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Flashcards in Benign Prostatic Hyperplasia Deck (27)
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1

What are key regulators of the prostate gland?

Androgens

2

What hormone plays a role in the development of BPH?

Androgens

3

Any drug that is capable of doing what may help improve flow of urine?

Relaxing contractile smooth muscle

4

What are the two subclasses of BPH drugs?

Alpha blockers
5-alpha-reductase inhibitors

5

Why do alpha blockers work for BPH?

They act as adrenergic antagonists

6

What is the common suffix for alpha blockers for BPH?

-osin

7

What is one of the more popular alpha blockers for BPH?

Tamsulosin [Flomax]

8

What is the MOA of Tamsulosin?

Selective competitive antagonism of lower urinary tract alpha-1a adrenergic receptors, relaxing smooth muscle of the bladder neck andprostate

9

What are the indications for Tamsulosin?

BPH
Nephrolithiasis (kidney stones)

10

What are the common adverse effects of Tamsulosin?

Dizziness
Sinusitis
Pharyngitis
Cough
Infection

11

What are the serious adverse side effects of Tamsulosin?

Orthostatic hypotension
Syncope

12

What are the ocular adverse side effects of Tamsulosin?

Floppy iris syndrome

13

Why does Tamsulosin have Dizziness as a side effect, as well?

While it is selective for the urinary tract, it also works a bit to relax blood vessels, decreasing BP

14

If a patient is on a drug ending in -osin, and they may need lens or retinal surgery, what should your first step be?

Contact PCP to get them off of it so that they don't have floppy iris syndrome

15

What is the effect of chloroquine interacting with Tamsulosin?

Reduces the hepatic metabolism of Tamsulosin, increasing the likelihood of side effects

16

Macrolides, azole antifungals, and fluorouinolones do what when they interact with Tamsulosin?

Enhance hepatic metabolism of Tamsulosin

17

What are the contraindications for Tamsulosin?

Cataract surgery
Glaucoma surgery
Sulfonamide allergy

18

What is the suffix for the BPH drugs classified as 5-alpha-reductase inhibitors (5-ARIs)?

-eride

19

What are the two 5-alpha-reductase inhibitors?

Finasteride
Dutasteride

20

What is the MOA of 5-ARIs?

Inhibits type II 5-alpha-reductase, interfering with conversion of testosterone to 5-alpha-dihydrotestosterone

21

What are the indications for Finasteride?

BPH
Androgen-dependent hair loss

22

What are the common adverse effects of Finasteride?

Orthostatic hypotension

23

What are the serious adverse effects of finasteride?

Prostate cancer
Breast cancer

24

Why is it that finasteride can cause cancer?

It messes with the hormones that play in cell cycling

25

What happens if a patient is on Finasteride as wells as a CYP3A4 substrate, like nafcillin (penicillin)?

It enhances the matbolism of Finasteride, to the point where there may be no benefit of Finasteride

26

What are the contraindications to Finasteride?

Hypersensitivity
Hepatic disease

27

Why is finasteride prone to cause hepatic disease?

Changes hormone regulation and the liver is key in metabolism