Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm II- Exam 1 > BPH > Flashcards

BPH Flashcards

1
Q

Obstructive s/s of BPH?

A

urinary hesitancy
urine dribbling
bladder fullness post voiding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Irritative s/s of BPH?

A

result from long-standing obstruction at the bladder neck

urinary frequency

urgency

nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Complications of BPH progression?

A

chronic kidney disease

gross hematuria

urinary incontinence

recurrent UTI

bladder diverticula

bladder stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal prostate size?

A

2 x 3 x 4 cm

weighs ~ 20g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 types of tissue in the prostate?

A

epithelial tissue (aka glandular)

stromal (aka smooth muscle)

capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What stimulates epithelial tissue growth?

A

androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Stromal tissue and the capsule is embedded with….

A

alpha 1 adrenergic receptors

-norepinephrine causes smooth muscle contraction and capsule contraction around the urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the principal testicular androgen?

What is the principal adrenal androgen?

A

testosterone

Androstenedione

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Testosterone and Androstenedione are responsible for….

A

penile and scrotal enlargement

increased muscle mass

maintenance of the normal male libido

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Testosterone and Androstenedione are converted by…. in target cells to….

A

5 alpha reductase

dihydrotestosterone (DHT), an active metabolite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which is a more potent androgen in the prostate, DHT or testosterone?

A

DHT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does DHT do in the prostate?

A

induces growth and enlargement of the gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drug class can help to reduce enlarged prostate gland (epithelial tissue)?

A

5 alpha reductase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drug class can help with sxs due to problem with stromal tissue?

A

alpha1-adrenergic antagonists are quickly effective in symptomatic management of urinary flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

BPH sxs may be exacerbated by which drug classes?

A

anticholinergic agents
antihistamines
tricyclic antidepressants
phenothiazines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Goals of BPH management?

A

control sxs

prevent progression of complications

delay need for surgical intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for moderate/severe sxs BPH?

A

drug therapy or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sxs of BPH usually result from both…

A

static and dynamic factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which drugs can help to reduce dynamic factors?

A

Blocks alpha adrenergic receptors in prostatic stromal tissue: Prazosin, Doxazosin, Terazosin

Blocks alpha receptors in the prostate: tamsulosin

Causes smooth muscle relaxation: Tadalafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 2 types of 5alpha reductase?

A

Type I- localized to sebaceous glands in frontal scalp, liver and skin > causes acne and increased body and facial hair

Type II- localized to the prostate, genital tissue, and hair follicles of the scalp > induces growth and enlargement of the gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What ratio is exaggerated in BPH?

A

stromal-to-epithelial tissue ratio of 5:1

normal is 2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What drug class can help with sxs due to problem with stromal tissue?

A

alpha1-adrenergic antagonists are quickly effective in symptomatic management of urinary flow

23
Q

What are static factors involved in BPH?

A

anatomic enlargement of the prostate gland

> depends on androgen stimulation of epithelial tissue and estrogen stimulation of stromal tissue in the prostate

24
Q

What are dynamic factors involved in BPH?

A

excessive alpha-adrenergic tone of the stromal component of the prostate gland

> results in contraction of the prostate gland around the urethra and narrowing of the urethral lumen

25
Q

What are the 3 categories of drug therapies for BPH?

A
  • Agents that interfere with testosterone’s stimulatory effect on prostate gland enlargement (static)
  • agents that relax prostatic smooth muscle (dynamic)
  • agents that relax bladder detrusor muscle (improves urine storage capacity)
26
Q

Which drugs can help to reduce dynamic factors?

A

Doxazosin, Terazosin, Prazosin, etc.

Tamsulosin

Tadalafil

27
Q

What are the two ways to dose IR Terazosin and Doxazosin?

A

Schedule 1: slow titration

Schedule 2: quicker titration

(slow to minimize orthostatic hypotension)

28
Q

What mechanisms reduce static factor?

A

blocks 5 alpha reductase enzyme (Finasteride)

Blocks diihydrosterone at its IC receptor

blocks pituitary release of LH

blocks pituitary release of LH and blocks androgen receptor

29
Q

MOA of Oxybutynin and Mirabegron?

A

relaxes detrusor muscle of bladder

30
Q

Role of alpha 1 adrenergic antagonist?

A

relieves voiding sxs

31
Q

Older second-generation immediate-release formulations(e.g., terazosin, doxazosin) can cause…

A

adverse CV effects: 1st dose syncope, orthostatic hypotension, dizziness

32
Q

Name 2 3rd generations alpha 1 adrenergic antagonists

A

Tamulosin, Silodosin

Uroselective agents, good alternatives

33
Q

Which patients are 5 alpha reductase inhibitors good for?

A

for pts with large prostates who wish to avoid surg and can’t tolerate the side effects of alpha1 adrenergic antagonists

34
Q

Disadvantage of 5 alpha reductase inhibitors?

A

SLOW ONSET, taking up to 6 months for maximal effects

35
Q

What should you monitor in pts taking alpha adrenergic antagonists?

A

BP, HR

36
Q

ADEs of alpha adrenergic antagonists?

A

floppy iris syndrome, priapism, syncope, lightheadedness, orthostatic hypotension, nasal congestion

37
Q

What should you monitor in a pt taking 5 alpha reductase inhibitors?

A

PSA

should decrease by 50% iif adherent to therapy(

38
Q

ADEs of 5 alpha reductase inhibitors?

A

Erectile dysfunction
Decreased libido
Ejaculatory dysfunction
Gynecomastia

39
Q

What should you use if you need to fix BPH immediately?

What if sxs are just mild and prostate is enlarging slowly?

A

alpha1 adrenergic antagonists

5 alpha reductase inhibitors

40
Q

ADEs of phosphodiesterase inhibitors?

A 
Headache
Dizziness
Nasal congestion
Dyspepsia
Back pain
Myalgia
Hearing loss
41
Q

What side effect would make you want to discontinue Tadalafil?

A

hearing loss

42
Q

Name a beta3 adrenergic agonists. What does it do?

A

Mirabegron

release cAMP, which relazes the detrusor muscle –> reducing the irritative voiding sxs (increased urinary bladder capacity)

43
Q

ADE of Mirabegron?

A

HTN

impaired cognition

others: tachycardia, dry mouth, nausea, constipation, HA

44
Q

Surgical option for BPH?

A

for pts with severe sxs who don’t respond to or don’t tolerate meds

TURP (Bx possible)

Green Light (no bx possible)

45
Q

Tx for mild sxs?

A

watchful waiting

46
Q

Tx for moderate sxs with ED?

A

alpha-adrenergic antagonist

phosphodiesterase inhibitor

or BOTH

47
Q

Tx for moderate sxs with small prostate and low PSA?

A

alpha-adrenergic antagonist

48
Q

Tx for moderate sxs with large prostate and increased PSA?

A

5 alpha reductase inhibitor

+

alpha-adrenergic antagonist

49
Q

Tx for moderate sxs predominant irritative voiding sxs?

A

alpha-adrenergic antagonist
+ anticholinergic agent

OR

alpha-adrenergic antagonist +
Mirabegron

50
Q

Tx for severe sxs with complications?

A

minimally invasive surg or prostectomy?

51
Q

Which decreased prostate size; alpha1 adrenergic antagonists or 5alpha reductase inhibitors?

A

5 alpha reductase inhibitors

52
Q

Which relaxes prostatic smooth muscle; alpha1 adrenergic antagonists or 5alpha reductase inhibitors?

A

alpha 1 adrenergic antagonists

53
Q

which halts disease progression; alpha1 adrenergic antagonists or 5alpha reductase inhibitors?

A

5 alpha reductase inhibitors

54
Q

which has CV adverse effects; alpha1 adrenergic antagonists or 5alpha reductase inhibitors?

A

alpha 1 adrenergic antagonists

Pharm II- Exam 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions