Drugs for Mens Health

and
Reproductive Disorders

57
MSN/ED, ARNP

Chapter
T. Holloman,

Testes
Androgen the primary hormone of
male reproductive system
Contributes to growth, health,
maintenance
Responsible for maturation of male sex
organs
Responsible for secondary sex
characteristics of men

Hormonal
control of the
male
reproductive
hormones

Androgens
Used to treat
hypogonadism in
males
Primary hypogonadism
due to testicular failure
Secondary due to lack
of follicle-stimulating
hormone (FSH) or
luteinizing hormone
(LH)

Androgens
Prototype drug: Testosterone
Mechanism of action: Stimulates RNA synthesis
and protein metabolism
Primary use: for treatment of hypogonadism in
males; given IM in gluteal muscle

Adverse effects: virilization

Salt and water often retained
Causes edema, liver damage, acne and skin
irritation
Priapism, Gynecomastia, Oligospermia
Hives or redness at injection site (Common)

Role of the Nurse: Androgen Therapy for Hypogonadism

Monitor VS
Monitor lab results, especially liver
enzymes
Monitor weight; I/O
Monitor serum cholesterol, especially
with history of MI or angina
This drug can increase this lab value

Role of the Nurse: Androgen Therapy for Hypogonadism

Drug Administration
Oral-same time daily
Patches to scrotal area after shaving
(rotate sites)
Gels-to upper torso, extremities, or
abdomen

(AVOID CONTACT WITH WOMEN

AND CHILDREN!!!)

Erectile Dysfunction
Common disorder associated with:
Physical conditions (atherosclerosis,
diabetes, kidney disease, stroke,
hypertension)
Psychogenic causes
Depression, fatigue, guilt, fear of failure

Agents for Erectile DysfunctionPhosphodiesterase-5 Inhibitor

Prototype drug: sildenafil (Viagra)

Vardenafil (Levitra); Tadalafil (Cialis)

Mechanism of action: Relaxes

smooth muscle in corpus
cavernosum
Blocks enzyme phosphodiesterase-5
Allows increased blood flow into penis

Primary use: to treat erectile

dysfunction

Agents for Erectile DysfunctionPhosphodiesterase-5 Inhibitor

Adverse effects: Most serious is

hypotension (AVOID NITRATES!)
Headache, dizziness, flushing, rash
Nasal congestion, diarrhea, dyspepsia
UTI, chest pain, indigestion
Blurred vision, changes in color
perception, priapism

Natural Products for Erectile

Dysfunction
Herbs used for sexual
performance
Yohimbine
Ginseng
Damiana
Ginkgo biloba
Muira puama
Tribulus terrestris

Role of the Nurse: Pharmacotherapy

for Erectile Dysfunction
Obtain physical exam and history
Impaired sexual function
Cardiovascular disease
Presence of emotional disturbances
Monitor results of lab tests related to
liver function
A blood-flow test used to determine if
sufficient blood flow to penis

Benign Prostatic Hyperplasia (BPH)

Enlargement of
prostate
Obstructs urethra
and
decreases flow
Not precursor to
cancer

Benign Prostatic Hyperplasia

(BPH)
Symptoms
Increased urinary frequency, urgency
Leakage, nocturia, decreased force
Incomplete emptying of bladder

Aggravating factors
Alpha-adrenergic agonists,
anticholinergics, testosterone
Caffeine, alcohol, fluids at bedtime

Severe disease requires surgery

Agents for Benign Prostatic

5-alpha reductase inhibitors
**Finasteride(Proscar);
Dutasteride(Avodart)
Promotes shrinkage of enlarged prostates
Assess for changes in urinary elimination
Monitor for hypotension
Monitor for sexual dysfunction

Agents for Benign Prostatic

Alpha-adrenergic blocking agents
**Tamsulosin (Flomax); Doxazosin (Cardura);
Terazosin (Hytrin)
Relaxes smooth muscle of urethra
Use cautiously in patients with asthma or heart
failure
Cause bradycardia and bronchoconstriction
Depression common side effect

Role of the Nurse: Drug Therapy with Antiprostatic Agents

for BPH

612 months of treatment for maximum

benefit
Monitor for impotence, decreased volume
of ejaculate, or decreased libido
Monitor PSA levels and hepatic function
Protect exposure from Women of child
bearing age and Children

HERBAL ALERT
Saw Palmetto can help shrink
enlarged prostate gland;
discontinue herb 1 to 2 weeks
before PSA test

Questions