Benign Prostatic Hyperplasia

Question 1

What are key regulators of the prostate gland?

Answer 1

Androgens

Question 2

What hormone plays a role in the development of BPH?

Answer 2

Androgens

Question 3

Any drug that is capable of doing what may help improve flow of urine?

Answer 3

Relaxing contractile smooth muscle

Question 4

What are the two subclasses of BPH drugs?

Answer 4

Alpha blockers

5-alpha-reductase inhibitors

Question 5

Why do alpha blockers work for BPH?

Answer 5

They act as adrenergic antagonists

Question 6

What is the common suffix for alpha blockers for BPH?

Answer 6

-osin

Question 7

What is one of the more popular alpha blockers for BPH?

Answer 7

Tamsulosin [Flomax]

Question 8

What is the MOA of Tamsulosin?

Answer 8

Selective competitive antagonism of lower urinary tract alpha-1a adrenergic receptors, relaxing smooth muscle of the bladder neck andprostate

Question 9

What are the indications for Tamsulosin?

Answer 9

BPH

Nephrolithiasis (kidney stones)

Question 10

What are the common adverse effects of Tamsulosin?

Answer 10

Dizziness
Sinusitis
Pharyngitis
Cough
Infection

Question 11

What are the serious adverse side effects of Tamsulosin?

Answer 11

Orthostatic hypotension

Syncope

Question 12

What are the ocular adverse side effects of Tamsulosin?

Answer 12

Floppy iris syndrome

Question 13

Why does Tamsulosin have Dizziness as a side effect, as well?

Answer 13

While it is selective for the urinary tract, it also works a bit to relax blood vessels, decreasing BP

Question 14

If a patient is on a drug ending in -osin, and they may need lens or retinal surgery, what should your first step be?

Answer 14

Contact PCP to get them off of it so that they don’t have floppy iris syndrome

Question 15

What is the effect of chloroquine interacting with Tamsulosin?

Answer 15

Reduces the hepatic metabolism of Tamsulosin, increasing the likelihood of side effects

Question 16

Macrolides, azole antifungals, and fluorouinolones do what when they interact with Tamsulosin?

Answer 16

Enhance hepatic metabolism of Tamsulosin

Question 17

What are the contraindications for Tamsulosin?

Answer 17

Cataract surgery
Glaucoma surgery
Sulfonamide allergy

Question 18

What is the suffix for the BPH drugs classified as 5-alpha-reductase inhibitors (5-ARIs)?

Answer 18

-eride

Question 19

What are the two 5-alpha-reductase inhibitors?

Answer 19

Finasteride

Dutasteride

Question 20

What is the MOA of 5-ARIs?

Answer 20

Inhibits type II 5-alpha-reductase, interfering with conversion of testosterone to 5-alpha-dihydrotestosterone

Question 21

What are the indications for Finasteride?

Answer 21

BPH

Androgen-dependent hair loss

Question 22

What are the common adverse effects of Finasteride?

Answer 22

Orthostatic hypotension

Question 23

What are the serious adverse effects of finasteride?

Answer 23

Prostate cancer

Breast cancer

Question 24

Why is it that finasteride can cause cancer?

Answer 24

It messes with the hormones that play in cell cycling

Question 25

What happens if a patient is on Finasteride as wells as a CYP3A4 substrate, like nafcillin (penicillin)?

Answer 25

It enhances the matbolism of Finasteride, to the point where there may be no benefit of Finasteride

Question 26

What are the contraindications to Finasteride?

Answer 26

Hypersensitivity

Hepatic disease

Question 27

Why is finasteride prone to cause hepatic disease?

Answer 27

Changes hormone regulation and the liver is key in metabolism