Flashcards in BPH Deck (19):
MOA Alpha Blockers
Reduce smooth muscle tone
Works on Receptor Alpha-1A
What time of day do you administer the first dose of an alpha-blocker?
What do you do to avoid postural hypotension and syncope when starting alpha-blockers?
Alpha-Blockers must be titrated in a step-wise fashion.
MOA of Tamsulosin
Selective alpha-1A receptor
Don't have to do stepwise titrations.
Side effect of tamsulosin
MOA of Alfuzosin
Uroselective alpha adrenergic selective
No ejaculation disruption
Alpha-1A receptor specific
Increase in ejaculatory disturbances
5-alpha Reductase Enzyme Inhibitors
Blocks DHT producion
Good for patients with large prostate.
Blocks conversion of testosterone to DHT by inhibiting Type 2 5-alpha reductase
What does long term administration of Finasteride cause?
Inhibits peripheral and prostate specific enzymes
VA Trial 359
Terazosin is superior to finasteride
Finasteride is no more effective than the placebo
Combination therapy was not synergistic
Said Alpha-blocker and 5AREI combo slows progression the best.
Said that men with enlarged prostate benefit best when using 5AREI with or without an alpha-blocker
Prevents DHT binding to receptor
Saved for nonsurgical candidates, finasteride failures, and patients that cannot use alpha-blockers
Acute Bacterial Prostatitis
Sudden onset of fever, tenderness, and urinary/constitutional sypmtoms
Chronic Bacterial Prostatitis
Urinating difficulty, low back pain
Recurring infections with same organism
Treatment for Acute Bacterial Prostatitis
Bactrim, fluoroquinolones, cephalosporins for 4 weeks to reduce development of chronic prostatitis