Hill welcome back to the real life. Pharmacology podcast I am your host Air Christianson. Today I'm going to cover testosterone so testosterone is a medication used primarily in the setting of GME so essentially This is replacement where patients are deficient in testosterone now from a mechanistic physiological standpoint testosterone and its derivatives are found in the body. They're classified as in Anchorage Trajan in Andrew Jans or really responsible for a creating maintaining up male characteristics and the development element of male sex organs. Now you've probably heard about steroids primarily through Abuse if you follow Allo Sports Athletics Track and Field Baseball. You name the sport and Testosterone has probably been associated aided with it As a potential drug To be diverted and in addition to those male characteristics and formation mation of those male sex organs Anabolic steroids like testosterone promote muscle building. So you can imagine regardless of your sport if you're bigger faster stronger. There's potential for abuse of these agents so definitely keep that in mind with testosterone for sure now one really unique thing about testosterone her own and the commercially available products of testosterone. Is there a ton of different drug formulations. We've got got you know intramuscular we've got Topical Testosterone like Gels and Patches Oral injectable actionable as far as We've got a subcutaneous pellets. For example that are kind of time released delayed release of testosterone so multiple multiple different Avenues to deliver testosterone in those patients. That needed one really important and What I think is an important patient? Education point particularly with topical agents especially topical agents. That have have strong. Systemic absorption is that risk of incidental exposure To others that may be helping pick up medications indications or closely intimate with those that Are Using these medications. And they're on the skin and probably most concerning with testosterone Is it does have some negative impacts if a patient a female is pregnant and they're exposed to that so be really really careful in educating patients that that may be using the topical Gel or the patches that you know skin to skin Contact with that GEL or coming in contact with that patch. That drug is obviously going to be absorbed through the skin. That's how we're using it in pregnancy and we can have some really negative outcomes there so Be Extremely careful with patients. Be Sure to educate them. about Those risks especially for those Topical agents now adverse drug reactions from testosterone asteroid. So you can probably think of some of the things that maybe you've heard associated with the abuse of steroids or her Andrew Genyk Anabolic Steroids So I think Acne you've also heard the term Maybe heard the term road rage. So you can have some emotional Changes You know more aggressive agitated anxiety insomnia things like that can happen from Excessive doses of testosterone in certainly in situations of abuse where people people are abusing these for their muscle building purposes. But in addition to that. You know you might say well. Why don't you know we use destroyed a little bit more often? Well there is more risks than just superficial risk and testosterone. Ken Raise Blood Pressure. And with that there's definitely associations with cardiovascular risks things like heart attacks strokes To stop strong can also increase lipids So again there were were creating Maybe exacerbating multiple risk factors That could increase the risk of cardiovascular events in addition there's association with DVD N.. P. Risks as welder older so lots of potential negatives from the use of testosterone. So we need to be really careful. I need to be paying attention into the patient population that we might be using this medication in as well. So let's take a quick break from our sponsor and we'll finish up On Drug Interactions. If you're in the market for board certification study material if you're a pharmacist pharmacy student. I GO CHECK OUT ALL OUR RESOURCES MED MED. One zero one DOT COM Slash Store S. T. O. R. E. In addition to all those exam resources We've we've got clinical books. clinical education. We've got audible books as well promotion. We have going on. You can get your free your first audible book for free. So if you've never listened to inaudible book go check out pharmacotherapy or thrill of the case. both are are excellent clinical pharmacy resources where I've shared a lot of my case studies and clinical pearls things that you actually see in. Clinical Iraq is so great way to get a little bit of experience without actually being in practice. So definitely go take take a look at those resources. support our sponsor minute one one dot com and support this podcast real-life pharmacology as well getting check. ALL THOSE OUT MED. One zero one DOT COM Slash Store S. T. O. R. E.. So let's finish up on. Drug interactions out with testosterone. There isn't a ton of clinically significant drug interactions that you need to be aware of but I'll highlight a few here So what is it can increase Concentrations are there is that potential to raise those orphaned concentrations which which could increase. Irr there so in a patient that you're starting testosterone. You're probably GONNA want to check in I in our and they're on more for new probably GonNa want to check in our You know within maybe a week of starting that testosterone also educate your patients. Beware Hey you you know. You're at increased. Risk Bleed Bruise. I keep it keep tabs on that and definitely let us know If you're having any troubles or concerns in that department even now corticosteroids When we say steroids in clinical in healthcare terms we generally think of corticosteroids so for an asthma exacerbation for rheumatoid arthritis flare? When we hear steroids we I generally think of okay? Yeah you know. We're talking about corticosteroids to reduce inflammation when we say steroids to the lay public You may get different results. There may be patients that have been on corticosteroids in the past for inflammation and they may recognize that that's what we're talking about But many patients that haven't I've been on steroids. They associate Steroids with testosterone in drugs of abuse. There there is a potential interaction in between the two. And it's more of an additive type of fact particularly with the risk of Fluid retention and Dima so if you're using them in combination with one another There may be some additive effects there to keep an eye out for and then we do have some alterations in Kind of glucose metabolism and things of that nature so patients who have diabetes and are taking agents that had a either are insulin or Stimulate the release of insulin in the body we can run into some risks of hypoglycemia Ziemia. So pay attention in a patient that you know. Maybe they're on design. Maybe they're on a you know a long acting. Insulin like glare gene keep an eye on those patients. Maybe a little bit closer when we first start that testosterone. Could you may see a little bit of a drop in a blood sugar in potentiate. Hinchey eight that risk for hypoglycemia. So I think that's going to wrap it up for today if you enjoyed the podcast if you found it helpful do us a huge huge favor. leave us a kind rating review on itunes or wherever. You're listening so so appreciative of all that have done that Also go go to real life. PHARMACOLOGY DOT COM. Snag Your Free Thirty one page. PDF simply I subscribing To follow the the blog or the podcast cast when we've got new releases and new episodes ready for release so Once you sign up you'll get that free. PDF thirty one pages of the top two hundred drugs And I highlight Really important clinical things that actually happen in real life with if those top two hundred drugs so go check that out again. Totally free resource just for following the real life pharmacology podcast. So I'm going to wrap it up for today. Thanks so much to all of you who have supported our sponsor met at one one dot com. If you haven't done so yet again go check out. Those resources there met at one DOT COM Slash Store S. T. O. R. E.. And thank you so much for listening take care and a great rest of your day.