Male Disorders - 9/7 Fitzpatrick

Question 1

What drug should be avoided in hepatic impairment?

Answer 1

Alfuzosin

Question 2

Which PDE I has selectivity for the retina?

What drugs act here?

What adverse side effect?

Answer 2

6

Sildenafil, vardenafil

Blue vision disturbance

Question 3

Which SAR inhibitor is specific?

For what?

Answer 3

Finasteride

SAR II

Question 4

Prostate alpha subtype receptor?

Answer 4

Alpha-1 A

Question 5

Alpha 1A receptors + NE = what?

Answer 5

Muscle contraction

Question 6

Hypertrophic prostate has excess what?

Answer 6

Steroid 5alpha-reductase (SAR) type II

Question 7

How does NO cause smooth muscle relaxation?

Answer 7

Activates guanylate cyclase -> cGMP

Question 8

What breaks down cAMP?

Answer 8

PDE-2, 3, 4

Question 9

What do PDE-5 I’s inhibit?

Name them

Answer 9

cGMP breakdown

Sildenafil
Vardenafil
Tadalafil

Question 10

Which PDE-5I should be taken on an empty stomach?

Answer 10

Sildenafil

Vardenafil

Question 11

Terazosin and Doxazosin have what adverse effects?

Uroselective?

Drug interaction?

Answer 11

Postural hypotension

NO

PDE-5 inhibitors

Question 12

What are the adverse effects of SAR inhibitors?

Answer 12

ED
Gynecomastia
Dec libido
Ejaculation disturbance

Question 13

How are PDE-5I’s cleared?

Answer 13

hepatic CYP 3A4

Question 14

How does caverject and PGE2 work?

Answer 14

Activates cAMP

Question 15

What are the adverse effects of Tamsulosin and Silodosin?

Drug interaction?

Answer 15

Reduced ejaculation
Floppy iris syndrome (IFIS)

Cyp450

Question 16

What is the main contraindication of PDE-Is?

Answer 16

Organic nitrates (for chest pain)

Question 17

PDE-5I have what adverse side effects?

Answer 17

Headache
Dyspepsia
Nasal congestion

Question 18

Caverject injects what substances to cause vasodilation and erection?

Answer 18

PGE2
Papaverine
Phentolamine

Question 19

Which drug is non-specific for alpha 1 subtypes?

Answer 19

Alfuzosin

Question 20

Which PDE-I is not recommended to be use for BPH with alpha 1-blockers?

Answer 20

Tadalafil

Question 21

Alpha 1D receptors + NE = what?

Answer 21

Detrusor instability

Question 22

Detrusor alpha subtype receptor?

Answer 22

Alpha 1D > alpha 1A

Question 23

What are the alpha 1 antagonists used to treat LUTS?

Answer 23

Da TATS

Doxazosin
Terazosin
Afluzosin
Tamsulosin
Silodosin

Question 24

What drug causes the side effects of back pain, myalgia, and lim pain?

Treatment?

Answer 24

Tadalafil

NSAID

Question 25

Spinal Cord alpha subtype receptor?

Answer 25

alpha 1D

Question 26

Which SAR decreases serum DHT more?

Answer 26

Dutasteride

Question 27

Which PDE I has selectivity for the corpus cavernosum?

Answer 27

5

Question 28

Which alpha 1 antagonists are selective? Selective for which sub-types?

Answer 28

Tamsulosin Silodosin Alpha 1A and alpha 1D

Question 29

What converts serum testosterone to DHT in cells?

Answer 29

5alpha-reductase (I and II)

Question 30

Which PDE-5I has the longest efficacy and half life?

Answer 30

Tadalafil

Question 31

What are the direct effects of SARII inhibition? Indirect?

Answer 31

Testosterone accumulation and DHT depletion AR receptor less occupied

Question 32

Which SAR inhibitor is non-specific? For what?

Answer 32

Dutasteride SAR I and II

Question 33

What PDE5I is FDA approved for treatment of BPH?

Answer 33

Tadalafil

Question 34

Blood vessels alpha subtype receptor?

Answer 34

alpha 1B >/equal to alpha 1A

Question 35

Alfuzosin has what adverse effects?

Answer 35

QT prolongation

Question 36

How are SAR inhibitors metabolized? Caution for use when?

Answer 36

CYP3A Liver abnormality