Gynecomastia

Gynecomastia may be associated with the use of spironolactone and is reversible upon withdrawal of the dmg. 

Spironolactone antagonizes the effects of aldosterone by binding at the aldosterone receptor in the cytosol of the late distal tubules and renal collecting ducts. Side effects of spironolactone are gynecomastia, decreased Hbido, and impotency. 

Gynecomastia Addison syndrome Hyponatremia Comeal opacity... 

Hyperkalemia (increase in potassium in the blood), a serious event, may be seen with the administration of potassium-sparing diuretics. Hyperkalemia is most likely to occur in patients with an inadequate fluid intake and urine output, those with diabetes or renal disease tiie elderly, and those who are severely ill. In patients taking spironolactone, gynecomastia (breast enlargement in tiie male) may occur. This reaction appears to be related to both dosage and duration of therapy. The gynecomastia is usually reversible when therapy is discontinued, but in rare instances, some breast enlargement may remain. 

Fbtassium-sparing diuretics Avoid eating foods high in potassium and avoid the use of salt substitutes containing potassium. Read food labels carefully. Do not use a salt substitute unless a particular brand has been approved by the primary health care provider. Avoid the use of potassium supplements. Male patients taking spironolactone may experience gynecomastia. This is usually reversible when therapy is discontinued. 

Headache, edema, irritability, fatigue, nervousness, restlessness, precocious puberty, gynecomastia Vasomotor flushes, breast tenderness, abdominal discomfort, blurred vision, ovarian enlargement, nausea, vomiting, nervousness Same as glucocorticoids (Display 50-2)... 

In men, administration of an androgen may result in breast enlargement (gynecomastia), testicular atrophy, inhibition of testicular function, impotence, enlargement of the penis, nausea, jaundice, headache, anxiety, male pattern baldness, acne, and depression. Fluid and electrolyte imbalances, which include sodium, water, chloride, potassium, calcium, and phosphate retention, may also be seen. 

Hot flashes, loss of libido, impotence, diarrhea, nausea, vomiting, gynecomastia... 

Headache, dizziness, intolerance to contact lens, edema, thromboembolism, hypertension, nausea, weight changes, testicular atrophy, acne, breast tenderness, gynecomastia... 

Eplerenone 25 mg once 50 mg once baseline and within 1 week of initiation and dose titration Adverse effects gynecomastia or breast tenderness, menstrual changes, hirsutism... 

Domperidone minimally crosses the BBB it acts in the CTZ which lies outside of the BBB. As such, domperidone is less likely to cause the centrally-mediated adverse effects seen with metoclopramide and has an estimated overall incidence of 5% to 10%.1,30 However, domperidone has been associated with prolonged QT intervals, cardiac arrhythmias, and sudden death.31 It should not be used for patients with underlying long QT interval or for those on other medications that prolong the QT interval. Both metoclopramide and domperidone can cause hyperprolactinemia, galactorrhea, and gynecomastia. 

Changes in steroidal hormone production, conversion, and handling are also prominent features of cirrhosis. These changes can result in decreased libido, gynecomastia (development of breast tissue in men), testicular atrophy, and features of... 

Nonspecific signs on physical exam include jaundice, tea-colored urine, bruising, hepatomegaly, splenomegaly, spider angiomata, caput medusae, palmar erythema, gynecomastia, and testicular atrophy. 

Doses should be titrated at intervals no more frequent than every 2 to 3 days. Because spironolactone is used for its antialdosterone effects, much higher doses (up to 400 mg/day) are used than those used when treating hypertension. If intolerable side effects such as gynecomastia occur with spironolactone, other potassium-sparing diuretics may be used, but clinical trials have not shown equivalent efficacy.22... 

P-hydroxylase 16 g/day in 3-4 gynecomastia. Lower rate of relapse when used... 

Decreased libido, decreased energy, erectile dysfunction, impotence, decreased sperm production, infertility, gynecomastia, and rarely, galactorrhea. 

General side effects of testosterone include gynecomastia, dyslipidemia, polycythemia, and acne. Weight gain,... 

Estramustine, an oral drug, also inhibits microtubule assembly and has weak estrogenic activity at the estradiol hormone receptors of the cell. Approximately 75% of a dose of estramustine is absorbed.15 The terminal half-life ranges between 20 to 24 hours, with nonrenal excretion as the major route of elimination. This drug is used primarily for the treatment of prostate cancer, but its use is limited by the side effects, which include nausea and vomiting, diarrhea, thromboembolic events, and gynecomastia. 

Flutamide is an androgen receptor antagonist that achieves peak concentrations approximately 2 to 4 hours after an oral dose. Flutamide is metabolized extensively, with a terminal half-life of about 8 hours. Bicalutamide achieves peak concentrations approximately 6 hours after the dose, with a terminal half-life of 6 to 10 days. Bicalutamide undergoes stereospecihc metabolism, where the S-enantiomer is cleared more rapidly by the liver than the -enantiomer. Nilutamide achieves peak serum concentrations between 1 to 4 hours after an oral dose and has a terminal half-life of 38 to 60 hours. Nilutamide is metabolized extensively, with less than 2% excreted as unchanged drug by the kidney. Side effects common to these agents are hot flashes, gynecomastia, and decreased libido. Flutamide tends to be associated with more diarrhea and requires three-times-daily administration, whereas bicalutamide is dosed once daily. Nilutamide may cause interstitial pneumonia and is associated with the visual disturbance of delayed adaptation to darkness. 

Flutamide 750 mg/day Gynecomastia Hot flushes Gastrointestinal disturbances (diarrhea) Liver function test abnormalities Breast tenderness Methemoglobinemia... 

Estramustine -inhibitor of microtubules -nausea and vomiting -headache -edema -impotence -gynecomastia -increases thromboembolic risk... 

Flutamide -nonsteroidal antiandrogen -endocrine effects -hot flashes -decreased libido -gynecomastia -impotence -galactorrhea -diarrhea -nausea and vomiting -myalgias -elevated liver function tests... 

A 50-year-male with pitting edema of the ankles develops gynecomastia and erectile dysfunction while being treated with which of the following agents ... 

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