Mens Health Flashcards
What is the most common type of alopecia
Androgenic alopecia
What is the other type of alopecia that is that is auto immune less common and patient have patches of hair
Alopecia areata
What type of alopecia causes complete hair loss on scalp and body
Alopecia universalis
For drug induced alopecia what drugs can cause it
Anabolic steroids and cancer chemotherapy
What is the treatment option for alopecia in men
Finasteride or propecia
What are the side effects of Finasteride
ED, decreased volume of ejaculation, women of child bearing age should not handle, decreased libido.
How does Finasteride work
Block 5 alpha reductase from changing testosterone to DHT
What is the dosing for Finasteride for treating alopecia
1 mg by mouth daily. We want low dose cos they use high dose to treat BPH
Mention another treatment for alopecia
Minoxidil or rogaine..apply to scalp twice daily
What is the serum concentration levels of testosterone that confirms low testosterone level
First test has to be less than 300 ng/dl and a second test of free testosterone being less than 5 ng/dl
What are the counter indications for testosterone replacement therapy
Breast cancer. Prostrate cancer. Hematocrit greater than 50 percent Recent or poorly Cardiovascular disease base line PSA greater than 4 ng/ml or PSA greater than 3 ng/ml in men at high risk of prostrate cancer
What disease can contribute to diabetes
Diabetes. Hypertension Parkinson’s. Stroke. Low testosterone
What are the physical things that can cause ED
Injury on the bicycle. Prostrate surgery and chemotherapy
What are the drugs that can cause ED
Antidepressants particularly SSRI’s. Antihypertensive drugs. Estrogens/anti androgens. 5 alpha reductase Inhibitors. Cancer chemotherapy
What unhealthy lifestyles can cause ED
Excessive alcohol. Tobacco smoking. Obesity. Inadequate sleep. Stress
Stepwise treatment for Ed
Treat or eliminate known causes. Oral PDE-5 inhibitors. Intraurtheral or intracarvenous injection. Combination therapy. Penis prosthesis
What is the first line treatment for ED and what is important about their usage
PDE-5 inhibitors. You need to have sexual stimulation for this drugs
What are the two PDE-5 Inhibitors
Tadalafil. Sildefanil
Counterindications for PDE 5 inhibitors
Oral or transdermal Nitrates cos it can cause hypotension. Patients on alpha blockers Patients with severe coronary artery disease. If erection lasts more than 4 hours call your doctor
What is the only PDE-5 inhibitor indicated for BPH and list the dosing
Tadalafil and the dose are 2.5, 5, 10 and 20 mg
What are alprostadil pallets? What makes them better than oral PDE-5 inhibitors
They are prostaglandins and their dosage form is a transurtheral suppository. They are better than oral PDE-5 inhibitors cos you don’t need stimulation for them
What type of patients can take alprostadil injection
Best for patients who fail PDE-5 inhibitors or patients whose source of ED is neurogenic(from the brain)
What are the potential side effects of alprostadil injections
Risk of priapism(prolonged erect ion) during titration. Penile pain and local irritation, cavernosal plagues
Why is trimix not used for ED intracavernosal injection
Greater risk of priapism and also aloprostadil injection is more efficacious
What drug can be used to treat priapism
Phenylpherine
What drugs can cause priapism
ED drugs, antidepressants, antipsychotics, blood thinners, cocaine and alcohol
What is Xiaflex
Treats peyronie disease
What ethnicity has the highest rate of prostrate cancer
Non Hispanic blacks. They have 198.4 per 100,000. 42.8 per 100,000
What is the PSA score for a person who does not have prostrate cancer
Under 4ng/ml
What are the two symptoms of BPH
Obstructive and irritative
What type of BPH symptoms is the most devastating to the quality of life
Irritative
What symptoms of irritative BPH makes it bad
Nocturia which is 2 or more voids per night
Explain obstructive BPH
You have residual volume of like 25-30 ml of urine inside of you
Rank the severity of BPH based on AUA score from mild to severe
Mild : AUA score is less or equal to 7. Moderate: AUA score is 8 to 19. Severe: AUA score is greater or equal to 20
What drugs do we wanna avoid for treatment of BPH
First general antihistamines like Benadryl. Tricyclic antidepressants
When should we not consider a muscarinic antagonist for BPH
If the residual volume is greater than 200 no or the max urine flow is lesser than 5 ml per seconds
What is the alpha blocker drug used to treat BPH commonly
Tamsulosin
What are the side effects of alpha blockers
Orthostatic hypotension, dizziness, fatigue, headache
What is the PDE-5 inhibitor used for BPH and what is the strength
Tadalafil 5mg daily
What drug must alpha reductase inhibitors be in combo with to treat BPH and why
In combination with an alpha antagonist because it takes 6 months for the drug to start working.
What are the two drugs for alpha reductase inhibitors for BPH and lost their dose
Finasteride 5 mg daily and dutasteride 0.5 mg daily.
What makes Dutasteride 0.5 mg better than Finasteride 5mg
Finasteride 5mg is high dose so can cause ED but dutasteride is 0.5 mg so low dose can’t cause ED
What is the drug and dose of the drug used for alopecia
Finasteride 1mg daily.
