NUR 221- Men's Health

initiates spermatogenesis

stimulates testosterone production

maturation of sperm, sex characteristics, protein metabolism, muscle development

major endogenous androgen: Testosterone

expression of male sex characteristics

management of androgen deficiency in males

virilization and hepatotoxicity

overproduction of androgens

• development of male sex characteristics

skeletal muscle

• synthesis of erythropoietin

• men have higher hematocrit than women

delayed puberty

• patient takes until initial signs of puberty begin

  • enlargement of testes is first sign of puberty

• virilization in women, girls and boys

• premature epiphyseal closure (hinders growth)

• prostate cancer

• abuse potential (athletic performance)

• IM T esters

• transdermal T patches

• transdermal T gels

• transdermal T under arms

• hypertension, suppression of release of LH and FSH, testicular shrinkage, sterility, gynecomastia, acne, reduced HDL, increase in LDL

• renal damage

• intensified aggression

schedule III drugs are defined as those with a low to moderate potential for dependence

• prostate becomes huge and obstructs urination

• hyperplasia of prostatic tissue

• compression of urethra and urinary obstruction

• related to estrogen-testosterone imbalance

  • DOES NOT PREDISPOSE PROSTATIC CARCINOMA (cancer)

• leads to frequent infections

• continued obstruction causes distended bladder, dilated ureters, hydronephrosis, and renal failure if untreated

• hesitancy to start flow

• dribbling

• decreased flow strength

• increased frequency and urgency

• nocturia

• Dutasteride (Avodart)- slows enlargement

• Tamsulosin (Flomax)- smooth muscle relaxer

• Combo of Finasteride (Proscar) and Doxazosin (Cardura)- reduces progression of hypertrophy

• Surgery

may cause sudden drop in BP

gland is tender + swollen, urine and secretions contain bacteria

urine and secretions contain large numbers of leukocytes

gland only slightly enlargement, dysuria, frequency and urgency

• sign of physical or psychological condition

• can be secondary to other conditions

• can be caused by medications

• relationship strain

• poor self-esteem

• HTN meds (beta blockers, thiazide and loop diuretics)

• Antidepressants

• Anti-hyperlipidemics

• Phosphodiesterase (PDE) inhibitors

• Sildenafil (Viagra)

• Vardenafil (Levitra)

• Tadalafil (Cialis)

  • similar to viagra but longer duration of action

  • Sildenafil and Tadalafil also used to treat pulmonary hypertension

Priapism

• erection lasts > 4 hours

  • may cause ischemia

• seek medical attention

• aspiration

Nitrates (nitroglycerine)

• nitrates are contraindicated in patients taking PDE inhibitors

  • may be given in emergency situations if at least 24-48 hours after last dose of PDE inhibitor medications

administered by injecting it directly into the erectile tissue of the penis or pushing a suppository form of the drug into the urethra