Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal System > Drugs for BPH, RCC and Wilm's Tumor > Flashcards

Drugs for BPH, RCC and Wilm's Tumor Flashcards

1
Q

What is BPH?

A

Benign prostatic hyperplasia, a common urologic disorder in males.
Non-malignant enlargement of the prostate, which occurs naturally with age

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

What are the classes of drugs used to treat BPH?

A

α -1 adrenergic antagonists
5-α reductase inhibitors
PDE-5 inhibitors

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

What are examples of α -1 adrenergic antagonists (BPH)? (5)

A

Terazosin
Doxazosin
Tamsulosin
Alfuzosin
Silodosin

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

What are α -1 adrenergic antagonists?

A

They are all selective blockers of α -1 adrenergic

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

What is Prazosin?

A

Also, an α -blocker that is used off-label to treat BPH, current guidelines do not support this use

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

What kind of agonist is Prazosin?

A

Inverse agonist at α -1ARs

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

What does α(1A) target?

A

The prostate

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

What does α(1B) target?

A

Prostate and vascalture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does α(1D) target?

A

Vascalture

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

What is the effect of blocking α(1A) and α(1B)?

A

Blocking A & B of the prostate will cause SMCs of the prostate to relax –> improving urine flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MOA of Doxazosin, Terazosin, and Alfuzosin?

A

Block α(1A) and α(1B), thus reducing systemic vascular resistance and BP by relaxing vascular smooth muscle cells

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

What is the MOA of Tamsulosin & Silodosin?

A

Block mainly α(1A), which means little effect on systemic vascular resistance and BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the PK of α1-adrenergic antagonists? (5)

A
  1. Well-absorbed following oral administration
  2. Absorption of alfuzosin, tamsulosin, and silodosin is increased if taken with food
  3. Doxazosin, alfuzosin, tamsulosin, and silodosin are metabolized by the P450 system
  4. Terazosin metabolized in the liver but NOT through the CYP system
  5. Silodosin requires dose adjustment in Renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What other way is Silodosin metabolized?

A

By P-glycoprotein

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

When are Alfuzosin, Tamsulosin, and Silodosin given?

A

With or after a meal

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

What is the contraindication with Silodosin?

A

Patients with severe renal dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the adverse effects of α1-adrenergic antagonists? (9)

A
  1. Orthostatic hypotension
  2. Tachycardia
  3. Vertigo
  4. Headache
  5. Fatigue
  6. Nasal congestion
  7. Dizziness & Drowsiness
  8. Floppy iris syndrome
  9. Blocking αARs on the ejaculatory duct may inhibit ejaculation or cause retrograde ejaculation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which α1-adrenergic antagonists mainly causes floppy iris syndrome?

A

Tamsulosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is retrograde ejaculation like?

A

Semen enters the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the drug interaction of α1-adrenergic antagonists?

A

Inducers of CYP450 reduce levels of these antagonists
Inhibitors of 3A4 and 2D6 increase the levels of alpha1 blockers
Alfuzosin –> QT prolongation (class III antiarrhythmics)
Silodosin is broken by P-glycoprotein, so P-glycoprotein inhibitors increase Silodosin’s levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are examples of CYP450 inducers?

A

Phenytoin
Phenobarbital
St. John’s wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an example of a P-glycoprotein inhibitor?

A

Cyclosporine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are examples of 5-α reductase inhibitors?

A

Finastreride and Duttasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How long may 5-α reductase inhibitors take to relieve symptoms?

A

Up to 12 months

25
How long may -alpha blockers take to relieve symptoms?
Within 7 to 10 days
26
What is the MOA of 5α reductase Inhibitors?
They inhibit 5α reductase which prohibits the conversion of testosterone into dihydrotestosterone (which is more active)
27
What are the PK of 5α reductase Inhibitors? (2)
1. Food does not affect their absorption 2. Both are metabolized by the PY450 system
28
What are the adverse effects of 5α reductase Inhibitors?
Sexual and teratogenicity
29
What are the contraindications of 5α reductase Inhibitors?
Pregnancy because they are teratogenic
30
What are the sexual adverse effects of 5α reductase Inhibitors?
Decreased libido, decreased ejaculate, erectile dysfunction, gynecomastia, oligospermia
31
What is the combination therapy of 5α reductase Inhibitors?
Since it takes several months to reduce prostate size, use in combination with alpha-blockers
32
Which drug causes a decrease in prostate size?
5α reductase Inhibitors
33
Which drug causes decrease in PSA?
5α reductase Inhibitors
34
Which drug has hypotensive effects?
α-1 adrenergic antagonists
35
What are the commonly used α-1 adrenergic antagonists?
Tamsulosin and Alfuzosin
36
What is an example of PDE 5 Inhibitors?
Tadalafil is the only one approved for BPH
37
What is te function of PDE 5 Inhibitors?
PDE 5 is present in the prostate and the bladder thus, blocking it allows for vasodilation AND smooth muscle cells relaxation of the prostate and bladder --> improving symptoms of BPH
38
What is PDE 5 approved regimen for BPH?
ENTADFI (Finasteride & Tadalafil)
39
Where does RCC arise from?
Renl tubular epithelium
40
What are the clinical divisions of RCC?
Clear cell and Non-clear cell
41
What is the most common subtype of RCC?
Clear cell RCC (75% or more)
42
Why is clear cell RCC named as such?
Due to the dissolution of high lipid contents during histological preparation that leaves a clear residual cytoplasm
43
What does non-clear RCC affect?
Papillary, medullary, chromophobe, and collecting duct
44
What is the treatment for localized RCC?
Surgery
45
What % of ccRCC cases have alteration in the VHL tumor suppressor gene?
90% of the cases
46
What does the loss of function of the VHL gene cause?
Hypoxia-inducible factor (HIF)
47
What is the effect of increased HIF?
Production of proangiogenic factors, mainly VEGF, PDGF, and FGF Also induces activation of MET and AXL, proangiogenic factors that promote malignancy and metastasis
48
What are the currently used first-line agents used in RCC?
1. Suntinib, antixinib, pazopanib 2. Cabozantinib 3. Permolizumab 4. Ipilimumab 5. Nevilumab
49
What is the purpose of TKIs (tyrosine kinase inhibitors) in the systemic therapy of RCC?
Inhibits signaling pathways
50
What is the MOA of Cabozantinib?
Targets VEGFR, MET & AXL --> thus simultaneously suppresses metastasis, angiogenesis, and tumor growth
51
What is the MOA of Sunitinib?
Blocks RTK autophosphorylation and the consequent signaling
52
What are the PK of Sunitinib?
1. Food has no effect on urs bioavailability 2. Meatbolised by CYP3A4
53
What are the adverse effects of Sunitinib?
Fatigue Diarrhea Nausea Anorexia Hypertension Yellow skin discoloration Hand-foot skin reaction Stomatitis
54
What are the drug interactions of Sunitinib?
Inducers of CYP3A4 will reduce its levels Avoid GRAPEFRUIT juice Avoid St. John's wort
55
Why should you avoid grapefruit juice when taking Sunitinib?
It inhibits CYP3A4
56
57
57
58

Renal System (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions