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Flashcards in BPH Deck (19):
1

MOA Alpha Blockers

Reduce smooth muscle tone
Works on Receptor Alpha-1A

2

What time of day do you administer the first dose of an alpha-blocker?

At bedtime

3

What do you do to avoid postural hypotension and syncope when starting alpha-blockers?

Alpha-Blockers must be titrated in a step-wise fashion.

4

MOA of Tamsulosin

Selective alpha-1A receptor
Don't have to do stepwise titrations.

5

Side effect of tamsulosin

Interrupts ejaculations

6

MOA of Alfuzosin

Uroselective alpha adrenergic selective

No ejaculation disruption

7

Silodosin

Alpha-1A receptor specific
Increase in ejaculatory disturbances

8

5-alpha Reductase Enzyme Inhibitors

Blocks DHT producion

Good for patients with large prostate.

9

Finasteride

Blocks conversion of testosterone to DHT by inhibiting Type 2 5-alpha reductase

10

What does long term administration of Finasteride cause?

Prostate shrinkage

11

Dutasteride

Inhibits peripheral and prostate specific enzymes

12

VA Trial 359

Results:
Terazosin is superior to finasteride
Finasteride is no more effective than the placebo
Combination therapy was not synergistic

13

MTOPS

Said Alpha-blocker and 5AREI combo slows progression the best.

14

CombAT Trial

Said that men with enlarged prostate benefit best when using 5AREI with or without an alpha-blocker

15

Flutamide

Prevents DHT binding to receptor
Saved for nonsurgical candidates, finasteride failures, and patients that cannot use alpha-blockers

16

Acute Bacterial Prostatitis

Sudden onset of fever, tenderness, and urinary/constitutional sypmtoms

17

Chronic Bacterial Prostatitis

Urinating difficulty, low back pain
Recurring infections with same organism

18

Treatment for Acute Bacterial Prostatitis

Bactrim, fluoroquinolones, cephalosporins for 4 weeks to reduce development of chronic prostatitis

19

Treatment for Chronic Bacterial Prostatitis

Trimethoprim and fluoroquinolones