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NAPLEX > Chapter 51: BPH > Flashcards

Chapter 51: BPH Flashcards

1
Q

testosterone is metabolized to __ by __

A

DHT

5-alpha reductase

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2
Q

Drugs that can worsen BPH

A
  • Centrally-acting anticholinergics (e.g., benztropine)
  • Drugs with anticholinergic effects: antihistamines, decongestants, phenothiazines, TCAs
  • Caffeine
  • Diuretics
  • SNRIs
  • Testosterone products
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3
Q

What tests are used to diagnose BPH

A

Digital rectal exam and PSA

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4
Q

Symptoms of BPH

A
  • Hesitancy, intermittent urine flow, straining or a weak stream of urine
  • Urinary urgency & leaking or dribbling
  • Urinary frequency, especially nocturia
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5
Q

How is mild BPH treated

A

watchful waiting

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6
Q

Which natural products can be used for BPH

A

Saw palmetto

Lycopene (prostate cancer prevention)

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7
Q

Drug treatment for BPH consists of

A

alpha-blockers +/- 5-ARI

or tadalafil +/- finasteride

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8
Q

5-ARI MOA

A

decrease prostate size by blocking 5-alpha reductase enzyme which blocks conversion of testosterone to DHT

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9
Q

5-ARIs should NOT be used in:

A

men who have bladder outlet obstruction symptoms without prostate enlargement

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10
Q

What is the first-line treatment for mod-severe BPH

A

alpha blockers

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11
Q

Alpha-blocker MOA

A

Inhibit alpha-1 adrenergic receptors, causing relaxation of smooth muscle in the prostate bladder neck, reducing bladder outlet obstruction and improves urinary flow

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12
Q

Which alpha receptor is primarily found in the prostate

A

Alpha-1A

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13
Q

What are the non-selective alpha-1 blockers

A

terazosin and doxazosin

Have more side effects

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14
Q

Doxazosin brand name

A

Cardura

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15
Q

What time of day are non-selective alpha-blockers taken

A

at bedtime (to minimize initial first-dose effect of orthostasis/dizziness)

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16
Q

Tamsulosin brand name

A

Flomax

17
Q

Alpha-blockers warnings

A

Orthostatic hypotension/syncope

Intraoperative floppy iris syndrome can occur in cataract surgery

18
Q

Alpha-blockers SE

A

dizziness, fatigue, HA, abnormal ejaculation

19
Q

Alpha-blockers may need __-__ weeks to assess whether beneficial effects have been achieved

A

4-6 weeks

20
Q

T/F: Alpha-blockers do not shrink the prostate or change PSA levels

A

True

21
Q

Cardura XL counseling point

A

OROS formulation - leaves a ghost tablet

22
Q

Silodosin can cause

A

retrograde ejaculation

23
Q

Tamsulosin dosing

A

0.4 mg daily

24
Q

Finasteride brand name

A

Proscar

25
Q

5-ARI CI

A

women of childbearing age, pregnancy

26
Q

5-ARI SE

A

impotence, ↓ libido, ejaculation disturbances, breast enlargement and tenderness

27
Q

How long do 5-ARI take for maximal efficacy

A

6 months

28
Q

T/F: 5-ARI shrink the prostate and decrease PSA levels

A

True

NAPLEX (74 decks)

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