BPH and ED

Question 1

Population related risks for prostate enlargement

Answer 1

BPH more common in American/Australian and less common in Asian cultures

Question 2

Tests and exams for diagnosis of BPH

Answer 2

AUA symptom index, DRE, neuro exam, UA, PSA

Question 3

Relax smooth muscle of the prostate and bladder neck without interfering with bladder contractility.
Decrease bladder resistance to urinary outflow
Work quickly and increase urinary flow

Answer 3

α-blockers , Alpha-1 adrenergic antagonists

Question 4

Major side effect of α-blockers , Alpha-1 adrenergic antagonists

Answer 4

orthostatic hypotension

Question 5

Name the α-blockers , Alpha-1 adrenergic antagonists

Answer 5

tamsulosin (flomax), doxazosin (cardura), Terazosin (Hytrin)

Question 6

α-blockers , Alpha-1 adrenergic antagonist that causes less orthostatic HTN/fluid retention but may cause floppy iris syndrome

Answer 6

tamsulosin (flomax)

Question 7

α-blockers , Alpha-1 adrenergic antagonist that may have secondary benefit to patients with cardiac dz

Answer 7

doxazosin (cardura)

Question 8

α-blockers , Alpha-1 adrenergic antagonist often used for HTN and should be taken at bedtime to avoid hypotension

Answer 8

terazosin (hytrin)

Question 9

Blocks 5-alpha reductase, the enzyme that activates testosterone in the prostate.
Impairs prostate growth by inhibiting the conversion of testosterone to dihydrotestosterone

Answer 9

5-α-Reductase inhibitors

Question 10

What zone of the prostate doe 5-α-Reductase inhibitors

cause changes in the epithelial cells?

Answer 10

transition zone

Question 11

Name the 5-α-Reductase inhibitors

Answer 11

Finasteride (Proscar) and Dutasteride (Avodart)

Question 12

Antagonizes acetylcholine receptors. Used to help urgency symptoms by stabilizing the detrusor muscle

Answer 12

antimuscarinics

Question 13

Herb derived from dark berries of a palm tree. Inhibits testosterone conversion to DHT. Stops DHT at receptor sites

Answer 13

saw palmetto

Question 14

Vitamin that may prevent or decrease prostate enlargement

Answer 14

zinc

Question 15

Name the PDE-5 inhibitors

Answer 15

Sildenafil (Viagra), Vardenafil (Levitra), Tadalafil (Cialis)

Question 16

Work by blocking the action of type 5 phosphodiesterase maintaining vasodilation and increased blood flow to the penis

Answer 16

PDE-5 inhibitors

Question 17

What should be avoided in patient who is taking a PDE-5 inhibitors due to sharp decrease in BP?

Answer 17

nitrates

Question 18

Use for patients with ED who have contraindications to 5 PDE inhibitors. Available as intracavernosal injection or intraurethral suppository

Answer 18

Alprostadil (PGE1)

Question 19

Should be avoided in patients with leukemia, myeloma, or sickle cell anemia or sickle cell trait

Answer 19

alprostadil

Question 20

Treatment for premature ejaculation

Answer 20

SSRIs (fluoxetine or paroxetine) or TCA (clomipramine)