passmed 30/12

Question 1

BPH pharmacological management:

Answer 1

Tamsulosin alpha 1 antagonist; decreases smooth muscle tone of the prostate and bladder, considered first line if mod to severe voiding symptoms. SE; dizziness, postural hypotension, dry mouth, depression.

Significantly enlarged prostate and risk of progression: FINASTERIDE 5 alpha reducatse inhibitor. Cause reduction in prostate volume but can take up to 6 months to effect. SE: erectile dysfunction, reduced libido, ejaculation problems, gynaecomastia.

Mod to severe storage symptoms and enlargement causing voiding problems = combination therapy with tamsulosin and antimuscarinic e.g. tolterodine / darifenacin

Question 2

what is sildafenil used for and how does it work? And what are the contraindications

Answer 2

erectile dysfunction

Enhances effect of nitric oxide in the body which leads to vasodilation and increased blood flow to the penis during sexual stimulation

Use of nitrates and nicorandil is contraindicated due to the combined vasodilatory effect causing excessive drop in blood pressure.