Pharm 2 final - HORMONES, TRANSFUSION, MED SAFETY

Testosterone general

• PRODUCED IN GONADS (LEYDIG CELLS - LH)

• Libido and sexual function.

• Muscle mass and strength

• Bone density.

• Secondary sex characteristics

ALSO INDIRECT SPERM FUNCTION

DECLINES WITH AGE

• obesity insulin resistance, sleep apnea, stress

Male midlife presentation

Fatigue or reduced energy.
• Central weight gain
• Reduced muscle mass.
• Low mood, irritability, or poor sleep.
• Lower urinary tract symptoms: frequency, hesitancy, nocturia, weak stream
• Lower libido.
• Erectile dysfunction.

ED vs low libido

• ED » Difficulty achieving or maintaining an erection sufficient for sexual activity. Vascular, neurologic, hormonal, medication-related,

• Low libido » reduced desire

hypogonadism - general

• PRIMAIRILY LOW T

• Symptoms» Fatigue, changes in cognition decreased libido, mood changes, Decrease muscle mass + bone mineral density

TREAT WITH T - CAN DISTRUPT NORMAL PATHWAY WITH FSH LH AND GnRH

(↑ levels = less GnRH release = less FSH and LH, less stim to testes → lower body T and sperm production)

• ask about fertility goals

• review history of prostate and urinary symp

• Consider cardiovascular history Increase RBC production, increase HCT = increased risk for stroke

• Monitor for mood changes, acne or oily skin, gynecomastia, swelling, or fluid retention.

PdE 5 inhibitors “fil/nafil”

USED IN ED - blood vessel dilation and smooth muscle relaxation in heart, lungs and genitals

• MONITOR CARDIAC NITRATE HYPOTN, urgent symp

• support erection during sexual stimulation. - They do not independently create sexual desire or arousal

Take as prescribed

DONT COMBINE WITH NITRATES + USE CAUTOPN WITH A BLOCKERS AND ANTIHYPERTENSIVES

BPH pharm general

• symp » Hesitancy or delayed start, Weak stream, Nocturia, Frequency or urgency, Incomplete emptying, Urinary retention in more severe cases

Alpha 1 blockers » TAMSULOSIN - relax smooth muscles in prostate or bladder IMPROVE URINE SYMP (dizziness and orthohypotn can occur)

5 alpha reductase inhibi » steride - reduce T to DHT (contributes to prostate growth)