Renal

Question 1

what are some examples for alpha-blockers

Answer 1

doxazosin, tamsulosin, alfuzosin -sin

Question 2

indication for the alpha-blockers

Answer 2

first-line medical option to improve symptoms in benign prostatic hyperplasia

an add-on treatment in resistant HTN

Question 3

MOA for alpha-blocker

Answer 3

selective alpha1-adrenoceptor blockers (alpha1-adrenoceptors are found mainly in smooth muscle, incl in blood vessels and urinary tract- bladder neck and prostate

blockade induces relaxation - ie vasodilation and fall in blood pressure and reduced resistance to bladder outflow

Question 4

contra-indication for alpha blockers

Answer 4

should not be used in pt with existing postural hypotension

Question 5

side effect of alpha blockers

Answer 5

can cause postural hypotension, dizziness and syncope

postural hypotension most prominent after first dose

Question 6

interaction of alpha blockers

Answer 6

usually combining with antihypertensive drugs result in additive blood pressure lowering effects

to avoid first dose postural hypotension, the antihyperstensive drugs should be stopped at the day of alpha-blockers are used (esp in beta blocker)

Question 7

what is the classname for finasteride

Answer 7

5alpha-reductase inhibitors

Question 8

indication for 5alpha-reductase inhibitors

Answer 8

benign prostatic hyperplasia (2nd line, improve lower urinary tract symptoms such as difficulty passing urine, urinary retention and poor urinary flow and reduce the need for prostate-related surgery

Question 9

MOA for 5alpha-reductase inhibitors

Answer 9

reduces the size of prostate gland by inhibiting the intracellular enzyme 5alpha-reductase which convert testosterone to its more active metabolite dihydrotestosterone as dihydrotestosterone stimulates prostatic growth

can take several months to take effects - alpha blocker is therefore 1st line where it is started first and only add 5alpha-reductase inhibitors if unresponsive

Question 10

contra-induction for 5alpha-reductase inhibitors

Answer 10

expousre of a male foetus to 5alpha-reductase inhibitors can cause abnormal development of the external genitalia - should not take in pregnant women

Question 11

interaction of 5alpha-reductase inhibitors

Answer 11

no interaction

Question 12

where are alpha blockers and 5alpha-reducatase inhibitors elminated

Answer 12

liver

Question 13

side-effect of 5alpha-reductase inhibitors

Answer 13

related to their anti-androgen action - imptenc and reduced libido, gynaecomastia

hair growth which can be exploited ato advantage in treatment of male-pattern baldness

breast cancer in men taking finasteride