5 ALPHA REDUCTASE INHIBITORS

Question 1

5-α reducase inhibitor - indication

Answer 1

benign prostatic hyperplasia

usually second-line option after alpha blockers

Question 2

5-α reducase inhibitor - MOA ( dont need to know)

Answer 2

note: this can take SEVERAL MONTHS to take effect

Question 3

5-α reducase inhibitor - adverse effects (3)

Answer 3

1) Impotence - long-term therapy can make this irreversible - need to stop taking medication if signs of this happening
2) Reduced libido
3) Gynaecomastia

Question 4

5-α reducase inhibitor - examples

Answer 4

Finasteride

Question 5

5-α reducase inhibitor - contraindications

Answer 5

Pregnant women
Why? Exposure of the male foetus to this drug may cause abnormal development of male external genitalia

Advise pregnant women to not have unprotected sex w/males taking this medication - can be exposed to drug via semen + warn pregnant women NOT to touch any of this medication

Question 6

5-α reducase inhibitor - interactions

Answer 6

NO INTERACTIONS

Question 7

5-α reducase inhibitor - administration

Answer 7

swallowed whole (NOT CRUSHED) with or without food

Question 8

5-α reducase inhibitor - communication

Answer 8

aim of tx is to reduce size of prostate which will relieve compression and make it easier to pass urine

communicate that this may take upto 6 months

explain main side effects

Question 9

Benign prostatic hyperplasia - What is the first-line if moderate-severe voiding symptoms (IPSS ≥8) AND give examples

Answer 9

Alpha Blockers aka alpha-1 antagonist

Tamsulosin, alfuzosin

Question 10

Benign prostatic hyperplasia - what is the treatment if patient has a significantly enlarged prostate + high risk of disease progression AND give examples

Answer 10

5 alpha-reductase inhibitor (Finasteride)

Question 11

Benign prostatic hyperplasia - what is the treatment if moderate-severe voiding symptoms (IPSS ≥8) AND prostatic enlargement

Answer 11

combination alpha-1 antagonist AND 5 alpha-reductase inhibitors

e.g Tamsulosin + Finesteride