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Flashcards in BPH2 Deck (39):
1

what alpha-adrenergic agonist medications should be avoided in pt's w/ BPH?

1. pseudoephedrine
2. ephedrine
3. phenylephrine

2

what anticholinergic medications should be avoided in BPH?

1. antihistamines
2. phenothiazines
3. tricyclic antidepressants

3

what are treatment options for mild BPH symptoms

1. education and behavioral therapy (aka watchful waiting)
2. on going assessment

4

what are treatment options for moderate to severe BPH symptoms

1. noninvasive therapy: watchful waiting and medications (if don't want it fine)
2. invasive therapy: surgery

5

where is the alpha-1a receptors located

prostate and bladder neck

6

where is the alpha-1b receptors located

vascular smooth muscle

7

where is the alpha-1d receptors located

prostate

8

what agents work faster: alpha blockers or 5-alpha-reductase inhibitors

alpha blockers

9

what is the MOA of alpha blockers

inhibit alpha1 receptors, wich relaxes smooth muscle and relieves LUTS

10

how long does it take for pt's to have dynamic LUTS symptoms relieved with alpha blockers

2-4 weeks

11

which generation alpha blockers are the most specific

3rd generation; the later the gen the more specific

12

what alpha receptor subtypes are found on the prostate?

alpha 1a
alpha 1d

13

list 3 3rd gen alpha blockers

tamsulosin
siodosin
alfuzosin

14

list 3 2nd gen alpha blockers

doxazosin
terazosin
prazosin

15

list a 1st gen alpha blocker

phenoxybenzamine

16

what generation alpha blocker is prazosin?
what is it's indication?

2nd gen alpha-1 blocker
hypertension (not indicated for BPH)

17

what second gen medication is not indicated for BPH

prazosin

18

what 2nd gen alpha blocker has the longest half life

doxazosin

19

2nd gen alpha blocker is not typically used for BPH?

prazosin

20

what drug is technically a 2nd gen alpha blocker, but clinically is 3rd gen, concentrating in prostate

alfuzosin

21

what receptors are effected by 1st gen alpha blockers

alpha1 and alpha2

22

what receptors are effected by 2nd gen alpha blockers

alpha1

23

what receptors are effected by 3rd gen alpha blockers

alpha1a

24

what 2nd gen alpha blocker has the fewest CB side effects

terazosin

25

what is the preferred 2nd gen alpha blocker? why?

terazosin
less CV effects

26

what generation drugs do not require titration?

3rd generation alpha blockers

27

prazosin has what ADE that makes it not preffered

orthostatic hypotension

28

order 2nd gen from most preferential to least preferential

terazosin > doxazosin > prazosin

29

what 3rd gen alpha blocker should be taken on an empty stomach?

Tamsulosin

30

what are some dose dependent ADE's of Tamsulosin

tired, ejaculatory dysfunction, and flu like symptoms

31

what is floppy iris syndrome?

blocking alpha 1a receptors in the eye

32

what should be d/c'd before cataracts surgery?
why?
how long before surgery should it be d/c'd

Tamsulosin
floppy iris syndrome
1 week before surgery

33

silodosin is contraindicated with what?

strong 3A4 inhibitors

34

what drug may cause retrograde ejaculation?

silodosin (and tamsolosin too)

35

what drug has a very high affinity for alpha 1A receptors?

silodosin

36

list some adverse effects of alpha 1 blockers

syncope
headache
orthostatic hypotension
fatigue
abnormal ejaculation
dizziness

37

how long for FULL therapeutic benefit for alpha-1 blockers?
what are they efficacious for?

2-3 months
efficacious for short term relief

38

what is usual reason to stop using alpha blockers and switch to something else

intolerable side effects

39

patients with what disorder should use with caution ?

erectile dysfunction