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pharmacology > ED, BPH > Flashcards

ED, BPH Flashcards

1
Q

Sildenafil
Tadalafil
Vardenafil
Avanafil

A

PDE-5 inhibitors

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2
Q

True or false: PDE-5 inhibitors don’t CREATE erections, they FACILITATE erections

A

TRUE

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3
Q

Longest lasting PDE5 inhibitor

A

Tadalafil 18-36 hours

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4
Q

PDE-5’s with FASTEST onset (15 minutes)

A

Tadalafil & Avanafil

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5
Q

PDE-5 with slowest onset

A

Vardenafil (1 hour)

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6
Q

AEs of PDE-5 inhibitors

A

headache, facial flushing, nasal congestion, dyspepsia, myalgia, bac pain, hypotension, dizziness, hearing impairment, priaprism
RARE - ischemic optic neuropathy

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7
Q

Which 2 PDE-5 inhibitors can cause blurred vision, inability to distinguish between blue and green?

A

Vardenafil

sildenafil

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8
Q

What is the biggest contraindication with PDE-5 inhibitors?

A

CARDIOVASCULAR RISK

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9
Q

Which cardiovascular drug to be cautious of when prescribing a PDE-5 inhibitor, and what guidelines do you give regarding the interaction?

A

Nitrates + PDE-5.

Do not take within 24 hours of each other (48 hours w/ tadalafil)

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10
Q

Which ED drug works by stimulating adenyl cyclase, causing increased cAMP and increased blood flow, allowing erection?

A

Alprostadil

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11
Q

Alprostadil is used for what disorder?

A 
Erectile dysfunction
(2nd line treatment)
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12
Q

How is alprostadil administered?

A

IV - FAST onset

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13
Q

True or False: Testosterone supplementation can be started as long as the serum Testosterone levels are high

A

FALSE! must be LOW to consider this

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14
Q

What are the contraindications of using Testosterone supplementation?

A

prostate cancer
erythrocytosis
uncontrolled HF
sleep apnea

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15
Q

What is the ratio of epithelial to stromal tissue in the prostate?

A

1:5 (more stromal tissue)

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16
Q

Of the BPH medications, which is preferred over the other and why?

A

Alpha antagonists preferred over 5-alpha reductase

-faster, and improve symptoms regardless of prostate size

17
Q

Do 5-alpha reductase medications work fast or slow?

A

slow - delayed onset up to 6 months to reach full efficacy

18
Q 
Terazosin
Doxazosin
Alfuzosin
Tamsulosin
Silodosin
(prazosin)
A

Alpha adrenergic antagonists (BPH)

19
Q

Alfuzosin and Silodosin are contraindicated in what type of impairment?

A

hepatic

use others w/ caution

20
Q

Which alpha adrenergics are NONUROSELECTIVE?

A

Terazosin and Doxazosin

21
Q

Which alpha adrenergics are UROSELECTIVE?

A

Alfuzosin, Tamsulosin, Silodosin

22
Q

What does uroselective mean?

A

targets alpha 1A and 1D receptors, which dominate the prostate, urethra, bladder

23
Q

NONUROSELECTIVE alpha adrenergics have an increased risk of what complication?

A

CV effects - binds peripheral receptors, causing hypotension

24
Q

True or false: since alpha adrenergic antagonists lower BP, they are safe for hypertension monotherapy

A

FALSE!

higher risk of heart failure this way

25
Q

What are some other adverse effects of alpha adrenergics?

A

ejaculation disorders, rhinitis and malaise, floppy iris/small pupil syndrome

26
Q

Finasteride

Dutasteride

A

5-alpha reductase inhibitors

27
Q

This class of BPH medication shrinks prostate after 6 months of use

A

5-alpha reductase inhibitors

28
Q

Whereas alpha adrenergics are used for symptom relief, what are 5-alphas used for?

A

prevention of BPH complications and progression.

29
Q

Contraindication of 5-alpha reductase inhibitors?

A

PREGNANCY - may cause feminization of male fetus

30
Q 
Which adverse effect of 5-alpha reductase inhibitors is false:
decreased libido
ED
ejaculation disorder
decreased testosterone
A

Decreased testosterone (should be INCREASED)

31
Q

when is combo therapy 5-alpha reductase + alpha antagonists used?

A

when monotherapy is unsuccessful OR if patient at high risk of complications.

32
Q

25% of ED is caused by what?

A

medications

33
Q

CONTRAINDICATIONS for testosterone supplementation

A

High serum Testosterone, prostate cancer, sleep apnea, uncontrolled HF

34
Q

alpha antagonists work best if prostate is ______, while 5-alpha’s work best if prostate is _____

A

small; large

35
Q

what is first dose syncope?

A

syncope with first dose of Terazosin/Doxazosin (BPH meds) - start with lower dose and titrate up

pharmacology (12 decks)

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