bph

Question 1

PSA> ___ is a risk for BPH complications

Answer 1

1.4

Question 2

what are some BPH complications

Answer 2

urinary retention, overflow UI, bladder stones, UTI, hematuria, renal insufficiency

Question 3

meds that exacerbate BPH

Answer 3

Anticholinergics, antihistamines, antidepressants, antiarrhythmics/antianginals
Bronchodilators
Psychotropics

Question 4

non-pharm treatments for BPH

Answer 4

watchful waiting
behavioral– regular voiding, avoid alcohol/caffeine, restrict fluid at night
surgery

Question 5

pharm options for BPH

Answer 5

alpha 1 blockers
5 alpha reductase inhibitors
PDE5 inhibitors

Question 6

selective alpha 1 antagonists

Answer 6

Sildosin
Alfuzosin
Tamsulosin

Question 6

alpha 1 antagonists

Answer 6

Doxasozin
Prasozin
Terazosin

Question 7

5 alpha reductase inhibitors

Answer 7

dutasteride
finasteride

Question 8

combo agent

Answer 8

dutasteride/tamsulosin

Question 9

PDE5 inhibitor

Answer 9

tadalafil

Question 10

side effects of alpha 1 antagonists

Answer 10

dizzy, syncope, orthostatic hypotension, HA, CNS

Question 11

clinical pearls for alpha 1 antagonists

Answer 11

faster reduction in LUTS
but no reduction in prostate size or PSA

need to titrate

Question 12

side effects of selective alpha 1 antagonists

Answer 12

less hypotension

ejaculatory dysfunction, dizziness, fatigue

Question 13

dosing considerations for selective alpha 1 antagonists

Answer 13

take 30 minutes before the same meal every day. don’t have to titrate

Question 14

drug interactions for selective alpha 1 antagonists

Answer 14

cimetidine, phenytoin, diltiazem, carbamazepine

Question 15

5 alpha reductase inhibitor side effects

Answer 15

impotence, decreased libido, gynecomastia

Question 16

clinical pearls for 5 alpha reductase inhibitors

Answer 16

decrease prostate size and PSA
but delayed onset 6-12 months
and pregnancy category X

Question 17

combo agent when to use

Answer 17

when prostate gland >40 g/ PSA> 1.4, severe symptoms

Question 18

PDE5 inhibitor side effects

Answer 18

back pain, myalgia, limb pain, nasal congestion, flushing, headache, dyspepsia

Question 19

dosing pearls for PDE5 inhibitor

Answer 19

needs renal dose adjustments

Question 20

contraindication for PDE5 inhibitor

Answer 20

nitrates

Question 21

interactions for PDE5 inhibitor (besides nitrates contraindicated)

Answer 21

CYP3A4 inhibitors & inducers

Question 22

PDE5 cautions

Answer 22

priapism

stop use and contact provider if there is vision/hearing problems

Question 23

which drugs cause floppy iris syndrome

Answer 23

STD

sildosin, tamsulosin, doxazosin