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Pharm > Drugs for ED And BPH > Flashcards

Drugs for ED And BPH Flashcards

1
Q

The penis is innervated by what system?

A

ANS

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2
Q

Erection is under control of what system?

A

PSNS

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3
Q

Ejaculation and penile relaxation is under what system

A

SNS

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4
Q

Defined as the persistent inability to either achieve or sustain an erection to permit satisfactory intercourse

A

Impotence

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5
Q

What are potential causes of ED?
(Chronic diseases and psychological)

A

Chronic disease- DM and HTN
psychological- anxiety and depression

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6
Q

Drug induced causes:

A

Thiazide diuretics
Beta blockers
Cardiac glycosides
Aldosterone antagonist
Antidepressants(SSTIs-TCAs-MAOIs)
Antipsychotics
Mood stabilizers

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7
Q

Physiology of an erection

A

More blood flowing in and less flowing out, the penis enlarged, resulting in an erection

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8
Q

Prototype drug for ED:

A

sildenafil

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9
Q

Class and MOA of sildenafil

A

Class: selective phosphodiesterase-5 inhibitor(PDE5)
MOA: increases and preserves cGMP levels

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10
Q

Therapeutic uses for sildenafil

A

-enhances an erection caused by physical contact or other sexual stimuli
-DOES NOT DIRECTLY CAUSE AN ERECTION
-only administered PRN

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11
Q

While on sildenafil, you must wait 24 hours before taking what drug?

A

A nitrate

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12
Q

ADR for sildenafil?

A

-hypotension
-nonarteritic ischemic optic neuropathy(NAION)/ transient vision changes
-sudden hearing loss (unilateral)
-priapism
-milf transient visual disturbances

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13
Q

Should you take sildenafil with high-fat meals?

A

No, it delays absorption

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14
Q

How many times a day should you take sildenafil?

A

1 dose in 24 hours

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15
Q

What drug has a prolonged duration of action?

A

Tafalafil

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16
Q

How long should you wait before taking a nitrate with tadalafil?

A

48 hours (longer half-life)

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17
Q

What two things are contraindicated with in tafalafil?

A

-nitrates
- alpha blockers (except tamsulosin)

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18
Q

When does tadalafil reach its full therapeutic effect?

A

2 hours

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19
Q

What drug can be used for ED and BPH?

A

Tadalafil

20
Q

What is the class for alprostadil?

A

Prostaglandin E1

21
Q

What are the 2 routes of administration for alprostadil?

A

Intracavernous
Transurethral

22
Q

Most common adr for intracavernous alprostadil?

A

Penile burning

23
Q

Which route is injected directly into corpus cavernosum?

A

Intracavernous

24
Q

How long should an erection last on intracavernous?

A

No longer than 1 hour

25
Q

How many times should you use intracavernous?

A

No more than 3x/week & no more than once in a 24 hour period

26
Q

Which route is the insertion of a pellet into the urethra?

A

Transurethral

27
Q

What is the onset and duration of transurethral?

A

Onset of erection: 5-10 min
Duration: 30-60 min

28
Q

How many times a day can you use transurethral?

A

No more than 2 times/day

29
Q

What are 2 factors that are responsible for the patho genesis of BPH?

A
  1. Mechanical obstruction
  2. Dynamic obstruction
30
Q

4 clinical manifestations of BPH?

A
  1. Hesitancy and post-void dribble
  2. Diminished force of urinary stream
  3. Urinary frequency,urgency and nocturia
  4. Feeling of incomplete bladder emptying
31
Q

2 different classes of meds for BPH?

A

-alpha 1 adrenergic blockers (antagonist)
- 5-alpha reductase inhibitors

32
Q

What type of class is finasteride?

A

5-alpha reductase inhibitors

33
Q

MOAs of finasteride

A

-inhibits 5-alpha-resuctase
-eliminates hormonal signal for prostate growth
-gradually promotes shrinkage of enlarged prostate

34
Q

What is finasteride also marketed as?

A

Propecia- prescribed to promote hair regrowth in men with male-pattern baldness.

35
Q

In finasteride, the doses are 5 times higher when treating what?

A

BPH

36
Q

ADRs for finasteride

A

-diminished libido
-ejaculate volume reduction
-gynecomastia

37
Q

What drug is highly teratogenic and may cause harm to male fetus?

A

Finasteride

38
Q

BPH full therapeutic effects for finesteride?

A

6-12 months

39
Q

Alpha 1 receptor blockers MOA:

A

-relaxes smooth muscle in the
Prostatic capsule
Bladder neck ( trigone and sphincter)
Urethra- decreases dynamic obstruction

40
Q

Which two drugs only treat BPH?

A

-tamsulosin & silodosin

41
Q

ADR for tamsulosin &silodosin

A

-ejaculation failure
-retrograde ejaculation

42
Q

Tamsulosin and silodosin are selective for what

A

Alpha 1 receptors

43
Q

Is terazosin and doxazosin selective or nonselective?

A

Nonselective

44
Q

What 2 drugs are beneficial in those with HTN &BPH

A

Terazosin and doxazosin

45
Q

3 adrs for terazosin & doxazosin?

A
  • hypotension
    -fainting
    -dizziness
46
Q

Does alpha 1 receptor blockers reduce the prostate size or PSA level?

A

NO

Pharm (11 decks)

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