Androgens, Androgen Inhibitors, and Phosphodiesterase Inhibitors
TERMS
□ oxandrolone (Oxandrin)
□ sildenafil (Viagra)
□ testosterone (Testoderm, Depo-Testosterone, Androderm)
QUICK LOOK AT THE CHAPTER AHEAD
Androgens are the male sex hormones produced by the testes, ovaries, and adrenal cortex. They stimulate spermatogenesis, development of male secondary sex characteristics, and sexual maturity at puberty. Testosterone is the major endogenous androgen and is the prototype of the androgenic hormones. Androgens also have anabolic effects, which stimulate the formation and maintenance of muscular and skeletal protein. Athletes have used androgens to increase athletic performance, which has led to abuse of androgens. Androgens are considered controlled substances and are classified as Schedule III drugs. They have serious adverse effects such as hepatotoxicity, and their risks outweigh their benefits in increasing athletic performance.
Chemical derivatives of testosterone are known as anabolic steroids. They have a high anabolic activity.
Androgen inhibitors block the effect of endogenous androgens, inhibit the enzyme 5-alpha-reductase, and are called 5-alpha-reductase inhibitors. They are used to stop prostatic growth in benign prostatic hypertrophy (BPH).
Phosphodiesterase inhibitors enhance the effects of nitric oxide, a chemical that relaxes smooth muscle and increases blood flow to the penis during sexual stimulation.
Table 61-1 Androgens, Androgen Inhibitors, and Phosphodiesterase Inhibitors | ||||||||||||||||||
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ANDROGENS, ANDROGEN INHIBITORS, AND PHOSPHODIESTERASE INHIBITORS CLIENT TEACHING
All Androgens and Androgen Inhibitors
Take exactly as prescribed, dose is tapered before being discontinued, and do not discontinue without consulting with health care provider.
Advise other health care providers (eg, specialist, surgeon, dentist) about medication use before surgery or treatment.
Continue regular follow-up care with health care provider with periodic laboratory testing.
Androgens
Instruct male clients to report priapism or gynecomastia to health care provider.
Instruct female clients to report signs of virilism to health care provider.
Report yellowing of skin (jaundice), hypercalcemia, bleeding, bruising, edema, and weight gain to health care provider.
Explain the importance of not using androgens for athletic performance and the potential risk of serious adverse effects.
Diabetic clients need to monitor blood sugars for changes as androgens may cause hypoglycemia if taking insulin or oral hypoglycemics.
Transdermal Testosterone
Apply to clean, dry, hairless area; do not use depilatories.
May be reapplied after swimming or bathing
Testoderm is applied to the scrotum.
Androderm is applied to abdomen, back, thighs, or upper arms. (Do not apply to scrotum.)
If female sexual partner develops symptoms of virilization, notify health care provider.
Finasteride (Proscar, Propecia)
Females who are pregnant or may become pregnant should avoid exposure to semen of client taking drug and should not handle crushed form of drug because of the potential for absorption as finasteride poses a potential risk to a male fetus.1
May need to take drug for 6 to 12 months to determine if client is responsive to therapy.
Libido and volume of ejaculate may be decreased during therapy.1
Females who are pregnant or may become pregnant should avoid exposure to semen of client taking drug and should not handle crushed form of drug because of the potential for absorption as finasteride poses a potential risk to a male fetus.1