Male Disorders - 9/7 Fitzpatrick Flashcards
What drug should be avoided in hepatic impairment?
Alfuzosin
Which PDE I has selectivity for the retina?
What drugs act here?
What adverse side effect?
6
Sildenafil, vardenafil
Blue vision disturbance
Which SAR inhibitor is specific?
For what?
Finasteride
SAR II
Prostate alpha subtype receptor?
Alpha-1 A
Alpha 1A receptors + NE = what?
Muscle contraction
Hypertrophic prostate has excess what?
Steroid 5alpha-reductase (SAR) type II
How does NO cause smooth muscle relaxation?
Activates guanylate cyclase -> cGMP
What breaks down cAMP?
PDE-2, 3, 4
What do PDE-5 I’s inhibit?
Name them
cGMP breakdown
Sildenafil
Vardenafil
Tadalafil
Which PDE-5I should be taken on an empty stomach?
Sildenafil
Vardenafil
Terazosin and Doxazosin have what adverse effects?
Uroselective?
Drug interaction?
Postural hypotension
NO
PDE-5 inhibitors
What are the adverse effects of SAR inhibitors?
ED
Gynecomastia
Dec libido
Ejaculation disturbance
How are PDE-5I’s cleared?
hepatic CYP 3A4
How does caverject and PGE2 work?
Activates cAMP
What are the adverse effects of Tamsulosin and Silodosin?
Drug interaction?
Reduced ejaculation
Floppy iris syndrome (IFIS)
Cyp450
What is the main contraindication of PDE-Is?
Organic nitrates (for chest pain)
PDE-5I have what adverse side effects?
Headache
Dyspepsia
Nasal congestion
Caverject injects what substances to cause vasodilation and erection?
PGE2
Papaverine
Phentolamine
Which drug is non-specific for alpha 1 subtypes?
Alfuzosin
Which PDE-I is not recommended to be use for BPH with alpha 1-blockers?
Tadalafil
Alpha 1D receptors + NE = what?
Detrusor instability
Detrusor alpha subtype receptor?
Alpha 1D > alpha 1A
What are the alpha 1 antagonists used to treat LUTS?
Da TATS
Doxazosin Terazosin Afluzosin Tamsulosin Silodosin
What drug causes the side effects of back pain, myalgia, and lim pain?
Treatment?
Tadalafil
NSAID
Spinal Cord alpha subtype receptor?
alpha 1D
Which SAR decreases serum DHT more?
Dutasteride
Which PDE I has selectivity for the corpus cavernosum?
5
Which alpha 1 antagonists are selective?
Selective for which sub-types?
Tamsulosin
Silodosin
Alpha 1A and alpha 1D
What converts serum testosterone to DHT in cells?
5alpha-reductase (I and II)
Which PDE-5I has the longest efficacy and half life?
Tadalafil
What are the direct effects of SARII inhibition?
Indirect?
Testosterone accumulation and DHT depletion
AR receptor less occupied
Which SAR inhibitor is non-specific?
For what?
Dutasteride
SAR I and II
What PDE5I is FDA approved for treatment of BPH?
Tadalafil
Blood vessels alpha subtype receptor?
alpha 1B >/equal to alpha 1A
Alfuzosin has what adverse effects?
QT prolongation
How are SAR inhibitors metabolized?
Caution for use when?
CYP3A
Liver abnormality