[PHARMA] PROSTATIC DISEASES Flashcards
drugs reducing dynamic factors (4)
1-Tamsulosin
2-Tadalafil
3-Tolterodine
4-Mirabegron
drugs reducing static factors (6)
finasteride
2-gonadorelin
3-leuprolide
4-abiraterone
5-degarelix
6-enzulatamide
tamsulosin mechanism of action
(-) α1 receptor of smooth msc–>smooth msc relaxation–>↓bladder obstruction
advantage of tamsulosin (4)
1-improve voiding symptoms
2-improve storage symptoms
3-doesn’t change prostate size (in transitional zone)
4-doesn’t affect libido
side effects of tamsulosin (2)
1-orthostatic HypoTN w dizzines
2-retrograde ejaculation
dosage of tadalafil
5mg
alpha 1 blocker
tamsulosin
PDE5 inhibitor
tadalafil
tadalafil & sildenafil mechanism of action
improve LUTs by:
(-) PDE5 in c. cavernosa
(-) cGMP metabolism
↑CGMP through NO pathway
maintain VD
used in sexually active LUTS-BPH patients with or without ED
tadalafil
uses of tadalafil (3)
1-ED
2-pulmonary HTN
3-sexually active LUTS-BPH patients +/_ ED
drug used in pulmonary HTN
tadalafil
side effects of tadalafil (5)
1-VD & Hypotension
2-flushing, headache, nasal congestion
3-affect contractility
4-visual disturbances
5-back pain
visual disturbances caused by tadalafil due to
(-) PDE6 in retina= loss of discrimination b/w green & blue
contractility dysfunction caused by tadalafil due to
(-) PDE1 in ventricular muscle
contraindications of tadalafil (2)
1-with nitrates & alpha blockers
2-cardiac patients
sildenafil & tadalafil route of administration
orally
1st choice in young patients with erectile dysfunction
sildenafil & tadalafil
hypotension with sildenafil & tadalafil can be avoided by
starting w/ small dose & titration
M3 blocker
tolterodine
tolterodine mechanism of action
(-) M3 in bladder smooth msc–> ↓bladder contraction
advantage of tolterodine (3)
improve LUTS
improve nocturia
help treat overactive bladder
overactive bladder TTT
tolterodine
tolterodine side effects
1-atropine like effects; dry mouth, tremors, tachycardia,coma etc (MC)
2-acute urinary retention (Most serious)
causes detrusor flaccidity
tolterodine
treat nocturia
tolterodine
most serious side effect of tolterodine
acute urinary retention
selective B3 agonist
Mirabegron
mirabegrone side effects (5)
1-headache
2-HTN
3-constipation
4-nasopharyngitis
5-UTI
interval b/w nitrates intake & tadalafil should be
At least 48h
_____affect efficacy of tadalafil
diuretics
finasteride mechanism of action
(-)5-α reductase
↓conversion of testosterone to DHT
↓DHT
=shrink enlarged prostate + prevent progression
finasteride side effects (4)
1-impotence
2-decreased libido
3-decreased ejaculate volume
4-gynecomastia
GnRH analogs
Gonadorelin
Leuprolide
GnRH analogs mechanism of action
(-) gonadotropins release
GnRH analogs uses (3)
1-cancer prostate
2-endometriosis
3-IVF
GnRH side effects in males & females
1-headaches
2-depression
3-osteoporosis
4- ↓libido
GnRH side effects in females
1-hot flushes
2-vaginal dryness
3-ovarian cyst
phototherapy effects on BPH
1- (-) 5-α reductase
2-anti-inflammatory
3-free radical scavenger
4-protect prostate & detrusor function
5-antiandrogenic
(-) sex hormone binding globulin (SHBG) & aromatase
inhibits SHGB
phototherapy
(-) aromatase
Finasteride
phototherapy
TTT of hormone sensitive prostate cancer
androgen deprivation
LRH analogue disadvantage
initial stimulation of androgen release
Abiraterone route of administration
oral
Abiraterone mechanism of action
(-) androgen synthesis by testis & adrenals
Abiraterone side effects (3)
1-hypertriglyceridemic
2-hyperglycemic
3-↑ liver function enzymes
Degarelix mechanism of action
irreversible inhibitor of GnRH receptor
(-) gonadotropins
advantage of Degarelix over LHRH analogues
no initial stimulation of androgen release
enzalutamide route of administration
oral
enzalutamide mechanism of action
(-) androgen binding to its receptor
affects nuclear translocation of androgen receptors
