00 Male Issues Flashcards
What is the normal range for Prostate Specific Antigen (PSA)?
0-4 ng/mL
What are some medications that may worsen BPH?
Anticholinergics (TCAs, antipsychotics, etc), Antihistamines, Decongestants, Diuretics, Caffeine
What is the generic name of Hytrin?
Terazosin - BPH (Non-selective Alpha-1 blocker)
What is the generic name of Cardura?
Doxazosin - BPH (Non-selective Alpha-1 blocker)
What is the generic name of Uroxatral?
Alfuzosin - BPH (Non-selective Alpha-1 blocker)
What is the generic name of Flomax, Jalyn?
Tamsulosin - BPH (Selective Alpha-1a blocker)
What is the generic name of Rapaflo?
Silodosin - BPH (Selective Alpha-1a blocker)
What is important to know about Alpha-1 blockers in BPH?
1st dose phenomenon (orthostatic hypotension), dose at night. Does NOT affect PSA levels nor shrink the prostate. Can cause Priapism
What is important to know about 5-alpha reductase inhibitors in BPH?
Associated with prostate SHRINKAGE and symptom improvement. Delayed onset of response vs alpha blockers
What is the generic name of Proscar?
Finasteride - BPH (5-alpha reductase inhibitor)
What is the generic name of Avodart, Jalyn?
Dutasteride - BPH (5-alpha reductase inhibitor)
What pregnancy category are the 5-alpha reductase inhibitors used for BPH?
Category X
What are the main ADRs for 5-alpha reductase inhibitors for BPH?
Sexual dysfunction, Breast swelling and tenderness
What is the generic name of Viagra?
Sildenafil (PDE-5 inhibitor)
What is the generic name of Cialis?
Tadalafil (PDE-5 inhibitor)
What is the generic name of Levitra?
Verdenafil (PDE-5 inhibitor)
What is the generic name of Stendra?
Avanafil (PDE-5 inhibitor)
When are PDE-5 inhibitors contraindicated?
With Nitrates!
What are some unusual ADRs with PDE-5 inhibitors?
Transient abnormal blue/green vision (mostly with Sildenafil). Sudden vision loss d/t nonarteritic ischemic optic neuropathy (NAION). Priapism
What is the generic name of Rogaine?
Minoxidil (used for baldness) - increases blood flow to hair
What is the generic name of Propecia?
Finasteride (used for baldness) - inhibits testosterone –> DHT
Which baldness medication can be used in both men and women?
Rogaine (Minoxidil)
What are some medications that can induce hypogonadism?
Ketoconazole, Glucocorticoids, Spironolactone, Cimetidine, Phenytoin, Opioids, Alcohol, Anabolic steroids, Flutamide
What type of allergy should Androgel, Striant, Testim be avoided in?
Soy
What are the two oral medications that can be used for hypogonadism?
Methyltestosterone or Fluoxymesterone
What are the oral preparations limitations for hypogonadism?
Poor oral bioavailability, Poor androgen effect, Adverse lipid changes, Priapism, Increased risk of hepatic side effects
What is the generic name of Striant?
Testosterone buccal preparation - used for hypogonadism
What are the advantages of testosterone buccal preparation (Striant)?
BID dosing allows for normal testosterone levels throughout the day
What is the generic name of Androderm?
Testosterone transdermal patch (for hypogonadism). Should be applied in the evening, if it falls off you may press back on or replace before noon
Where can Androderm patch be placed?
Upper arms or back. Abdomen. Thighs
What are the advantages of using Androderm?
Closely mimics normal diurnal changes in testosterone levels
What is the generic name of AndroGel?
Testosterone gel formulation
What is the generic name of Testim?
Testosterone gel formulation
Where can AndroGel be applied?
Upper arms or Abdomen
Where can Testim be applied?
Upper arms only
What is the generic name of Fortesta?
Testosterone gel formulation
Where can Fortesta be applied?
To the thighs only!
What is the generic name of Axiron?
Testosterone topical formulation used in armpit, apply deodorant first
What should a patient do to minimize first-dose syncope with terazosin?
Start with 1mg daily
