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Related Concept Videos

Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
GPCRs Regulate Adenylyl Cylase Activity01:09

GPCRs Regulate Adenylyl Cylase Activity

Some GPCRs transmit signals through adenylyl cyclase (AC), a transmembrane enzyme. AC helps synthesize second messenger cyclic adenosine monophosphate (cAMP). AC catalyzes cyclization reaction and converts ATP to cAMP by releasing a pyrophosphate. The pyrophosphate is further hydrolyzed to phosphate by the enzyme pyrophosphatase, which drives cAMP synthesis to completion. However, cAMP is rapidly degraded to 5′ AMP by the enzymes phosphodiesterase (PDE), preventing overstimulation of cells.
Two...
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...

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Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies
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Drug-induced gynecomastia.

Ari Eckman1, Adrian Dobs

  • 1Johns Hopkins University School of Medicine, 1830 E. Monument Street, Baltimore, MD 21287, USA. adobs@jhu.edu

Expert Opinion on Drug Safety
|November 6, 2008
PubMed
Summary

Drug-induced gynecomastia affects 10-25% of cases, stemming from various medication mechanisms. Treatment involves stopping the drug or hormonal therapies like testosterone, tamoxifen, or aromatase inhibitors.

Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Gynecomastia, the enlargement of male breast tissue, can be a side effect of numerous medications.
  • Drug-induced gynecomastia accounts for a significant percentage of all cases, ranging from 10% to 25%.

Purpose of the Study:

  • To review common medications causing gynecomastia.
  • To elucidate the pathophysiologic mechanisms behind drug-induced gynecomastia.
  • To discuss potential treatment strategies for drug-induced gynecomastia.

Main Methods:

  • Literature review of common drugs associated with gynecomastia.
  • Analysis of pathophysiologic mechanisms including exogenous estrogen exposure, hypogonadism, anti-androgenic effects, and hyperprolactinemia.
  • Discussion of treatment options based on underlying mechanisms.

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Main Results:

  • Several drug classes can induce gynecomastia through diverse mechanisms.
  • Exogenous estrogen exposure, hypogonadism, anti-androgenic effects, and hyperprolactinemia are key pathophysiologic pathways.
  • Treatment efficacy varies depending on the causative agent and patient's hormonal status.

Conclusions:

  • Discontinuation of the offending medication is the primary treatment for drug-induced gynecomastia.
  • Hormonal replacement therapy, such as testosterone, may be indicated for hypogonadism.
  • Anti-estrogens like tamoxifen or aromatase inhibitors can be considered for eugonadal patients.