BPH Flashcards
Benign prostate hyperplasia
Caused by overstimulation of prostate by dihydrotestosterone (DHT)
What drugs exacerbate BPH?
Centrally acting anticholinergics (benztropine)
Anticholinergic drugs:
-antihistamines (Benadryl)
-Decongestants (psuedoedrine)
-Phenothiazines (proclorperazine)
-TCAs (amitryptyline
Caffeine
Diuretics
SNRIs
Testosterone
What are common symptoms of BPH
-weak stream urination
-urinary urgency or leakage
-urinary frequency
-incomplete emptying
What natural products help with BPH?
Saw palmetto
Alpha-1 blockers
inhibit alpha 1 to cause relaxation of smooth muscle reducing obstruction
Selective of Alpha 1:
Tamsulosin(Flomax)
Alfuzosin
Silodosin
Non-selective:
Terazosin
Doxazosin
***risk for intraoperative floppy irsis syndrome!!!!!!!
Cardura
Doxazosin
non-selective alpha 1 blocker
Warning: orthostatic hypotension, IFIS during cataract surgery
SE: dizziness, fatigue, abnormal ejaculation
**given at bedtime for orthostasis
**work FAST
Terazosin
non-selective alpha 1 blocker
Warning: orthostatic hypotension, IFIS during cataract surgery
SE: dizziness, fatigue, abnormal ejaculation
**given at bedtime for orthostasis
**work FAST
Flomax
Tamsulosin
Selective alpha 1 blocker
Warning: orthostatic hypotension, IFIS during cataract surgery
SE: dizziness, fatigue, abnormal ejaculation (MORE COMMON), rhinitis!!!
**given after a meal
**work FAST
5-alpha reductase inhibitors
**decrease the size of the prostate ==== should NOT be used in men without prostate enlargement!!!!!
EX; Finasteride (Proscar), Dutasteride
delayed onset, may take up to 6 months for FULL effect :(
Proscar
Finasteride
CI: women of child-bearing potential, pregnancy!!!!!!
SE: impotence, decreased libido, ejaculation disturbances, breast enlargement and tenderness
**Propecia is for hair loss, do not use both at the same time please
PDE-5 inhibitors
Tadalafil (Cialis) is the only approved one for BPH
Warning: hypotension, hearing loss, vision loss, color discriminition
SE: HA, flushing, BACK PAIN
What BPH treatment should be AVOIDED in pregnancy and in children?
Alpha 5 reductase inhibitors!!!!
Proscar and Dulasteride!!!
