Therapeutics - BPH 2

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Author:
kyleannkelsey
ID:
281053
Filename:
Therapeutics - BPH 2
Updated:
2014-08-22 08:18:05
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Therapeutics BPH
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Therapeutics - BPH 2
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Therapeutics - BPH 2
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  1. What are the precautions (non-CI) for alpha adrenergic blockers?
    • Co-administration with Phosphodiesterase inhibitors (separate by 4-5 hours)
    • i.e. Tamsulosin and Tadalafil
  2. Do 5-alpha reductase inhibitors decrease prostate size?
    Yes
  3. Do 5-alpha reductase inhibitors reduce need for surgery?
    Yes
  4. Finasteride brand name
    Proscar
  5. What are the 5-alpha reductase inhibitors?
    Finasteride (Proscar) and Dutasteride (Avodart)
  6. What is the OOA of symptom relief from Finasteride (Proscar)?
    3-6 months
  7. What are the effects of 5-alpha reductase inhibitors?
    • Decreases incidence of surgery
    • Decreases incidence of acute urinary retention
    • Decreases prostate size
    • Increases urine flow
    • Decreases AUA/IPSS score
  8. What effects do 5-alpha reductase inhibitors that alpha adrenergic blockers do not have?
    • Decreases incidence of surgery
    • Decreases prostate size
  9. What effect does Finasteride have on PSA levels?
    • Falsely lowers them by 50%
    • Re-determine baseline in 3-6 months after beginning use
  10. What is the dose for Finasteride (Proscar)?
    5 mg PO Daily
  11. What are the AE for Finasteride and Dutasteride?
    • Breast tenderness/gynecomastia (Dutasteride may have less effect)
    • Hair growth
    • Rash
    • Impotence/decreased libido
    • Falsely decreased (50%) PSA levels
  12. Who should not take Finasteride (Proscar)?
    Children and Women, particularly pregnant (category X)
  13. Why is Finasteride category X for women who are pregnant?
    Decreased male genitalia formation
  14. Dutasteride brand name
    Avodart
  15. How does the MOA of Dutasteride differ from that of Finasteride?
    Inhibits both isoforms (1 and 2) of 5-alpha reductase
  16. What other drugs should you caution use with Dutasteride (Avodart)?
    CYP3A4 related as it is metabolized by this enzyme
  17. What is the dose for Dutasteride?
    0.5 mg softgel capsule Daily
  18. What are the phosphodiesterase inhibitors?
    Tadalafil (Cialis)
  19. What effect do phosphodiesterase inhibitors have on BPH?
    Symptom improvement
  20. When are Phosphodiesterase inhibitors used?
    As an add on therapy (less effective than alpha blockers)
  21. What is the dose for Tadalafil (Cialis)?
    5 mg PO Daily
  22. What are the AE for Tadalafil (Cialis)?
    Duyspepsia and HA
  23. What drugs should be cautioned with use of Tadalafil (Cialis)?
    Alpha blockers (except tamsulosin)
  24. What group of patients are candidates for Anticholinergics?
    Add on therapy for men with overactive bladder (irritative symptoms) and moderate to severe symptoms
  25. What is the MOA of Anticholinergics in BPH?
    Blocks muscarinic receptors on the bladder detrusor, reducing uninhibited contraction
  26. Does combination therapy of Doxazosin and Finasteride improve AUASI scores?
    Only very slightly
  27. Does combination therapy of Doxazosin and Finasteride improve surgery risk?
    Only very slightly over just Finasteride
  28. What is Jalyn?
    Dutasteride 0.5 mg and Tamsulosin 0.4 mg
  29. What is the course of treatment for a BPH patient with moderate symptoms and ED?
    Alpha blocker and/or PDI
  30. What is the treatment for BPH with moderate symptoms and prostate of less than 40g or low PSA?
    Alpha blocker
  31. What is the treatment for BPH with moderate symptoms and prostate of more than 40g or low PSA?
    5 alpha reductase inhibitor or 5 alpha reductase inhibitor and an alpha blocker
  32. What is the peak OOA for Alpha blockers?
    2 weeks
  33. What is the peak OOA for 5-alpha reductase inhibitors?
    3-6 months
  34. What is the peak OOA for Phosphodiesterase inhibitors?
    4 weeks
  35. Which class of drugs provides the most symptom relief for BPH?
    Alpha blockers and 5-alpha reductase inhibitors
  36. Which class of drugs provides the best symptom relief for patients with enlarged prostates?
    5-alpha reductase inhibitors
  37. Which class of drugs provides the least symptom relief for BPH?
    Phosphodiesterase inhibitors
  38. Which class of drugs relax prostatic smooth muscle in BPH?
    Alpha blockers and Phosphodiesterase inhibitors
  39. Which classes of drugs decreased prostate size in BPH?
    5 alpha reductase inhibitors
  40. Which classes of drugs halt disease progression in BPH?
    5 alpha reductase inhibitors

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