Benign Prostatic Hyperplasia Flashcards
Epithelial tissue =
Produces prostatic secretion
Stromal tissue
SM contraction if alpha-adrenergic receptor stimulated
Capsule tissue
Fibrous, connective tissue that also contracts with alpha-adrenergic receptor stimulated
Adrenergic receptor location?
Mainly is prostate but a few are within the bladder
Static factors =
growing prostate around the urethra
Dynamic factors =
alpha-adrenergic receptor stimulation in the urethra and bladder neck
Detrusor factor
Irritability of the detrusor secondary to long-standing BOO
Symptoms of Benign Prostatic Hyperplasia
Obstructive: diminished stream, urinary hesitancy, incontinence
Irritative: urinary frequency and urgency, nocturia
Goals of therapy
Relieve symptoms
Prevent complications
Reduce need for surgical intervention
Mild
Asymptomatic
Urinary flow rate 25-50 mL
Moderate
Mild + Obstructive voiding symptoms and irritative voiding symptoms
Severe
Moderate + Complication of BPH
Mild treatment
Watchful waiting
Smoking cessation, exercise
Alpha-adrenergic antagonists
***Do NOT reduce prostate size
Relax sphincter and SM
Alpha-adrenergic antagonists Drugs
Prazosin Terazosin Doxasodin Alfuzosin Tamsulosin and silodosin (3rd gen)
Hytrin =
terazosin
Cardura =
Doxazosin
Flomax =
Tamsulosin
Alpha-adrenergic antagonists 2nd Gen AE
***orthostatic hypoTN
Cardura IR 1 mg PO HS
Hytrin 1 mg PO HS
Alpha-adrenergic antagonists 3rd Gen AE
Used in pts that can’t handle hypotension
Tamsulosin (Flomax) 0.4 mg PO QD
5 Alpha-reductase Inhibitors
***Reduce prostate size
Decrease DHT
2nd line in sexually active males
5 Alpha-reductase Inhibitors AE
Sexual dysfunction, gynecomastia, decreased libido
***Pregnancy Cat X
5 Alpha-reductase Inhibitors + Women
Should nto ahndle or come in contact with semen of men takin these if you are pregnant or seeking to become pregnant
5 Alpha-reductase Inhibitors + Women
Should not handle or come in contact with semen of men takin these if you are pregnant or seeking to become pregnant
5 Alpha-reductase Inhibitors Drugs/dosing
Dutasteride (Avodart) 0.5 mg PO daily
Finasteride (Proscar) 5 mg PO daily
General treatment for ALL pts =
Alpha adrenergic antagonists
Pts with enlarged prostate treatment =
5 Alpha-reductase Inhibitors + alpha adrenergic antagonist
