BPH Flashcards
What’s the brand name of Doxazosin?
Cardura
What’s the brand name of Terazosin?
Hytrin
What’s the brand name of Alfuzosin?
Uroxatral
What’s the brand name of Silodosin?
Rapaflo
What’s the brand name of Tamsulosin?
Flomax
Name all the non selective α1-Blockers?
Doxazosin (Cardura)
Terazosin (Hytrin)
Name the Uroselective α1-Blockers?
Alfuzosin (Uroxatral)
Silodosin(Rapaflo)
Tamsulosin(Flomax)
What are the indication of non-selective α1-blockers?
BPH and HTN
What are the indications of Uroselective α1-blockers?
BPH
What time of day should non selective α1-blockers be taken? Why?
non selective α1 -blockers should be taken at night (HS) to prevent Orthostatic hypotension (happens when you stand up and sit down.
Common SE of non selective α1-blockers?
Dizziness,fatigue, Orthostatic hypotension
Drug interaction for non selective α1-blockers?
Additive decrease in BP effect with anti-HTN
Which α1-blockers are contraindicated for Hepatic deficiency?
Alfuzosin(Uroxatral) (CI-Mod/severe)
Silodosin(Rapaflo) - CI (Severe)
Which α1-blockers has a common SE of Retrograde Ejaculation? And Highest incidence of Abnormal ejaculation?
Silodosin(Rapaflo
Which α1-blocker should you avoid in patients with Severe sulfonamide allergy?
Tamsulosin (Flomax)
Which α1-blocker prolongs QT interval?
Alfuzosin (Uroxatral)
Which α1-blockers are contraindicated for Potent CYP3A4 inhibitors?
Alfuzosin(Uroxatral)
Silodosin (Rapaflo)
Tamsulosin (Flomax)
Which α1-blockers have SE of abnormal ejaculation?
Tamsulosin (Flomax)
Silodosin (Rapaflo)
This α1-blocker should be used in caution when
Crcl< 30ml/min?
Alfuzosin (Uroxatral)
This α1-blocker dose should be changed to 4mg when
Crcl 30-50 ml/min?
What CrCl should this drug be Discontinued?
Silodosin (Rapaflo)
DC and Contraindicated <30ml/min
Which α1-blockers should the dose be tirated to max dose?
Doxazosin (Cadura)
Terazosin (Hytrin)
What α1-blocker has an XL formulation?
Doxazosin (Cardura)
Why does the FDA warn in used in combination of alpha-antagonist and Phosphodiesterase?
Risk of Hypotension
Most common surgical options for BPH?
What are risk and benefits?
- Transurethral resection of the prostate (TURP), cut out piece of prostate.
- Open Prostatectomy - Enlarged prostate removed entierely -most potential for relief but must complications
Does α1-blocker (Alpha 1-adrenergic blockers) decrease the PSA levels?
No! No effect on PSA levels or Prostate size
Does 5 α-reductase inhibitors decrease the PSA levels?
Yes. Reduce prostate size by 25% and decrease PSA levels by 50%?
Which Pregancy Category is Does 5 α-reductase inhibitors?
Category X. Stay away from Pregnant women.
What are the hepatic cautions of 5 α-reductase inhibitors?
No specific renal/hepatic dosage adjustment
When do 5 α-reductase inhibitors work?
Slow onset of action: 6-12 months
What’s the brand name Dutasteride?
Avodart
What’s the brand name Finasteride?
Proscar
Name all 5 α-reductase inhibitors?
Dutasteride (Avodart)
Finasteride (Proscar)
What FDA statement was based on the PCPT and REDUCE trails?
Increased risk of high-grade prostate cancer with Name all 5 α-reductase inhibitors. The risk is low, but providers should be aware the overall reduction of prostate was found but increase incidence of high grade cancer was found in both trials.
Which Phophodiesterase inhibitor can be use for BPH?
Tadalafil (Cialis)
What’s the brand name of Tadalafi?
Cialis
What is the benefits of Tadalfil (Cialis)?
Reduction in total IPSS scores (international prostate symptoms score)
What medications should be avoided with BPH?
- Testosterone replacement regimen - Testostorone increase DHT which increase Prostate growth -> increase BPH
- α-adrenergic agonist - Allergy med,Psudefed, Increase BPH
- Anticholinergic agent- Cause Urinary retention (TCA,Benadryl,increase BPH)
- Diuretics -Polyuria (increase BPH s/s)
The only herbal therapy which has modest increase but lacks sound data?
Saw Palmetto
