reproductive system

• conjugated equine estrogens (Premarin)
• others: estradiol (Estrace, Bagifem), estradiol hemihydrate (Estrasorb)

block bone resorption and lower LDL levels. at high levels, suppress release of FSH needed for concetion

• contraception 
• relieve postmenopausal symptoms
• prevent postmenopausal osteoporosis 
• tx of dysfunctional uterine bleeding 
• tx of prostate cancer

• -endometrial and ovarian cancers (when prolonged estrogen is the only postmenopausal therapy) 
• -breast cancer
• -embolic event

• estrogen can reduce effect of warfarin 
• -use with phenytoin can decrease effects of estrogens 
• -steroids increase effects of estrogen 
• -smoking increase risk for thrombophlebitis

• medroxygprogesterone (Provera)
• other: norethindrone (Micronor), megestrol acetate (Megace)

induce favorable conditions for fetal growth and development and maintain pregg. drop in progesterone levels result in menstruation.

• for contraception
• -dysfunctional uterine bleeding
• -Amenorrhea 
• -Endometriosis 
• -advanced cancer of breast, endometrium, and kidney

• breast cancer 
• -thromboembolic events 
• -bleeding
• -edema
• -jaundice (liver toxicity) 
• -migraine headaches

estrogen-progestin/OCs

• thromboembolic events 
• -HTN
• -uterine bleeding 
• -breast cancer

• testosterone (Androderm-50, Testopel)
• others: methyltestosterone (Android, Testred)

• develop sex traits in men and production and maturation of sperms 
• -increase skeletal muscle 
• -increase synthesis of erythropoietin

tx hypogonadism in males, delayed puberty in boys, testicular failure, anemia (unresponsive to normal therapy), postmenopausal breast cancer, muscle wasting (males with AIDs)

• -androgenic effect 
• -epiphyseal closure 
• -hypercholesterolemia 
• -polycythemia (too much RBC)
• -edema from salt and water retention 
• -high abuse
• -hepatitis, jaundice 
• -increase growth of prostate cancer

• finasteride (Proscar, Propecia)
• others: dutasteride (Avodart)

• decreases usable testosterone by inhibiting the converting enzyme, and causes reduction of prostate size and increase hair growth
• (to treat prostate enlargement)

• benign prostate hyperplasia (BPH)
• male pattern baldness

• decrease libido, ejaculate volume
• -gynecomastia 
• -orthostatic hypotension

the preggos

by wearing gloves

unless they have stop taking the drug at least 1 month

at least 6 months or longer

• selective Alpha1 -adrenergic antagonists: tamsulosin (Flomax)
• others:
• selective Alpha1 -adrenergic antagonists: silodosin (Rapaflo)
• nonselective Alpha1 -adrenergic antagonists : Alfuzonsin (Uroxatral)
• Terazosin
• Doxazosin (Cardura)

decrease mechanical obstruction of the urethra by relaxing smooth muscles of the bladder neck and prostate 

nonselective agents lowers bp, for BPH and HTN

for BPH (thus increase urinary flow)

• -Hypotension 
• -problems with ejaculation

tamsulosin should be taken 30 mins after a meal at the same time each day

sildenafil (Viagra) 

others: tadalafil (Cialis), vardenafil (Levitra)

augments effects of nitric oxide released during sexual stimulation, results in enhancing blood flow to the corpus cavernosum and penile erection

• MI, sudden death 
• Priapism

• -contraindicated in patients taking any meds in the nitrate family (nitroglycerin) 
• -grapefruit juice may increase plasma conc. and possible adverse effects