Prostate Disease - Chapter 28

Question 1

Benign Prostatic Hyperplasia (BPH)

Answer 1

• A noncancerous condition that increases the size of the prostate gland
• Enlarged prostate obstructs urine flow

Question 2

Symptoms of BPH

Answer 2

• Weak of slow stream of urine
• Delay in starting urination
• Urinary frequency or urgency
• Nighttime awakening to urinate
• Need to strain to urinate
• Incomplete bladder emptying

Question 3

Diagnosis of BPH

Answer 3

• Digital rectal exam (DRE)
• Prostate specific antigen (PSA)
• Free PSA test
• Biopsy

Question 4

Drug Treatment of BPH

Answer 4

• a1 blockers
• 5a- Reductase inhibitors
• Combination of the above

Question 5

A1-Blockers

Answer 5

-Common ending: “osin”

• Bind to a1 receptor sites
• Relax prostate and bladder smooth muscle

Question 6

A1-Blockers Examples

Answer 6

• doxazosin
• terazosin
• tamsulosin
• alfuzosin
• silodosin

Question 7

Generic: doxazosin

Answer 7

Cardura

Question 8

Generic: terazosin

Answer 8

Hytrin

Question 9

Generic: tamsulosin

Answer 9

Flomax

Flomax CR

Question 10

Generic: alfuzosin

Answer 10

Xatral

Question 11

Generic: silodosin

Answer 11

Rapaflo

Question 12

A1-Blockers ADR’s

Answer 12

• Postural hypotension
• Dizziness
• Headache
• Fatigue
• Weakness
• Stuffy nose
• Reflex tachycardia

Question 13

A1-blockers Warning Labels

Answer 13

• MAY CAUSE DIZZINESS
• AVOID DRIVING
• DO NOT D/C WITHOUT MEDICAL SUPERVISION
• SWALLOW WHOLE; DONT CRUSH OR CHEW
• TAKE RIGHT AFTER SAME MEAL EACH DAY

Question 14

5a-Reductase Inhibitors

Answer 14

-Common Ending: “steride”

• Inhibit 5a-reductase, an enzyme that controls the production of DHT
• Take 6-12 months for full effect

Question 15

5a-Reductase Inhibitors Examples

Answer 15

• finasteride

- dutasteride

Question 16

Generic: finasteride

Answer 16

Proscar

Question 17

Generic: dutasteride

Answer 17

Avodart

Question 18

5a-Reductase Inhibitors Warning Labels

Answer 18

• PREGNANT WOMEN SHOULD AVOID CONTACT WITH CRUSHED OR BROKEN TABLETS OR LEAKING CAPSULES
• SWALLOW CAPSULES WHOLE; DO NOT CHEW (dutasteride)
• SWALLOW TABLETS WITH A DRINK OF WATER
• MAY CAUSE DIZZINESS

Question 19

Erectile Dysfunction (ED)

Answer 19

-The total inability to achieve erection, an inconsistent ability to achieve erection, or difficulty maintaining erection long enough for intercourse

Question 20

What Causes ED?

Answer 20

• Physiological
• Psychological
• Neurological
• Chronic disease
• Depression
• Lifestyle factors

Question 21

Drugs Treatment of ED

Answer 21

-ED is managed by the administration of drugs that promote penile engorgement and slow the loss of erection

• Phosphodiesterase type 5 inhibitors (PDE5)
• Prostaglandins

Question 22

PDE5 Inhibitors

Answer 22

• Common ending: “afil”

- Require sexual stimulation for effect

Question 23

PDE5 Inhibitors Examples

Answer 23

• sildenafil
• vardenafil
• tadalafil

Question 24

Generic: sildenafil

Answer 24

Viagra

Question 25

Generic: vardenafil

Answer 25

Levitra

Staxyn

Question 26

Generic: tadalafil

Answer 26

Cialis

Question 27

PDE5 Inhibitors ADR’s

Answer 27

• Dizziness
• Flushing
• Headache
• Nasal Congestion
• Diarrhea
• Indigestion
• Prolonged erection

Question 28

PDE5 Tech Note

Answer 28

Nitrates are contraindicated while taking PDE5 inhibitors

Question 29

PDE5 Warning Labels

Answer 29

• AVOID ALCOHOL
• MAY CAUSE DIZZINESS
• AVOID GRAPEFRUIT
• AVOID NITRATES
• TAKE 30-60 MINUTES BEFORE SEXUAL ACTIVITY (sildenafil, tadalafil)
• TAKE 1 HOUR BEFORE SEXUAL ACTIVITY (vardenafil)

Question 30

Prostaglandins

Answer 30

-alprostadil stimulates nitric oxide release, which relaxes cavernosal smooth muscle, causing an erection

Question 31

Generic: alprostadil

Answer 31

Muse

Caverject

Question 32

Prostaglandins Warning Labels

Answer 32

• REFRIGERATE (Muse)
• ROTATE SITE OF INJECTION
• PROTECT FROM EXTREME TEMPERATURES
• MAY STORE AT ROOM TEMP FOR UP TO 3 MONTHS