BPH

Question 1

BPH Drug use

Answer 1

For men with moderate disease. Severe disease is taken care of with surgery.
5-alpha reductase inhibitors: Decrease prostate size
Alpha adrenergic antagonists: Relax smooth muscle in bladder neck, urethra; improve symptoms and increase urinary flow rapidly.

Question 2

Finasteride

Answer 2

IND: BPH
MOA: 5-alpha reductase inhibitor; shrinks prostate by regressing the prostate epithelial tissue (converts testosterone)
BOX: n/a
CON: Pregnancy
ADR: Impotence

Question 3

Dutasteride

Answer 3

IND: BPH
MOA: 5-alpha reductase inhibitor
BOX: n/a
CON: Pregnancy
ADR: Impotence

Question 4

Doxazosin

Answer 4

IND: BPH, HTN
MOA: Alpha-1 antagonist; smooth muscle relaxation
BOX: n/a
CON: Hepatic dysfunction
ADR: dizzy, malaise, fatigue, HA

Question 5

Terazosin

Answer 5

IND: BPH, HTN
MOA: Alpha-1 antagonist; smooth muscle relaxation
BOX: n/a
CON: 
ADR: dizzy, muscle weakness

Question 6

Alfuzosin

Answer 6

IND: BPH
MOA: Alpha-1 antagonist; smooth muscle relaxation
BOX: n/a
CON: Liver impairment, use with CYP inhibitors
ADR: None

Question 7

Tamsulosin

Answer 7

IND: BPH, most common agent
MOA: Alpha-1A antagonist; smooth muscle relaxation. More selective.
BOX: n/a
CON:
ADR: Ortho hypo, dizzy, HA, Ejaculatory dysfunction
USE OFF LABEL IN KIDNEY STONES IN THE ER FOR MALES/FEMALES

Question 8

Silodosin

Answer 8

IND: BPH
MOA: Alpha-1A antagonist; smooth muscle relaxation. More selective
BOX: n/a
CON: Renal/hepatic impairment. Use with CYP inhibitors
ADR: Ejaculation dysfunction

Question 9

Tamsulosin/Dutasteride

Answer 9

IND: BPH

Combo drug. Nothing special. Save pt money by prescribing the 2 separate generics

Question 10

Saw Palmetto

Answer 10

MOA: similar to alpha 5 reductase inhibitors

Mixed safety and efficacy data