BPH

Question 1

What types of medications can exacerbate BPH?

Answer 1

Anticholinergics and alpha-agonists
Alpha-1: ozymetalozine, phenylephrine
Alpha-2: clonidine, guanfacine

Question 2

What are the types of medications used to treat BPH?

Answer 2

Alpha blockers: selective for bladder: tamsulosin, non-selective: doxazosin, terazosin
*works much faster than 5-alpha reductase inhibitors which can take weeks to months to shrink prostate
*risk for floppy eye syndrome in patients undergoing eye surgery
*orthostasis is major risk

5-alpha reductive inhibitors: finasteride, dutasteride
*sexual impairment primary adverse effect (mechanism reduces testosterone production)
*category X

PD-5 inhibitors: Tadalafil once daily indicated, may help with urinary symptoms and added benefit for erectile dysfunction
Anticholinergics: tolterodine (Detrol), solifenacin (Vesicare), oxybutynin
Beta-3 agonists: mirabegron (Myrbetric), vibegron (Gemtesa)