BPH

Question 1

Stromal Tissue

Answer 1

is smooth muscle containing alpha-1 adrenergic receptors, increase in stromal tissue/epithelial tissue ration in BPH (=5:1)

Question 2

Sympathetic

Answer 2

increase tone b/c of bladder pressure, closes the internal sphincter and stops urine flow

Question 3

DHT

Answer 3

from Testosterone and androstenedione converted to DHT by 5alpha-reductase-II, DHT responsible for prostate growth

Question 4

Static Factor

Answer 4

influenced by DHT, treatment with 5alpha-reductase inhibitors

Question 5

Dynamic Factor

Answer 5

influenced by alpha-adrenergic tone, causes urethral lumen to narrow and stops urine flow

Question 6

Diagnosis

Answer 6

Urine flow normal = 10-15ml/sec, PVR

Question 7

2nd and 3rd Gen alpha-blockers

Answer 7

relax smooth muscle of prostate to increase urine flow, for treatment of dynamic component

Question 8

Terazosin

Answer 8

Hytrin, QD at BEDTIME

Question 9

Doxazosin

Answer 9

Cardura, QD at BEDTIME

Question 10

Alfuzosin

Answer 10

Uroxatral ER, 1QD after same meal each day

Question 11

Tamsulosin

Answer 11

Flomax, selective for A1a, no BP influence, may have advantage in patients with other co-morbidities, TAKE ON EMPTY STOMACH

Question 12

Silodosin

Answer 12

Rapaflo, highly selective, practically no orthostatic hypotension, cause ejaculatory issues

Question 13

Finasteride

Answer 13

Proscar, 5mg daily, pregnancy category X

Question 14

Dutasteride

Answer 14

Avodart, pregnancy category X

Question 15

5alpha-reductase inhibitors

Answer 15

take for 6mo before effectiveness can be determined, dutasteride works faster but does not have a clinical advantage, helpful in decreasing PSA, ejaculation disorders, erectile dysfunction, GI issues

Question 16

Jalyn

Answer 16

dutasteride and tamsulosin