterone, which binds to cytosol- receptor proteins. Androgen-receptor complex then transported to nucleus of the cell, where it initiates transcription events and cellular changes • Dihydrotestosterone (DHT) is the essential androgen in the prostate • Responsible for o normal growth, maturation, and maintenance of male sex organs and secondary sexual characteristics o skeletal growth spurt in adolescence and for termination of linear growth by fusion of episphyseal growth plate o activation of sebaceous glands some cases of acne during puberty o enhancing production of erythropoietic stimulating factor increased RBC production o playing a role in libido • Synthetic androgens meant to supplement or replace endogenous hormones & used to treat disorders in male and female reproductive tract Uses • primary indicationprimary hypogonadal males or hypogonadotropic hypogonadism, and male climacteric • both sexes for disorders such as cancer & HIV • treat libido, endometriosis, & postmenopausal symptoms in women • have been used to enhance athletic performance and increase muscle mass • oral administration rapid • buccal administration lengthens ½ life • IM administration can last 2-4 weeks varying rates of administration leads to significant fluctuation in testosterone levels • transdermal by gel or patch once daily application to intact nonscrotal skin (Androderm, Androgel, Axiron, Testim) well absorbed through skin and results in rises in serum testosterone levels within 2-4 hours. Testoderm rapid return to baseline within two hours of removal Effects • contraindications: male breast cancer, prostate cancer, pregnancy (X), lactation • transdermal not for use in women • increased risk for prostatic hypertrophy and prostatic carcinoma • drug interactionsanticoagulatns, diabetic agents, corticosteroids Side effects (When used in high doses) • hepatitis, hepatic neoplasms, cholestatic hepatitis, jaundice, gynecomastia, reduced sperm levels, acne, baldness, paradoxical decrease in libido, depression, headache, scrotal pain, priaprism, n/v Monitoring • goal is to have normal serum testosterone levels • check at baseline, 3 -6months after initiating, then annually while on treatment • Male patients  prostate-specific antigen (PSA) and digital prostate evaluation prior to initiation of therapy and throughout the duration of treatment due to the increased risk of prostate hypertrophy and cancer associated with androgens Antiandrogens

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