Prostate Disease - Chapter 28 Flashcards
Benign Prostatic Hyperplasia (BPH)
- A noncancerous condition that increases the size of the prostate gland
- Enlarged prostate obstructs urine flow
Symptoms of BPH
- 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
Diagnosis of BPH
- Digital rectal exam (DRE)
- Prostate specific antigen (PSA)
- Free PSA test
- Biopsy
Drug Treatment of BPH
- a1 blockers
- 5a- Reductase inhibitors
- Combination of the above
A1-Blockers
-Common ending: “osin”
- Bind to a1 receptor sites
- Relax prostate and bladder smooth muscle
A1-Blockers Examples
- doxazosin
- terazosin
- tamsulosin
- alfuzosin
- silodosin
Generic: doxazosin
Cardura
Generic: terazosin
Hytrin
Generic: tamsulosin
Flomax
Flomax CR
Generic: alfuzosin
Xatral
Generic: silodosin
Rapaflo
A1-Blockers ADR’s
- Postural hypotension
- Dizziness
- Headache
- Fatigue
- Weakness
- Stuffy nose
- Reflex tachycardia
A1-blockers Warning Labels
- 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
5a-Reductase Inhibitors
-Common Ending: “steride”
- Inhibit 5a-reductase, an enzyme that controls the production of DHT
- Take 6-12 months for full effect
5a-Reductase Inhibitors Examples
- finasteride
- dutasteride
Generic: finasteride
Proscar
Generic: dutasteride
Avodart
5a-Reductase Inhibitors Warning Labels
- 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
Erectile Dysfunction (ED)
-The total inability to achieve erection, an inconsistent ability to achieve erection, or difficulty maintaining erection long enough for intercourse
What Causes ED?
- Physiological
- Psychological
- Neurological
- Chronic disease
- Depression
- Lifestyle factors
Drugs Treatment of ED
-ED is managed by the administration of drugs that promote penile engorgement and slow the loss of erection
- Phosphodiesterase type 5 inhibitors (PDE5)
- Prostaglandins
PDE5 Inhibitors
- Common ending: “afil”
- Require sexual stimulation for effect
PDE5 Inhibitors Examples
- sildenafil
- vardenafil
- tadalafil
Generic: sildenafil
Viagra
Generic: vardenafil
Levitra
Staxyn
Generic: tadalafil
Cialis
PDE5 Inhibitors ADR’s
- Dizziness
- Flushing
- Headache
- Nasal Congestion
- Diarrhea
- Indigestion
- Prolonged erection
PDE5 Tech Note
Nitrates are contraindicated while taking PDE5 inhibitors
PDE5 Warning Labels
- 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)
Prostaglandins
-alprostadil stimulates nitric oxide release, which relaxes cavernosal smooth muscle, causing an erection
Generic: alprostadil
Muse
Caverject
Prostaglandins Warning Labels
- REFRIGERATE (Muse)
- ROTATE SITE OF INJECTION
- PROTECT FROM EXTREME TEMPERATURES
- MAY STORE AT ROOM TEMP FOR UP TO 3 MONTHS
