Men's Health

Question 1

What is Tamsulosin used for?

Answer 1

tx of symptoms of benign prostatic hyperplasia in males aged 45 to 75 years

Question 2

How does tamsulosin work?

Answer 2

alpha-blocker that relaxes smooth muscle in BPH producing an increase in urinary flow-rate and an improvement in obstructive symptoms

Question 3

What dose is usually given?

Answer 3

400mcg after the same meal each day

Question 4

What are C/I associated with tamsulosin ?

Answer 4

• symptoms are <3 months duration
• prostate surgery
• unstable or undiagnosed diabetes
• problems with liver, kidney heart
• fainting dizziness or weakness when standing
• eye operation or catarct planned
• recent blurred or cloudy vision
• hypersenstivity

Question 5

When would you refer a pt on tamsulosin?

Answer 5

• dysuria, haematuria, cloudy urine in the past 3 months
• fever that might be related to a UTI
• if urinary symptoms have no improved within 14 days of starting tx or are getting worse - pt should stop with FLOMAX RELIEF

Question 6

how often should a pt see their doctor that is taking tamsulosin?

Answer 6

within 6 weeks of starting tx and every 12 months

Question 7

what can tamsulosin interact with?

Answer 7

Antihypertensive meds with significant alpha-1 adrenoreceptor antagonist activity
hypotensive effect when these drugs are given with other drugs to reduce BP
should be used in caution with (ketoconazole and erthroymycin) inhibitors of CYP3A4

Question 8

What age can sildenafil be supplied?

Answer 8

in men over 18 years old

Question 9

How often should you use sildenafil 50mg (viagra connect) ?

Answer 9

no more than one a day and one hour before sexual activity

Question 10

What is MOA of sildenafil?

Answer 10

phosphodiesterase type-5 inhibitor which breakdowns down cGMP caused by nitric oxide activation. This relaxes smooth muscle of the corpus cavernosum because of the breakdown of cGMP which allows continual blood flow to aid maintaining an erect penis. But sexual stimulation is required for sildenafil to actually work.

Question 11

When would you refer a pt when taking sildenafil?

Answer 11

1. Priapism - long lasting painful erection - pts on sildenafil can have an erection for more than 4 hours
2. Any of the following after sexual intercourse: Chest pains which do not go away - no GTN spray, pts should try and relax but if it continues call 999, any nausea or dizziness
3. sudden decreases or loss in vision
4. any anaphylactic reactions
5. serious skin reactions. stevens-johnsons syndrome

Question 12

Any contra-indications for pts taking sildenafil?

Answer 12

1. Hypotension
2. Hepatic impairment
3. Severe renal impairment
4. Any bleeding conditions (haemophillia) or suffer with stomach ulcers
5. Cardiovascular conditions
6. if pt does not ED, sildenafil will not work

Question 13

Which drugs can interact with sildenafil can cause a severe hypotensive effect?

Answer 13

nitrates - GTN, isosorbide mononitrate

nitric oxid donors - nicorandil

Question 14

what other drugs can interact with sildenafil?

Answer 14

CYP3A4 inhibitors - erythromycin, diltiazem
alpha blockers
grapefruit juice

Question 15

What are common side effects pts can get?

Answer 15

flushing
headache
dizziness
nausea

Question 16

What are some counselling points you would talk to pt about the contributing factors of ED?

Answer 16

Long-term conditions can affect ED - like diabetes, hypertension

Some medication can also affect - like MTX, ACEI, SSRIs

General healthy living - stop smoking, exercising regularly reducing stress

Make an appt with the doctor 6 mnths after starting tx