Deck 71: Drugs for Disorders and Conditions of the Male Reproductive System

Question 1

dorrie Jones, a 72-year-old white male, has been having difficulty with urinary -gquency and excessive nighttime urination. He scheduled an appointment 0 his health care provider and is diagnosed with BPH. He is prescribed fin?dende (Proscar) and needs to see his health care provider again in 6 months.
How would you explain the purpose of finasteride (Proscar) in treating BPH?

Answer 1

Benign prostatic hypertrophy (BPH) is an abnormal enlargement of prostate gland. Prostate gland is a bilobed structure, which surrounds the urethra close to its origin from the bladder. The diameter of the gland is just 3 cms. This gland is actually a combination of 30 to 50 compound tubuloacinar glands. The gland empties its contents into the urethra through pores in the wall of the urethra. The function of this gland is to pour an alkaline secretion into the semen as it passes through the urethra.
BPH is commonly seen in case of older adults after 60 years of age. The exact cause of BPH is not known, but is associated with the family history, heavy alcohol consumption, cigarette smoking, hypertension, diabetes and eating fatty diet.
Finasteride (proscar) acts by inhibiting the metabolism and testosterone production thus results in shrinkage of the prostate glands. This drug inhibits the "5-alpha reductase" that coverts testosterone into 5-alpha dihydrotestosterone, which is needed for the prostate cell proliferation.
Finasteride also decreases the mechanical obstruction of the urethra, which is common symptom of BPH. Thus, finasteride is used in the treatment of BPH.

Question 2

Anabolic steroids are often taken illegally by "stacking" or "pyramiding." From whatyou learned in Chapter 27, define the use of these terms in the abuse of these drugs.

Answer 2

Different patterns of usage are followed by the users of steroid drugs, which are commonly called anabolic steroid cycles. These patterns are used to minimize the side effects of the drug and to accelerate the chance of meeting the end result in a short time. The different patterns include cycling, stacking, and pyramiding.
Stacking is taking the multiple anabolic steroids of different classes over a scheduled period of time and repeating the same again. In this process, different classes of steroids are combined believing that they can produce pronounced effect rather than taking individual drugs.
In pyramiding type of steroid use, the drugs are initially started with a low dose, the dose and or the frequency of intake is gradually increased. At the mid, again the dose is gradually decreased to zero.

Question 3

Remember the patient "Mike Mayhew" at the beginning of the chapter? Now read the remainder ofthe case study. Based on the information presented within this chapter, respond to the critical thinking questions that follow.

One year after his divorce, Mike, a 54-year-old white male, began dating and soon met Dana. The couple found that they had a lot in common and enjoyed each other's company. As the relationship grew, the couple became more intimate and sexually involved. However, the emotional scars from his previous marriage were painful and deeply affected him.
After the divorce, Mike was depressed and had low self-esteem. The condition required short-term hospitalization, and he now follows up on an outpatient basis with a psychiatrist. He has been taking antidepressants and was recently prescribed tadalafil (Cialis) for a diagnosis of ED. Mike also has a past history of HTN and is taking nifedipine (Procardia).
What factors in Mike's life and health history do you think are contributing to the diagnosis of ED?

Answer 3

The inability of an individual to develop or maintain the erection of the penis during sexual activity is called erectile dysfunction. The cause of penile erection is hydraulic effect where the blood enters and is retained in sponge-like bodies with in the penis. During the process of erection, the signals are transmitted from brain to nerves in the penis, which results in sexual arousal.
The following are the two major causes contributing to the erectile dysfunction (ED) in "M" in the given case study:
• Using nifedipine (a calcium channel blocker)
• Depression
Calcium channel blockers cause decreased sympathetic activity, which interfere with the erection. During depression, ED is a common problem in men due to the decreased neuronal transmission of monoamines such as noradrenaline and serotonin.
Sildenafil is sold as Viagra in the market. This drug is used to treat erectile dysfunction or impotence and pulmonary arterial hypertension.

Question 4

dorrie Jones, a 72-year-old white male, has been having difficulty with urinary -gquency and excessive nighttime urination. He scheduled an appointment 0 his health care provider and is diagnosed with BPH. He is prescribed fin?dende (Proscar) and needs to see his health care provider again in 6 months.
What education would you provide Mr. Jones that he may find helpful in dealing with BPH?

Question 5

Clomiphene is used for both male and female infertility. From what you learned in Chapter 69, how does this drug act to improve female fertility?

Question 6

Remember the patient "Mike Mayhew" at the beginning of the chapter? Now read the remainder ofthe case study. Based on the information presented within this chapter, respond to the critical thinking questions that follow.

One year after his divorce, Mike, a 54-year-old white male, began dating and soon met Dana. The couple found that they had a lot in common and enjoyed each other's company. As the relationship grew, the couple became more intimate and sexually involved. However, the emotional scars from his previous marriage were painful and deeply affected him.
After the divorce, Mike was depressed and had low self-esteem. The condition required short-term hospitalization, and he now follows up on an outpatient basis with a psychiatrist. He has been taking antidepressants and was recently prescribed tadalafil (Cialis) for a diagnosis of ED. Mike also has a past history of HTN and is taking nifedipine (Procardia).
If you were the nurse, what patient education instructions would you provide to Mike regarding administration of tadalafil (Cialis) along with nifedipine (Procardia)?

Question 7

dorrie Jones, a 72-year-old white male, has been having difficulty with urinary -gquency and excessive nighttime urination. He scheduled an appointment 0 his health care provider and is diagnosed with BPH. He is prescribed fin?dende (Proscar) and needs to see his health care provider again in 6 months.
What additional health history and physical assessment findings would be considered in diagnosing this condition?

Question 8

Alpha 1 -adrenergic blockers are very susceptible to causing the "first-dose phenomenon." From what you learned in Chapter 16, define this phenomenon and describe what should be done to minimize its effects.

Question 9

Remember the patient "Mike Mayhew" at the beginning of the chapter? Now read the remainder ofthe case study. Based on the information presented within this chapter, respond to the critical thinking questions that follow.

One year after his divorce, Mike, a 54-year-old white male, began dating and soon met Dana. The couple found that they had a lot in common and enjoyed each other's company. As the relationship grew, the couple became more intimate and sexually involved. However, the emotional scars from his previous marriage were painful and deeply affected him.
After the divorce, Mike was depressed and had low self-esteem. The condition required short-term hospitalization, and he now follows up on an outpatient basis with a psychiatrist. He has been taking antidepressants and was recently prescribed tadalafil (Cialis) for a diagnosis of ED. Mike also has a past history of HTN and is taking nifedipine (Procardia).
After considering both options, Mike would rather be prescribed sildenafil (Viagra) instead of tadalafil (Cialis). What should the health care provider discuss with Mike about this request?