BPH/ED Drugs

Question 1

short acting a-1 blockers

Answer 1

prazosin, alfuzosin

Question 2

long-acting a-1 blockers

Answer 2

terazosin, doxazosin

Question 3

partially selective a-1 blockers

Answer 3

tamsulosin, silodosin

Question 4

location of a-1 receptors

Answer 4

a-1a on lower urinary tract

a-1d on detrussor muscle

Question 5

pharmacology of a-1 blockers

Answer 5

PO drugs w/ CYP metabolism
drug-drug interactions common
long lasting except prazosin (variability among pts)

Question 6

a-1 blocker adverse effects

Answer 6

xerostomia, nausea, CNS sx

Question 7

PDE-5 inhibitors

Answer 7

avanafil, sildenafil, tadalafil, vardenafil

Question 8

PDE-5 inhibitor MOA

Answer 8

inhibits PDE-5 –> less breakdown of cGMP –> increased cGMP levels –> increased phsophorylation of protein kinase G –> Ca efflux –> smooth muscle relaxation and vasodilation

Question 9

PDE-5 adverse effects

Answer 9

headache, loss of hearing and sight, CV issues

CANNOT BE TAKEN W/ NITRATES

Question 10

5a reductase inhibitors

Answer 10

finasteride, dutasteride

Question 11

5a reductase inhibitor MOA

Answer 11

block action of 5a reductase type I (dutasteride) and type II (finasteride) –> less production of DHT

Question 12

5a reductase inhibitor adverse effects

Answer 12

ejaculation and erectile dysfunction, decreased libido

teratogenic

Question 13

alprostadil MOA

Answer 13

PGE1 analog –> activates adenylate cyclase –> cAMP production –> Ca efflux –> smooth muscle relaxation and vasodilation

Question 14

alprostadil adverse effects

Answer 14

local adverse effects (b/c its put in urethra)

Question 15

yohimbine MOA

Answer 15

blocks a-2 receptors –> decreased intracellular Ca –> relaxation of smooth muscle and vasodilation
antagonizes inhibition of NANC nerves –> increased release of NO

Question 16

yohimbine adverse effects

Answer 16

CNS/psych sx (crosses BBB)
MAOI action
contradindicated w/ renal dysfunction