Top 100 drugs Flashcards
finasteride Class
5a-reductase inh
finasteride Mechanism
inh 5a-reductase (T ➝ DHT); DHT ↑ prostatic growth
finasteride Indications and Dose
Ⅰ benign prostatic hyperplasia (2nd line after a-blockers; 5mg OD) Ⅱ androgenetic alopecia in men (1mg OD)
finasteride Interactions
-
finasteride Side effects
antiandrogen - impotence & ↓ libido (transient), breast tenderness and gynaecomastia (see doctor), hair growth, breast cancer; depression and suicidal thoughts
finasteride Patient groups
✘pregnant women - avoid exposure (broken tablets and semen) - abnormal genitals in male fetus
finasteride Administration
swallow whole
dutasteride Class
5a-reductase inh
dutasteride Mechanism
inh 5a-reductase (T ➝ DHT); DHT ↑ prostatic growth
dutasteride Indications and Dose
Ⅰ benign prostatic hyperplasia (2nd line after a-blockers; 500mcg OD)
dutasteride Interactions
↑↑ - ↑exposure to dutasteride
dutasteride Side effects
antiandrogen - impotence and ↓ libido (transient), breast tenderness and gynaecomastia (see doctor), hair growth, breast cancer; depression
dutasteride Patient groups
✘pregnant women - avoid exposure (broken capsules and semen) - abnormal genitals in male fetus ✘severe hepatic impairment
dutasteride Administration
-
doxazosin Class
a-blockers
doxazosin Mechanism
↑ a1-adrenoceptor selective (smooth muscle - blood vessels, urinary tract) - blockade → relaxation
doxazosin Indications and Dose
Ⅰ resistant hypertension (add-on if other meds insufficient; 1mg OD/4mg MR OD start, max 16mg/8mg MR OD) Ⅱ benign prostatic hyperplasia (1st line when lifestyle changes insufficient; 1mg OD/4mg MR OD start, max 8mg/8mg MR OD)
doxazosin Interactions
other BP meds, esp b-blockers - avoid 1st dose hypotension omitting some doses
doxazosin Side effects
postural hypotension, dizziness, syncope - esp after 1st dose
doxazosin Patient groups
✘history of postural hypotension ✘history of micturition syncope ▲care with initial dose (postural hypotension) ▲heart failure ✘severe hepatic impairment (↑half-life)
doxazosin Administration
at night initially (marked BP lowering effect)
tamsulosin Class
a-blockers
tamsulosin Mechanism
↑ a1-adrenoceptor selective (smooth muscle - blood vessels, urinary tract) - blockade → relaxation
tamsulosin Indications and Dose
Ⅰ benign prostatic hyperplasia (1st line when lifestyle changes insufficient; 400mcg OD)
tamsulosin Interactions
other BP meds, esp b-blockers - avoid 1st dose hypotension omitting some doses
tamsulosin Side effects
postural hypotension, dizziness, syncope - esp after 1st dose
tamsulosin Patient groups
✘history of postural hypotension ✘history of micturition syncope ▲care with initial dose (postural hypotension) ▲renal impairment ✘severe hepatic impairment
tamsulosin Administration
swallow whole (as MR)