T4-BPH Flashcards
What is the patho of BPH?
The bladder holds urine. From the bladder it goes to the urethra. In men, surrounding the urethra, there is an organ called the prostate. BPH is a condition in which the prostate gets too large and impinges on the urethra.
What is in the neck of the bladder?
Alpha-1a receptors
What are the 2 kinds of drugs to help treat BPH?
Alpha1 blockers
5-alpha-reductase inhibitors
What is the MOA of alpha1 blockers?
We can target the Alpha 1a receptors on the bladder. This will dilate the urethra and decrease obstruction of it
Do alpha1 blockers decrease the size of the prostate?
NO
What are the 4 alpha-1 blocker drugs?
*all end in zosin or sin
- Doxazosin
- Terazosin
- Alfuzosin (alpha1 selective)
- Tamsulosin (alpha1 selective)
T/F: Alpha 1 drugs are well tolerated
TRUE
What are 3 adverse effects of alpha 1 blockers?
- Hypotension, dizziness
- Nasal congestion
- Abnormal ejaculation
Adverse effects of alpha 1 blockers: Which 2 adverse effects are mainly caused by the nonselective drugs?
Hypotension, dizziness
Nasal congestion
*nonselective drugs: doxazosin and terazosin
Adverse effects of alpha 1 blockers: which adverse effect is caused by the selective agents?
Abnormal ejaculation
*Alfuzosin and Tamsulosin
What is the client teaching regarding alpha1 blockers?
- 1-2 weeks for full effect
- Stand up slowly and stay hydrated (orthostatis hypotension is worse if you’re dehydrated)
- Take at bedtime (to help with orthostatic hypotension [ie. you aren’t getting up if you’re in bed])
Which BPH meds can also treat HYPERtension?
Alpha 1 blockers: Doxazosin and terazosin
*these are nonselective and they mainly are the ones that cause HYPOtension. Giving this to someone with HYPERtension will decrease their BP!
What would happen if a patient took an alpha blocker and ED med together?
Too much dilation–BP bottoms out
What is the MOA of the 5 alpha reductase inhibitors?
- Testosterone is converted to DHT via the 5 alpha reductase enzyme because the 5 alpha reductase enzyme chews off part of the testosterone.
- The prostate has a lot of DHT receptors. DHT ENLARGES the prostate [and also causes male pattern baldness]. The 5-alpha reductase inhibitors inhibit the enzyme that converts testosterone to DHT.
- DHT isn’t made anymore so the prostate is not being enlarged
Do 5-alpha reductase inhibitors decrease the size of the prostate?
Yes, overtime
What are the two 5-alpha-reductase inhibitors?
*end in ASTERIDE
DutASTERIDE
FinASTERIDE
What are the 4 adverse effects associated with 5-alpha reductase inhibitors?
- Lowers prostate specifc antigen (PSA)–you may have cancer, but your levels look “normal”
- High grade prostate cancer [deadly!]
- Ejactulatory problems
- Gynecomastia
5-alpha reductase inhibitors are pregnancy risk category __!
X
Why are the 5-alpha reductase inhibitors Preg category X?
- Teratogenix to male fetuses
- PREGS and CHILDREN cannot handle this drug [extemely lipid soluble + teratogenic= BAD..children can’t touch bc we don’t want to mess with the testosterone levels of a child]
- NO blood transfusions by males taking this drug!–your blood could be given to a PREGO
- must wait 1 month before donating after stopping the BPH drug!!!
What are the 3 client teachings for 5-alpha-reductase inhibitors?
- 3-6 months for full effect
- Can take with or without food
- PREG category X!
