BPH2

Question 1

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

Answer 1

1. pseudoephedrine
2. ephedrine
3. phenylephrine

Question 2

what anticholinergic medications should be avoided in BPH?

Answer 2

1. antihistamines
2. phenothiazines
3. tricyclic antidepressants

Question 3

what are treatment options for mild BPH symptoms

Answer 3

1. education and behavioral therapy (aka watchful waiting)

2. on going assessment

Question 4

what are treatment options for moderate to severe BPH symptoms

Answer 4

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

Question 5

where is the alpha-1a receptors located

Answer 5

prostate and bladder neck

Question 6

where is the alpha-1b receptors located

Answer 6

vascular smooth muscle

Question 7

where is the alpha-1d receptors located

Answer 7

prostate

Question 8

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

Answer 8

alpha blockers

Question 9

what is the MOA of alpha blockers

Answer 9

inhibit alpha1 receptors, wich relaxes smooth muscle and relieves LUTS

Question 10

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

Answer 10

2-4 weeks

Question 11

which generation alpha blockers are the most specific

Answer 11

3rd generation; the later the gen the more specific

Question 12

what alpha receptor subtypes are found on the prostate?

Answer 12

alpha 1a

alpha 1d

Question 13

list 3 3rd gen alpha blockers

Answer 13

tamsulosin
siodosin
alfuzosin

Question 14

list 3 2nd gen alpha blockers

Answer 14

doxazosin
terazosin
prazosin

Question 15

list a 1st gen alpha blocker

Answer 15

phenoxybenzamine

Question 16

what generation alpha blocker is prazosin?

what is it’s indication?

Answer 16

2nd gen alpha-1 blocker

hypertension (not indicated for BPH)

Question 17

what second gen medication is not indicated for BPH

Answer 17

prazosin

Question 18

what 2nd gen alpha blocker has the longest half life

Answer 18

doxazosin

Question 19

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

Answer 19

prazosin

Question 20

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

Answer 20

alfuzosin

Question 21

what receptors are effected by 1st gen alpha blockers

Answer 21

alpha1 and alpha2

Question 22

what receptors are effected by 2nd gen alpha blockers

Answer 22

alpha1

Question 23

what receptors are effected by 3rd gen alpha blockers

Answer 23

alpha1a

Question 24

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

Answer 24

terazosin

Question 25

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

Answer 25

terazosin | less CV effects

Question 26

what generation drugs do not require titration?

Answer 26

3rd generation alpha blockers

Question 27

prazosin has what ADE that makes it not preffered

Answer 27

orthostatic hypotension

Question 28

order 2nd gen from most preferential to least preferential

Answer 28

terazosin > doxazosin > prazosin

Question 29

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

Answer 29

Tamsulosin

Question 30

what are some dose dependent ADE's of Tamsulosin

Answer 30

tired, ejaculatory dysfunction, and flu like symptoms

Question 31

what is floppy iris syndrome?

Answer 31

blocking alpha 1a receptors in the eye

Question 32

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

Answer 32

Tamsulosin floppy iris syndrome 1 week before surgery

Question 33

silodosin is contraindicated with what?

Answer 33

strong 3A4 inhibitors

Question 34

what drug may cause retrograde ejaculation?

Answer 34

silodosin (and tamsolosin too)

Question 35

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

Answer 35

silodosin

Question 36

list some adverse effects of alpha 1 blockers

Answer 36

``` syncope headache orthostatic hypotension fatigue abnormal ejaculation dizziness ```

Question 37

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

Answer 37

2-3 months | efficacious for short term relief

Question 38

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

Answer 38

intolerable side effects

Question 39

patients with what disorder should use with caution ?

Answer 39

erectile dysfunction