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Therapeutics Test 2 > BPH2 > Flashcards

BPH2 Flashcards

1
Q

what alpha-adrenergic agonist medications should be avoided in pt’s w/ BPH?

A
  1. pseudoephedrine
  2. ephedrine
  3. phenylephrine
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2
Q

what anticholinergic medications should be avoided in BPH?

A
  1. antihistamines
  2. phenothiazines
  3. tricyclic antidepressants
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3
Q

what are treatment options for mild BPH symptoms

A
  1. education and behavioral therapy (aka watchful waiting)

2. on going assessment

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4
Q

what are treatment options for moderate to severe BPH symptoms

A
  1. noninvasive therapy: watchful waiting and medications (if don’t want it fine)
  2. invasive therapy: surgery
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5
Q

where is the alpha-1a receptors located

A

prostate and bladder neck

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6
Q

where is the alpha-1b receptors located

A

vascular smooth muscle

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7
Q

where is the alpha-1d receptors located

A

prostate

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8
Q

what agents work faster: alpha blockers or 5-alpha-reductase inhibitors

A

alpha blockers

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9
Q

what is the MOA of alpha blockers

A

inhibit alpha1 receptors, wich relaxes smooth muscle and relieves LUTS

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10
Q

how long does it take for pt’s to have dynamic LUTS symptoms relieved with alpha blockers

A

2-4 weeks

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11
Q

which generation alpha blockers are the most specific

A

3rd generation; the later the gen the more specific

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12
Q

what alpha receptor subtypes are found on the prostate?

A

alpha 1a

alpha 1d

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13
Q

list 3 3rd gen alpha blockers

A

tamsulosin
siodosin
alfuzosin

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14
Q

list 3 2nd gen alpha blockers

A

doxazosin
terazosin
prazosin

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15
Q

list a 1st gen alpha blocker

A

phenoxybenzamine

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16
Q

what generation alpha blocker is prazosin?

what is it’s indication?

A

2nd gen alpha-1 blocker

hypertension (not indicated for BPH)

17
Q

what second gen medication is not indicated for BPH

A

prazosin

18
Q

what 2nd gen alpha blocker has the longest half life

A

doxazosin

19
Q

2nd gen alpha blocker is not typically used for BPH?

A

prazosin

20
Q

what drug is technically a 2nd gen alpha blocker, but clinically is 3rd gen, concentrating in prostate

A

alfuzosin

21
Q

what receptors are effected by 1st gen alpha blockers

A

alpha1 and alpha2

22
Q

what receptors are effected by 2nd gen alpha blockers

A

alpha1

23
Q

what receptors are effected by 3rd gen alpha blockers

A

alpha1a

24
Q

what 2nd gen alpha blocker has the fewest CB side effects

A

terazosin

25
Q

what is the preferred 2nd gen alpha blocker? why?

A

terazosin

less CV effects

26
Q

what generation drugs do not require titration?

A

3rd generation alpha blockers

27
Q

prazosin has what ADE that makes it not preffered

A

orthostatic hypotension

28
Q

order 2nd gen from most preferential to least preferential

A

terazosin > doxazosin > prazosin

29
Q

what 3rd gen alpha blocker should be taken on an empty stomach?

A

Tamsulosin

30
Q

what are some dose dependent ADE’s of Tamsulosin

A

tired, ejaculatory dysfunction, and flu like symptoms

31
Q

what is floppy iris syndrome?

A

blocking alpha 1a receptors in the eye

32
Q

what should be d/c’d before cataracts surgery?
why?
how long before surgery should it be d/c’d

A

Tamsulosin
floppy iris syndrome
1 week before surgery

33
Q

silodosin is contraindicated with what?

A

strong 3A4 inhibitors

34
Q

what drug may cause retrograde ejaculation?

A

silodosin (and tamsolosin too)

35
Q

what drug has a very high affinity for alpha 1A receptors?

A

silodosin

36
Q

list some adverse effects of alpha 1 blockers

A 
syncope
headache
orthostatic hypotension
fatigue
abnormal ejaculation
dizziness
37
Q

how long for FULL therapeutic benefit for alpha-1 blockers?

what are they efficacious for?

A

2-3 months

efficacious for short term relief

38
Q

what is usual reason to stop using alpha blockers and switch to something else

A

intolerable side effects

39
Q

patients with what disorder should use with caution ?

A

erectile dysfunction

Therapeutics Test 2 (31 decks)

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