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Board Review > BPHFC > Flashcards

BPHFC Flashcards

1
Q

Benign Prostatic Hyperplasia (BPH) pathophys

A

Prostate is dependant on androgens (testosterone) for development and maintenance of size
As the Prostate enlarges, the gland presses agaisnt the urethra like a clamp
the bladder will become thicker and irritated
the bladder will begin to contract even when it contains small amounts of urine

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2
Q

BPH: Signs & Symptoms

A

Hesitant, interrupted, weak stream of urine
Urgency and leaking or dribbling
Incomplete emptying of the bladder
More frequent urination (especially at night)
Rare: acute renal failure or UTI

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3
Q

Drugs that Worsen BPH Symptoms

A

Combination cold medicines, decongestants, antihistamines, and medications with anticholinergic
testosterone
Diuretics
Caffeine

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4
Q

Treatment of BPH

A

International Prostate Symptom Score (IPSS) is used to determine how bothered a patient’s symptoms are and guides therapy
Alpha blockers
5 alphareductase inhibitors
Tadalafil
Natural products

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5
Q

Natural Products for BPH

A

Saw palmetto
Pygeum
Beta sitosterol
Rye grass pollen

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6
Q

Alpha Blockers

A

Inhibit alpha1 adrenergic receptors and relax the smooth muscle of the prostate and bladder neck to improve urinary flow

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7
Q

NonSelective Alpha blockers: two

A

terazosin (Hytrin), doxazosin (Cardura)

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8
Q

Selective alpha1A blockers: three

A

tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo)

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9
Q

when to take alpha blockers ?

A

Usually taken at bedtime (to minimize the initial “first dose effect” of orthostasis/dizziness)

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10
Q

se of alpha blockers

A

SE: orthostatic hypotension, dizziness, fatigue, floppy iris syndrome

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11
Q

when do alpha workers start working for bph?

A

Start to work right away, but maximal efficacy may take weeks to months

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12
Q

do the alpha blockers shrink the prostate ?

A

They do not shrink the Prostate or change PSA levels

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13
Q

Selective Alpha1A Blockers names

A

Tamsulosin (Flomax), Tamsulosin/dutasteride (Jalyn), alfuzosin (Uroxatral), sidodosin (Rapaflo)

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14
Q

ci of selective alpha 1a blockers

A

CI: concurrent use with strong 3A4 inhibitors and hepatic insufficiency (with alfuzosin and silodosin), severe renal impairment (silodosin)

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15
Q

se of alpha 1a blockers

A

SE: orthostatic hypotension, dizziness, fatigue, floppy iris syndrome

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16
Q

who should not use alfusozin?

A

do not use alfuzosin in patients at risk of QTprolongation

17
Q

what is the problem with silodosin ?

A

Silodosin can cause retrograde ejaculation

18
Q

which of the selective 1 a alpha blockers require renal dosing?

A

alfuzosin and Silodosin need renal dose adjustments

19
Q

Alpha Blocker Drug Interaction

A

Caution with PDE5 inhibitors (hypotension)
Silodosin cannot be used with strong Pgp inhibitors (cyclosporin)
alfuzosin should not be used with drugs that can cause Qtprolongation

20
Q

Alpha Blocker Counseling

A

Should see improvement in symptoms within 12
Watch for drop in BP
Notify doctor if experiencing any side effects
Avoid cold medicines and decongestants
take with food same time each day
alfuzosin: do not crush, chew, or break

21
Q

5Alpha Reductase Inhibitors names and brands

A

Finasteride (Proscar), dutasteride (Avodart)

22
Q

moa of 5 alpha reductase inhibitors

A

Inhibit the 5alpha reductase enzyme which blocks the conversion of testosterone to DHT

23
Q

ci of 5 alpah reductase inhibitors

A

CI: pregnancy (X) and children

24
Q

se of 5 alpah reductase inhibitor

A

SE: decreased libido, decreased ejaculation, impotence (all decrease over time 1year)

25
Q

moa of 5 alpah reductase inhibitor ; do they shrink the prostate?

A

These agents shrink the Prostate and lower PSA levels

26
Q

how long for effectivenss of 5 alpah reductase inhibitor

A

May need to use for more than 6 months for maximum efficacy

27
Q

5Alpha Reductase Inhibitors Counseling

A

Women who are or may become pregnant should not handle (male semen using These drugs may also be harmful)
can reduce the amount of PSA in the blood
Notify doctor if experiencing any side effects
Avoid cold medicines and decongestants

28
Q

PDE5 Inhibitors used in BPH

A

Tadalafil (Cialis)

29
Q

moa of PDE 5 inhibitos in BPH

A

decrease smooth muscle and endothelial cell proliferation and increase in smooth muscle relaxation and tissue perfusion of the Prostate and bladder

30
Q

CI of cialis

A

CI: use with nitrates

31
Q

se of cialis

A

SE: dizziness, hypotension, headache, flushing, runny nose, stomach pain, priapism, vision or hearing abnormalities

32
Q

dose adjustment of cialis

A

renal dose adjust with CrCl <50

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