male reproductive pharm

Question 1

PDE5 I

Answer 1

sildenafil
(prototype)

Question 2

PDE5 I: moa

Answer 2

inhibit PDE5
increase and preserves cGMP levels
only enhances normal response to sexual stimuli
no effect on erection quality if no ED

Question 3

PDE5 I: I

Answer 3

relief of ED
pulmonary arterial htn
BPH
timing: up to 4hr before sexual activity (onset: 30-60)

Question 4

PDE5 I: SE

Answer 4

HA, flushing, dyspnea
caution with preexisting CV disease, if on nitrate RX; and hypoT

Question 5

PDE5 I: teaching

Answer 5

dont take if taking any nitrates (will drop BP and pass out)
if you have chest pain or other S of MI during sex, call 911
sudden loss of vision in 1 or both eyes, sudden loss of hearing
no more than 1/day
priapism: erection is painful or lasts >4hr = medical emergency

Question 6

5 alpha reductatse I

Answer 6

finasteride
dutasteride

Question 7

5 alpha reductatse I: I

Answer 7

mechanical obstruction of urethra

Question 8

5 alpha reductatse I: moa

Answer 8

blocks conversion of testosterone to DHT (alpha 1 receptors) thereby decreases epithelial tissue in prostate (decreasing mechanical obstruction)
doesnt decrease overall circulating testosterone levels

Question 9

5 alpha reductatse I: nc

Answer 9

will work best if those with extremely enlarged prostates
takes 6-12 mo to see results
take for rest of life

Question 10

5 alpha reductatse I: SE

Answer 10

increase hair growth (sometime used to treat pattern baldness)
impotence, decreased libido, gynecomastia
side note: decreases prostate specific antigen levels (PSA - measure before starting drug and 6 mo after, eval for prostate cancer if # not falling), used for male pattern baldness
caution in handling: preg women dont touch - defects of male fetus
males taking this cannot give blood

Question 11

alpha 1 adrenergic antagonists

Answer 11

tamsulosin
(prototype)

Question 12

alpha 1 adrenergic antagonists: moa

Answer 12

relaxes smooth muscle cells
selective for alpha receptors in prostate (no systemic effect), bladder neck, and urethra

Question 13

alpha 1 adrenergic antagonists: I

Answer 13

dynamic obstruction of urethra

Question 14

alpha 1 adrenergic antagonists: nc

Answer 14

smooth muscle relaxation happens almost immediately
take lifelong if you want to maintain benefits

Question 15

alpha 1 adrenergic antagonists: SE

Answer 15

well tolerated
abn ejaculation
does not reduce PSA

Question 16

combo therapy

Answer 16

dutasteride + tamsulosin
FDA approved for BPH
evidence based: combining a 5 alpha reductase I with an alpha blocker is superior to either agent alone
expensive