Pharm2 4 Renal Androgens

Fosfomycin (Monurol) treats?

adult UTI / cystitis

Fosfomycin (Monurol) (adult UTI/Cystitis) MOA

bactericidal

inactivates enolpyruvyl transferase

Fosfomycin (Monurol) (adult UTI/Cystitis) interactions

vaccines, OCP

2nd most common bacterial STD

gonorrhea

<150 kg tx for urethritis gonorrhea

ceftriaxone 500 mg IM one dose

>150 kg tx for urethritis gonorrhea

ceftriaxone 1 g IM in one dose

tx for urethritis gonorrhea

ceftriaxone, and then azi/doxy for possible concurrent chlamydia infection

most common bacterial STD

chlamydia

tx of urethritis chlamydia

azi or doxy, give ceftriaxone for concurrent gonorrhea

usage of androgens

primary/secondary hypogonadism

For secondary, you can use androgens but should tx the cause

androgen SE in males*

 priapism

impotence (ED)

decreased spermatogenesis

gynecomastia

Stimulates growth of prostate

androgen SE in females*

acne

masculinization deepening of voice

menstrual irregularities

growth of facial hair

common meds with androgen (testosterone replacement)

androgel (transdermal gel)

depo-testosterone - parenteral

testim - transdermal

volgelxo - transdermal gel

jatenzo - po

Testosterone effects…

internal genitalia, skeletal muscle, bone

5a-dihydrotestosterone (DHT) effects…

external genitalia and hair follicles

prostate cancer pharm tx

androgen receptor antagonist

LHRH agonist

Androgen receptor antagonists name (prostate cancer)

-amide

flutamide, enzalutamide, bicalutamide, and nilutamide

LHRH agonist drugs

-relin

leuprolide, goserelin, triptorelin, histrelin

MOA of LHRH agonist (simple)

increase LHRH -> pituitary gland stops producing testosterone

flutamide freq

TID

bicalutamide freq

QD

admin of androgen receptor antagonists

PO

Androgen receptor antagonists SE

hot flashes

gynecomastia

pain

constipation

MOA of flutamide

antiandrogen, 2-hydroxyflutamide inhibits androgen uptake

flutamide is metabolized where

in liver → watch hepatotoxicity

freq of leuprolide (lupron) (prostate cancer)

SC QD

LHRH/GnRH agonists (prostate cancer) MOA

increase LHRH -> pituitary gland stops producing testosterone, inhibits gonadotropin release

LHRH/GnRH agonists (prostate cancer) SE

tumor flare (worsening of sx after starting tx)

hot flashes

asthenia (lack of energy/weak)

gynecomastia