Flashcards in BPH3 Deck (27):
how long should you wait to use a PD-5 inhibitor after taking alpha inhibitors?
what is one exception that is okay
4 hours before or after
tamsolozin with tadalafil
what is the MOA of 5-alpha-reducase inhibitors
inhibits 5-alpha reductase, decreasing conversion of testosterone to dihydrotestosterone
which class of drugs may actually reduce size of prostate?
5-alpha reductase inhibitors (not alpha inhibitors)
what substances concentration in the prostate does not decrease with age
what is decreased by 5-alpha reductase inhibitors?
1. prostate size
2. PSA levels
3. static factors
what are the 2 5-alpha reductase inhibitors
both 5-alpha reductase inhibitors inhibit what specific type of receptors
type II 5-alpha reductase
what 5-alpha reductase inhibitor has longest half life
what 5-alpha reductase inhibitor has the quickest onset?
what 5-alpha reductase inhibitor is preferred
no preference both have equal treatment effects
what 5-alpha reductase inhibitor inhibits both type 1 and 2 receptors
list some adverse effects of 5-alpha reductase inhibitors
1. sexual dysfunction (reversible)
2. decreased libido (reversible)
5. abdominal pain
who should not handle the 5-alpha reductase inhibitors?
females (category X for pregnancy)
can absorb thru the skin
what can you not do when taking 5-alpha reductase inhibitors?
what is a positive and a negative characteristic of 5-alpha reductase inhibitors?
positive: reduce prostate cancer
negative: long time for symptom improvement
list 3 benefits of alpha blockers over 5-alpha reductase inhibitors
1. improve symptoms better
2. faster onset
3. considered 1st line
when should 5-alpha reductase inhibitors be used for BPH?
1. if pt. is intolerant to alpha blockers
2. if prostate is larger than 40 grams
when is combination therapy preferred for BPH
1. prostate larger than 40 grams
2. PSA of at least 1.4
3. AUASI score greater than 20
what drugs were used in combination therapy studies?
finasteride and doxazosin
what drugs are combined in Jalyn?
dutasteride and tamsulosin
what is the gold standard of BPH surgical intervention?
how is this done?
transurethral resection of the prostate (TURP)
endoscopic insertion to remove core of prostate often reduces pressure on urethra
what are 3 minimally invasive procedures?
(PROBLY NOT ON TEST)
1. Transurethral needle ablation (TUNA)
2. Transurethral microwave thermotherapy (TUMT)
3. Interstitial laser thermoblation
what is the main phytotherapeutic used for BPH?
why should it not be used
not studied by FDA, could be ineffective, side effects, drug interactions
what are 4 tx options of BPH
1. alpha blocker
2. 5-alpha reductase inhibitors
3. Combination therapy
what are the staging classifications of BPH and treatment for each?
1. mild = watchful waiting
2. moderate to severe = medication
what AUASI scores indicate what staging?
mild = 0-7
moderate = 8-19
severe = 20-35