Drugs Affecting the Male Reproductive System

Androgens: Therapeutic Actions

growth of male sex organs

increase protein anabolism

decrease protein catabolism

increase RBC production

increase nitrogen, sodium, potassium retention

decrease urinary calcium excretion

Androgens: Indications

Testosterone: hypogonadism

Danazol: endometriosis, fibrocystic breast disease, hereditary angioedema

Androgens: Pharmoacokinetics

well absorbed

widely distributed

metabolized in liver

excreted in urine

Androgens: Contraindications

pregnancy/lactation

prostate or breast cancer

liver dysfunction

cardio disease

Androgens AEs

virilization in prepubescent males (deep voice)

gynecomastia

pirapism (long painful erections)

testicular atrophy

baldness

electrolyte changes

hepatocellular cancer (long term)

Drug Interactions of Androgens

interactions w/oral anticoagulants and antidiabetic agents

decreased thyroid function —> increased creatine clearance

may decrease blood glucose, requiring insulin adjusted doses

Nursing Considerations for Androgens

Monitor CBC, INR/PT, glucose levels, and liver enzymes regularly

Erectile Dysfunction Drugs

PDE5 Inhibitors and Prostaglandin

PDE5 Inhibitors

increase cGMP —> cause smooth muscle relaxation

allow penile erection w/stimulation

Exs: Sildenafil, Tadalafil, Vardenafil, Avanafil (end w/-nafil)

AEs of PDE5 Inhibitors

headache

flushing

hypotension

vision changes

hearing loss

PDE5 Inhibitors Contraindications

use of nitrates

severe hypo/hypertension

retinitis pigmentosa

severe hepatic or renal disorders

congenital prolonged QT interval

PDE5 Inhibitors Drug Interactions

nitrates

alpha-adrenergic blockers

CYP3A4 inhibitors—> increase drug lvls

grapefruit juice—> increases drug lvls

avoid alcohol

Prostaglandin ED Drug

local vasodilation—> increases blood flow

injected ror urethral pellet

rapid onset

Ex: Alprostadil

Nursing Considerations for Prostaglandin ED Drug

Teach sterile injection technique​

Monitor for fibrosis, bruising, infection​

Assess for priapism

Which statement about androgen production is correct?

C. Testosterone is produced in the testes, and other androgens are produced in the adrenal glands

Which erectile dysfunction medication requires local penile inspection for injection-site reactions?

D. Alprostadil (Caverject, Muse)