Brainscape's Knowledge GenomeTM

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


See full index

Clinical Pharmacy 4 > BPH > Flashcards

BPH Flashcards

1
Q

Signs and symptoms of BPH are considered to be either _____________ in nature

A

obstructive or irritative

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

Incomplete emptying is a what sx?

A

obstructive

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

Frequency or urination is a what sx?

A

can be from obstruction but also can be from irritation (stimulation of muscarinic receptors)

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

Intermittency is a what sx?

A

obstructive - trying to push urine through the urethra with an enlarged prostate

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

Urgency is a what sx?

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

Weak urinary stream is a what sx?

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

Nocturia is a what sx?

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

What symptoms of BPH would make us think it was a more urgent case?

A
  • blood in urine
  • pain upon urination
  • under 45 years of age
  • men with incontinence - backing up of bladder so badly that it forcibly pushes out urine through the prostate
  • complete bladder obstruction (suprapubic pain), agitation – need to out in a catheter to get rid of all of the urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes acute urinary retention?

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

What are some of the medications that people with BPH need to avoid?

A
  • antihistamines (muscarinic receptors are taking away the signal to empty the bladder)
  • decongestants
  • TCAs
  • antipsychotics
  • anti-muscarinic agents
  • some parkinsons meds
  • diuretics (furosemide, metolazone)
  • testosterone gel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If a person ever tells you that their _________ infection is getting worse on BPH meds, TAKE IT SERIOUSLY

A

lower respiratory tract infection

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

What is the pathophys of BPH?

A
  • increased size of the prostate- prostate encircles like a donut
  • increased prostate = increased urine block through the urethra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the purpose of the prostate?

A
  • gland that moves the fluid to the ejaculate- helps with reproduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is one mechanism in which the prostate grows?

A
  • testosterone

- usually makes it grow by 30-40 cc’s in size

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

What do PSAs help us with?

A

not much- not specific for cancer or BPH

- just doing a PSA level is not definitive to diagnosing prostate cancer

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

What do 5-alpha reductase inhibitors do?

A
  • block the production of DHT and cause a reduction in the size of the prostate
  • reduces the amount that the gland grows and can also actually shrink it by as much as 25%
  • – makes sense because if someone wasn’t having their prostate shrunk, then they wouldn’t have had any relief from the medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If someone has a small prostate and a lot of smooth muscle clenching down on the urethra, you can get away with just using a ________

A

alpha blocker

18
Q

When __________ is contracting, then you have the prostate squeezing down on the bladder

A

stromal cells

19
Q

What receptors are the most overactive when men have an irritative bladder?

A

muscarinic

20
Q

What do untreated symptomatic males likely end up developing?

A
  • acute urinary retention
21
Q

What is the MAIN SE associated with terazosin?

A
  • dizziness (usually people take this med at night)
22
Q

Is there a difference in efficacy between terazosin, alfuzosin and tamsulosin?

A
  • NO (only difference is that first gen causes more vasodilation or action on a lot of other parts of the body- dizziness and hypotension can still happen)
23
Q

What is the efficacy of these alpha-1 inhibitors?

A
  • decrease the ISS score by 3-4
24
Q

What are the main SE associated with alpha-1 blockers?

A
  • dizziness, decrease in BP, unsteadiness on feet

- also nasal congestion, ejaculatory changes (retrograde ejaculation), and cataracts

25
Q

What is the benefit of using tamsulosin instead of other medications?

A
  • less dizziness and cardiovascular signs and symptoms- BUT NOT NONE
26
Q

____ changes are still a concern with tamsulosin and _____ syndrome

A

ejaculatory

floppy iris

27
Q

What is the main thing finasteride is used for

A

enlarged prostate and more severe symptoms

- only way to stop prostate growth is to add a 5-a blocker

28
Q

What finasteride, we can decrease the IPSS score by ______ units

A

6-9 units

29
Q

What are the main SE of finasteride?

A
  • sexual dysfunction (erectile dysfunction, ejaculatory issues, decreased libido)
30
Q

Does finasteride increase the risk of developing prostate cancer?

A
  • no it doesn’t- it does increase the probability that the cancer a patient will get will be higher grade though and more severe (need to have this conversation with patients)
31
Q

Notice from health canada about using finasteride and ______ cancer in men

A

breast

32
Q

When is cialis usually used for bph?

A
  • when used with a combo of ED and BPH
33
Q

How much does cialis decrease IPSS scores?

A

by 2-3 units

34
Q

What are the main SE associated with cialis?

A

flushing, back pain, priapism (erection that lasts longer than 4 hours)

35
Q

What is the most significant DI associated with cialis?

A
  • nitrates
36
Q

What is the main effect of saw palmetto?

A
  • some effect, but some of the guidelines say not enough evidence
  • will see people using this
37
Q

What anticholinergics will you see people using for BPH?

A
  • oxybutinin

- tolteridone

38
Q

What do anticholinergic drugs help with?

A
  • trying to help with the irritative effect of the bladder

ask the patient if they were getting up every hour, if they had to pee all the time, etc

39
Q

What are the endpoints associated with BPH?

A
  • decrease in signs and symptoms pretty instantly, by 3-4 units within 1 week
  • finasteride takes 3-6 months to start working and will decrease the IPSS score in about 6 months
  • decreased risk of AUR
  • decreased risk of prostate surgery by 3% in 5-10 years
40
Q

When do side effect stay present for?

A
  • 1-2 weeks
41
Q

PSA levels will go down by 50% in first _____ months

A

6

42
Q

If you see a person’s PSA levels go up while on finasteride or dutasteride, what are you concerned about?

A
  • concerned about cancer

Clinical Pharmacy 4 (7 decks)

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