BPH Flashcards
What is the function of the prostate?
add fluid to ejaculate
What tissue of the prostate is sensitive to testosterone?
epithelial
What tissue of prostate is sensitive with a1 receptors?
stromal
AT what age do most men have BPH?
> 70
How does an enlarged prostate occur?
androgens converted to DHT= hyperplasia in prostate
If testosterone decreases as we age why do older men get prostate enlargement?
more intra-prostatic 5-a- reductase (makes DHT)
Symptoms of BPH?
frequency, nocturia, leakage, straining, pain
complications of BPH?
incontinence, UTI, renal failure, kidney stones
What test to monitor progression of prostate?
PSA
Drugs that exacerbate BPH?
androgens, anticholinergics
AD-TCA
Antihistamines
antipsychotics-1st gen
muscle relax
stimulants
Non pharm for BPH?
less fluid, caffeine, alcohol
stop smoking
bladder training, active
What alpha blockers are pro selective?
alfuzosin, silodosin, tamsulosin
Do Alpha blockers lower PSA?
NO
How long for alpha blockers to work?
1-2 weeks
s/e of alpha blockers?
dizzy, fatigue, headache, IFIS (ocular)
Which alpha blocker causes more IFIS?
tamsulosin
CI of alpha blockers
too hypotensive
HF
3A4 drugs
How do dutasteride/finnasteride work?
block conversion to DHT
Does dutasteride lower PSA?
YES
How long for effect of dutasteride/finnasteride?
months
s/e of dutasteride?
sex dysfunction
gyno
birth defects in male
Does dutasteride reduce prostate cancer?
YES but not approved for it
Why does tadalafil work for BPH?
smooth muscle relaxation will help
Why is tadalafil only indicated?
long half life
Difference in dosing for Cialis for ED vs BPH?
daily for BPH
Why would we use anticholinergics in BPH?
if urgency/frequency
go low go slow
what anticholinergics for BPH?
oxybutinin, solfenacin, tolterodine
What natural health products likely work for BPH?
pygeum-helps with nocturia
beta-sitosterol- urinary sx
saw palmetto- NO
