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Reproductive Pharm

Terms in this set (74)

Hypothalamus-Pituitary-Testis axis?
(pulsatile) GnRH --> FSH and LH --> Sertoli and Leydig --> spermatogensis and testosterone
How is the HPT axis regulated?
testosterone negatively feedbacks both to the anterior pituitary to inhibit LH release and to the hypothalamus to inhibit GnRH release
Testosterone
made by Leydig cells, regulates male reproductive function, rapidly metabolized by liver
How are testosterone esters different?
more lipophilic and can be admin in an oil suspension IM for prolonged release
DHT
converted from testosterone by 5a reductase
major male sex hormone in skin, prostate, SV, epididymis
Methyltestosterone
synthetic analog, common abused by athletes, hepatotoxic
Clinical uses?
-androgen replacement therapy IF SPERMATOGENESIS IS NOT REQUIRED
-anabolic agent
-anabolic steroid abuse, given at 10-200x normal, controlled substances and classified as Schedule 3
Adverse Effects?
-women: virilization including hirsutism, acne, ameorrhea, clitoral enlargement, deepening of voice
-hepatic dysfunction
-azoospermia
-hepatic adenomas and carcinomas after high doses
-high doses produce addiction, increased aggressiveness, psychotic sx
Why are androgen receptor antagonists not used alone?
cause reflex increase in LH secretion that causes increased testosterone synthesis adn release
How are androgen receptor antagonists used?
in conjunction w/GnRH for treatment of metastatic prostate cancer
What is an example of an androgen receptor antagonist?
Flutamide (also used to treat female hirsutism)
What 2 classes of drugs are used to treat BPH?
smooth muscle relaxants and 5a reductase inhibitors
Examples of smooth muscle relaxants (a1 adrenergic receptor antagonists)?
Alfuzosin, Tamsulosin, Silodosin, Terazosin, Doxazosin
Alfuzosin
uroselective, little CV effects at dose
Tamsulosin
little effects on peripheral vascular resistance and hypotension
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