Module 6: GU

Question 1

Prostatitis

-1st line Treatment w/ NO suspected STD?

Answer 1

1. Levofloxacin (Levoquin)
2. Ciprofloxacin (Cipro)
3. Bactrim

Duration is 4-6 weeks of treatment

Question 2

Prostatitis

-1st line Treatment w/ Suspected STD

Answer 2

1. Ceftriaxone Or Cefixime
   AND
2. Azithromycin

Doxycycline may work better for Chlamydia but is 2nd line for gonorrhea
-Best to treat w/ Azithromycin for adherence

Question 3

Prostatitis

-Chronic Treatment?

Answer 3

1. Lasting longer than 4-6 weeks (May need treatment for 12-15 weeks.
2. Treat with:
   - Levofloxacin (Levoquin)
   - Ciprofloxacin (Cipro)
   - Bactrim

Question 4

Prostatodynia

Answer 4

1. Pelvic pain usually between the scrotum and anus that is NON-BACTERIAL
2. S/S include fever, chills, low back pain, body aches
3. Typically chronic
4. Treatment with:
   - Alpha blockers (Tamsulosin) and anti-inflammatories for 6-12 weeks.

Question 5

Prostatodynia

-Treatment

Answer 5

1. To with alpha blockers (Tamsulosin) and anti-inflammatories for 6-12 weeks

Question 6

Prostatitis

-Adjunct treatment

Answer 6

1. Reduce caffeine intake
2. Antipyretics
3. Sitz bath
4. Stool softeners
   - Pain from prostatitis can be worse when stool pushes against the prostate.

Question 7

BPH

Answer 7

1. Most common prostatic problem in men over 50 yrs
2. Causes difficulty with urination
3. Diminished stream, urgency, can’t empty bladder; increased nocturnal voiding

Question 8

BPH

-Treatment Goals

Answer 8

1. Reduce bladder neck obstruction
2. Reduced symptoms
3. Decreased residual urine volume in bladder

Question 9

BPH

-1st line treatment?

Answer 9

1. Alpha blocker
   - Tamsulosin (Flomax) is not a BP med
   - Terazosin and doxazocin are both BP meds; caution with hypotension

Question 10

BPH Treatment

-Alpha Blockers S/E, Contraindications?

Answer 10

1. S/E
   - Tachyarrhythmias d/t BP dropping
   - Orthostatic hypotention
   - 1st dose syncope** Take first dose at night
   - Dizziness & fatigue
2. Contraindicated with:
   - Hepatic and renal insufficiency

Question 11

BPH Treatment

-2nd Line Treatment

Answer 11

1. Reductive Inhibitors
   - Finasteride (Proscar) & Dutasteride (Avodart)
2. Consider PSA effect
   - These meds can MASK or worsen prostate cancer
3. Finesteride is also used as a hair loss treatment in med and women

Question 12

BPH Treatment

-2nd Line (Reductase Inhibitors) S/E

Answer 12

1. Impotence
2. Decreased libido
3. Lower ejaculatory volume
4. Increased risk of prostate cancer

Contraindication:
-Category X for pregnant women

Question 13

Over Active Bladder Treatment

Answer 13

1. Oxybutinin (Ditropan)
2. Tolterodine (Detrol)
3. Work by antagonizing muscarinic receptors, reducing urine frequency and strength of destrutor muscle contraction (Feel less pressurized