Pharm II- Exam 3 Flashcards
1
Q
- Male Genitourinary Issues x2
- What is BPH
- how often in men > 60 yrs
- How often in men > 90 yrs
A
- Benign Prostatic Hyperplasia, erectile dysfunction
- Enlarged prostate gland
- 50%
- 90%
2
Q
- How do drugs work in treating BPH
- How long with patient need to take meds
- What three drug categories are used to treat?
A
- Alleviate symptoms only
- entire life
- Alpha 1 blocker- selective/nonselective, 5 alpha reductase inhibitors
3
Q
- What do non selective alpha 1 block?
- Most common reason ppl discontinue med tx
- When should you take this med?
A
- Alpha adrenergic receptors, arterioles, used to treat HTN
- orthostatic hypotension, headaches
- At night to work against SE of hypotension
4
Q
- What does not selective mean?
- Examples of nonselective drugs
- What is the difference between Selective alpha 1
A
- does not select for the prostate (also contraction receptor)
- terazosin, doxazosin, alfuzosin
- selects for prostate, no effect on BP
5
Q
- Examples of Selective Alpha 1’s
- What do 5a reducstase inhibitors do?
- How long for improvements
A
- Tamsulosin, Sliodosin
- reduce size of the prostate
- 6-12 mnths
6
Q
- What type of enzyme is 5A reductase
- What does dihydrotestosterone do?
- Instructions for admin
A
- responsible for converting testosterone to dihydrotestosterone
- proliferation of prostate cells
- Women wear gloves
7
Q
- 5A reductase inhibitor examples
- What is the first line agent for BPH?
- How is 5A reductase used?
A
- Finasteride, dutasteride
- Selective Alpha 1 Blocker (without hypertension)
- used in combination with either alpha 1 blocker
8
Q
- How does erectile dysfunction occur?
- Causes of erectile dysfunction
- How is it treated
A
- not enough blood flows to the penis during sexual stimulation
- psychoemotional, diabetes, HTN, Neurologic, Vascular insufficiency
- tx’s the cause
9
Q
- What is the first line therapy for erectile dysfunction
- How do they work?
- What do cGMP levels do?
A
- PDE5 inhibitors
- increase cGMP levels
- areterial vasodilation, increases blood flow and local BP
10
Q
- What can the increase in cGMP lead to?
- Exampes of PDE5 inhibitors
- What happens if there is no sexual stimuli?
A
- venous occlusion and reduces venous outflow
- Sildenafil, tadalafil, vardenafil, avanafil (keep the penis fill)
- Ineffective
11
Q
- What affect does Sildenafil (Viagra) have on men who do not have ED?
- Is Viagra approved for women?
- Does it have an affect on sexual arousal?
A
- no effect on erection quality or duration
- no
- no
12
Q
- What can Viagra treat in women?
- What else can PDE5 Inhibitors be used for?
- Side effects of PDE5 Inhibitors
A
- Pulmonary Hypertension
- BPH, pulmonary htn
- hypotension, no nitrates, caution with Alpha blockers, priapism
13
Q
- What is priapism?
- What is the half life for Tadalfil?
- What is the half life for Sildenafil/Vardenafil?
A
- persistent and painful erection, if > 4hrs intervention necessary
- 17.5 hours
- 4 hours
14
Q
- What is the duration of tadalafil?
- What is the duration for sildenafil/vardenafil
- How long must you wait before taking taldafil with nitrates?
A
- 36 hours
- 4 hours
- wait 48 hrs
15
Q
- How long must you wait before taking sildenafil with nitrates?
- What is menopause
- Symptoms
A
- 24 hours
- decrease in estrogen secretion by ovaries
- vag dry, urogenital atrophy, hot flahes, sexual disinterest
16
Q
- What is the treatment for menopause
- What does it do?
- A bone related consequence of estrogen loss?
A
- Hormone Replacement Therapy
- counteracts symptoms and prevent long term consequences of estrogen loss
- osteoporosis
17
Q
- Benefits of HRT
A
- Relief of hot flashes
- decrease in atrophy
- prevent osteoporosis
- prevent colorectal cancer
- improved quality of life
18
Q
- Risks of HRT
A
- Embolism
- CAD
- CVD
- Endometrial cancer
- breast cancer
- ovarian cancer
- dementia
19
Q
- What is the recommended use of HRT
- How long should treatment last?
- Every woman undergoing HRT receives this (with or without a uterus)
A
- lowest dose possible for shortest duration possible
- 4-5 years
- estrogen
20
Q
- What does a woman with a uterus also get in addition
- What is it used for
- What does progestin do for the uterus
A
- progestin
- protect endometrial lining from estrogen stimulation, prevents uterine cancer, increase risk for estrogen induced breast cancer and adverse cardiac
- protects it
21
Q
- What drugs can be used for hot flashes (vasomotor sx)
- What does anterior pit gland cause?
- what does post pit gland cause
A
- SSR, SNRI, Clonidine (antiHTN), Gabapentin (antiseizure)
- growth hormone deficiency
- diabetes insipidus
22
Q
- What does the adrenal gland cause?
- What does GH affect?
- Example of Growth hormone replacement?
A
- Cushings/Addisons, glucos or mineralo’s
- tissue and bone
- Somatropin
23
Q
- When is synthetic growth hormone administered?
- Why?
- Why do they need to be administered SQ or IM
A
- At night
- GH release increases during sleeping hours
- they are inactivated in the GI
24
Q
- How often are GH replacement injections received
- When must you stop adminstering
- Cost of GHT?
A
- 6-7 times a week
- once epiphseal plate is closed (become an adult)
- $20,000-$40,000/ yr
25
Q
- What can prolonged use of GHT conribute
- What should you monitor?
- Where is ADH secreted from?
A
- antagonize insulin, lead to diabetes
- Glucose tolerance
- Posterior pituitary gland
26
Q
- Another name for ADH?
- Action of ADH
- ADH deficiency leads to?
A
- Vasopressin
- keep water, vasoconstricts
- diabetes Insipidous