BPH and Erectile Dysfuntion Pharmacology

Question 1

Lower urinary tract symptoms

Answer 1

• interrupted stream
• frequency
• hesitation
• fullness
• dribbling, urgency, weak stream

Question 2

How do α1 adrenergic receptor antagonists relieve LUTS?

Answer 2

• reduce spasm
• promote muscle relaxation
• improve urine flow

Question 3

terazosin specificity

Answer 3

α1&raquo_space;>α2

Question 4

doxazosin specificity

Answer 4

α1&raquo_space;>α2

Question 5

tamsulosin specifcity

Answer 5

α1A = α1D > α1B

Question 6

silodosin specificity

Answer 6

α1A = α1D > α1B

Question 7

alfuzosin

Answer 7

non specific α1 selective

Question 8

adverse effects terazosin

Answer 8

postural hypotension, dizziness, fatigue

Question 9

adverse effects doxazosin

Answer 9

postural hypotension, dizziness, fatigue

Question 10

adverse effects tamsulosin

Answer 10

reduced ejaculation, intraoperative floppy iris syndrome

Question 11

adverse effects silodosin

Answer 11

reduced ejaculation, intraoperative floppy iris syndrome

Question 12

adverse effects alfuzosin

Answer 12

QT prolongation

Question 13

What is best singular Tx for prompt relief of LUTS with BPH?

Answer 13

α1 adrenergic receptor antagonists (relieves Sx in days)

Question 14

What α1 adrenergic receptor antagonist has functional uroselectivity?

Answer 14

Alfuzosin

Question 15

How do steroid 5α reductase inhibitors blunt prostate enlargement?

Answer 15

inhibit SAR-1 and SAR-2 which starves the prostate of DHT, which causes the prostate to atrophy and shrink

Question 16

What do steroid 5α reductase inhibitors do?

Answer 16

blunt prostate enlargement

Question 17

What does finasteride do?

Answer 17

Decrease DHT by inhibiting SAR-2 (specifically)

Question 18

What does dutasteride do?

Answer 18

Decrease DHT by inhibitng SAR-1 and SAR-2 (dual inhibitor)

Question 19

How long does it take for steroid 5α reductase inhibitors to work?

Answer 19

about 3 months for measurable effect

Question 20

What pharmacologic intervention should be used for severe BPH?

Answer 20

steroid 5α reductase inhibitors and α1 adrenergic receptor antagonists

Question 21

What is tadalafil (cialis)?

Answer 21

PDE-5 inhibitor used to treat BPH and erectile dysfunction

Question 22

What PDE-5 inhibitor has by far the longest half life and duration of action?

Answer 22

tadalafil (cialis)

Question 23

What PDE-5 inhibitor has the fastest onset?

Answer 23

avanafil (stendra)

Question 24

What drug is contraindicated to use with PDE-5 inhibitors and why?

Answer 24

Organic nitrates (NTG) due to possible severe and dangerous hypotension

Question 25

What is priapism and why is it a medical emergency?

Answer 25

prolonged erection, it is a medical emergency because it can result in permanent corporal fibrosis and erectile dysfunction

Question 26

what is alprostadil and what is it for?

Answer 26

prostaglandin E1 agonist, penile injection for erectile dysfunction

Question 27

Action of alprostadil

Answer 27

increase PGE1, increase adenylate cyclase activity, and increase cAMP to cause erection