BPH

Question 1

metabolism of testosteron

Answer 1

to dihydrotestosterone by 5 alpha reductase

Question 2

BPH is a result of

Answer 2

overgrowth of the stromal and epithelial cells of the prostate gland

Question 3

What are drugs that can worsen BPH

Answer 3

testosterone, SNRIs, diuretics, caffeine, anticholinergic drugs (benztropine, antihistamines, decongestants, phenothiazines, TCAS)

Question 4

how is bph diagnosed

Answer 4

via a digital rectalexam (DRE) and a serum prostate specific antigen (PSA)

Question 5

Symptoms of BPH

Answer 5

1) Hesitancy/intermittent urine glow, straining or a weak stream of urine
2) Urinary urgency, leaking, or dribbling
3) urinary frequency, especially nocturia

Question 6

what can bph blockage cause

Answer 6

acute renal failure

Question 7

differential for bph

Answer 7

prostate cancer

Question 8

how is mild bph treated

Answer 8

watchful waiting

Question 9

what is the name of the surgical procedure

Answer 9

transurethral resection of the prostate

Question 10

what natural product is used for prostate but not recommended to work well

Answer 10

Saw palmetto

Question 11

what natural product is used for prostate cancer prevention

Answer 11

lycopene

Question 12

medication tx for BPH

Answer 12

apha blockers alone (1st line) or in combo with a 5-alpha reductase inibitor

Question 13

what can bph meds cause

Answer 13

ED

Question 14

MOA of an alpha-blocker

Answer 14

inhibit aloha 1 adrenergic receptors causing relaxation of the smooth muscle thus reducing bladder outlet obstruction and improves urinary flow

Question 15

where are the alpha 1 receptors found

Answer 15

prostate

Question 16

which types of alpha blocker has more side effects

Answer 16

non-selective

Question 17

what should ophthalmologists be concerned about with alpha blockers

Answer 17

intraoperative floppy iris syndrome which would require pausing analpha blocker in cataract surgery

Question 18

cardura

Answer 18

doxasosin (a non selective alpha blocker)

Question 19

Terazosin

Answer 19

a nonselective alpha 1 blocker

Question 20

flomax

Answer 20

tamsulosin (selective alpha 1 blocker)

Question 21

alfuzosin

Answer 21

selecive alpha 1 blocker

Question 22

sildosin

Answer 22

selective alpha blocker

Question 23

which pde 5 inhibitor canbe used for BPH and thus should not be used with any other tx

Answer 23

Cialis (tadalafil)

Question 24

daily dose of flomax

Answer 24

0.4mg

Question 25

When to give the non selective drugs

Answer 25

at bedtime due to orthostasis/dizuness

Question 26

how long does it take to assess the benefit of an alpha blocker

Answer 26

4-6 weeks may be required

Question 27

which alpha blocker can cause a ghost tablet

Answer 27

cardura (doxasosil) XL

Question 28

which drug can cause retrograde ejeculation

Answer 28

Silodosin

Question 29

caution when using alpha blocker and PDE-5

Answer 29

hypotensive effects

Question 30

moa of 5 alpha reductase

Answer 30

inhibits 5-alpha reductase enzyme which blocks the conversion of testosterone to dihydroxytestosterone

Question 31

proscar

Answer 31

finasteride

Question 32

propecia

Answer 32

finesteride for hair loss

Question 33

what is finesteride contraindicated in?

Answer 33

Women of child-bearing potential, pregnancy

Question 34

what are the side effects of finesteride

Answer 34

impotence, decreased libido, ejaculaton disturbances, breast enlargement, tenderness

Question 35

how long does the treatment take to work

Answer 35

6 months for maximal efficiency

Question 36

side effects of pde5 inhibitors

Answer 36

vision loss (color discrimination, hearing loss, hypotension, pirapirism, headache, flyshing, diziness, dyspesia, back pain