Benign Prostatic Hyperplasia (BPH)

Question 1

What are some symptoms of BPH?

Answer 1

• Hesitancy
• Intermittent urine flow
• Straining or weak stream of urine
• Urgency and leaking or dribbling
• Urinary frequency, especially nocturia

Question 2

What drug classes are used in the treatment of BPH?

Answer 2

• Alpha-1 blockers
• 5-alpha reductase inhibitors
• PDE-5 inhibitor Tadalafil with or without Finasteride

Question 3

5-alpha reductase inhibitors MOA, Clinical Pearls

Answer 3

MOA:
- Work by reducing the prostate size

Clinical Pearls:
- Should not be used in men without prostate enlargement

-They have delayed onset

Question 4

What are the first line treatment for BPH? MOA

Answer 4

Alpha blockers
MOA: Inhibit alpha-1 adrenergic receptors to relax the smooth muscle of the bladder neck, reducing bladder outlet obstruction and improving urinary flow.

Question 5

What are the non-selective Alpha-1 blocker Agents?

Answer 5

• Terazosin (Hytrin)
• Doxazosin (Cadura)
• Prazosin (Minipress)

Question 6

What are the selective Alpha-1 blocker Agents?

Answer 6

• Tamsulosin (Flomax)
• Alfuzosin (Uroxatral)
• Silodosin (Rapaflo)

Question 7

Alpha-1 blocker Warning

Answer 7

• Orthostatic hypotension
• Intraoperative floppy iris syndrome can occur in cataract surgery
• Priapism (erection lasting > 4 hours)

Question 8

Alpha-1 blocker AED

Answer 8

• Dizziness
• Fatigue
• Headache
• Abnormal ejaculation

Question 9

5-alpha reductase inhibitors Agent

Answer 9

• Finasteride (Proscar)
• Dutasteride (Avodart)

Can also be used for alopecia at low doses

Question 10

5-alpha reductase inhibitors ADE

Answer 10

• Impotence
• Decreased libido
• Ejaculation disturbance
• Breast enlargement and tenderness

Question 11

5-alpha reductase inhibitors Contraindication

Answer 11

• Pregnancy

- Woman of child-bearing potential