BPH Flashcards
metabolism of testosteron
to dihydrotestosterone by 5 alpha reductase
BPH is a result of
overgrowth of the stromal and epithelial cells of the prostate gland
What are drugs that can worsen BPH
testosterone, SNRIs, diuretics, caffeine, anticholinergic drugs (benztropine, antihistamines, decongestants, phenothiazines, TCAS)
how is bph diagnosed
via a digital rectalexam (DRE) and a serum prostate specific antigen (PSA)
Symptoms of BPH
1) Hesitancy/intermittent urine glow, straining or a weak stream of urine
2) Urinary urgency, leaking, or dribbling
3) urinary frequency, especially nocturia
what can bph blockage cause
acute renal failure
differential for bph
prostate cancer
how is mild bph treated
watchful waiting
what is the name of the surgical procedure
transurethral resection of the prostate
what natural product is used for prostate but not recommended to work well
Saw palmetto
what natural product is used for prostate cancer prevention
lycopene
medication tx for BPH
apha blockers alone (1st line) or in combo with a 5-alpha reductase inibitor
what can bph meds cause
ED
MOA of an alpha-blocker
inhibit aloha 1 adrenergic receptors causing relaxation of the smooth muscle thus reducing bladder outlet obstruction and improves urinary flow
where are the alpha 1 receptors found
prostate
which types of alpha blocker has more side effects
non-selective
what should ophthalmologists be concerned about with alpha blockers
intraoperative floppy iris syndrome which would require pausing analpha blocker in cataract surgery
cardura
doxasosin (a non selective alpha blocker)
Terazosin
a nonselective alpha 1 blocker
flomax
tamsulosin (selective alpha 1 blocker)
alfuzosin
selecive alpha 1 blocker
sildosin
selective alpha blocker
which pde 5 inhibitor canbe used for BPH and thus should not be used with any other tx
Cialis (tadalafil)
daily dose of flomax
0.4mg
When to give the non selective drugs
at bedtime due to orthostasis/dizuness
how long does it take to assess the benefit of an alpha blocker
4-6 weeks may be required
which alpha blocker can cause a ghost tablet
cardura (doxasosil) XL
which drug can cause retrograde ejeculation
Silodosin
caution when using alpha blocker and PDE-5
hypotensive effects
moa of 5 alpha reductase
inhibits 5-alpha reductase enzyme which blocks the conversion of testosterone to dihydroxytestosterone
proscar
finasteride
propecia
finesteride for hair loss
what is finesteride contraindicated in?
Women of child-bearing potential, pregnancy
what are the side effects of finesteride
impotence, decreased libido, ejaculaton disturbances, breast enlargement, tenderness
how long does the treatment take to work
6 months for maximal efficiency
side effects of pde5 inhibitors
vision loss (color discrimination, hearing loss, hypotension, pirapirism, headache, flyshing, diziness, dyspesia, back pain
