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Flashcards in BPH3 Deck (27):
1

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

2

what is the MOA of 5-alpha-reducase inhibitors

inhibits 5-alpha reductase, decreasing conversion of testosterone to dihydrotestosterone

3

which class of drugs may actually reduce size of prostate?

5-alpha reductase inhibitors (not alpha inhibitors)

4

what substances concentration in the prostate does not decrease with age

dihydrotestosterone

5

what is decreased by 5-alpha reductase inhibitors?

1. prostate size
2. PSA levels
3. static factors

6

what are the 2 5-alpha reductase inhibitors

finasteride (proscar)
dutasteride (Avodart)

7

both 5-alpha reductase inhibitors inhibit what specific type of receptors

type II 5-alpha reductase

8

what 5-alpha reductase inhibitor has longest half life

finasteride

9

what 5-alpha reductase inhibitor has the quickest onset?

dutasteride

10

what 5-alpha reductase inhibitor is preferred

no preference both have equal treatment effects

11

what 5-alpha reductase inhibitor inhibits both type 1 and 2 receptors

dutasteride

12

list some adverse effects of 5-alpha reductase inhibitors

1. sexual dysfunction (reversible)
2. decreased libido (reversible)
3. gynecomastia
4. nausea
5. abdominal pain
6. dizziness

13

who should not handle the 5-alpha reductase inhibitors?

females (category X for pregnancy)
can absorb thru the skin

14

what can you not do when taking 5-alpha reductase inhibitors?

blood donation

15

what is a positive and a negative characteristic of 5-alpha reductase inhibitors?

positive: reduce prostate cancer
negative: long time for symptom improvement

16

list 3 benefits of alpha blockers over 5-alpha reductase inhibitors

alpha blockers:
1. improve symptoms better
2. faster onset
3. considered 1st line

17

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

18

when is combination therapy preferred for BPH

severe symptoms:
1. prostate larger than 40 grams
2. PSA of at least 1.4
3. AUASI score greater than 20

19

what drugs were used in combination therapy studies?

finasteride and doxazosin

20

what drugs are combined in Jalyn?

dutasteride and tamsulosin

21

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

22

what are 3 minimally invasive procedures?
(PROBLY NOT ON TEST)

1. Transurethral needle ablation (TUNA)
2. Transurethral microwave thermotherapy (TUMT)
3. Interstitial laser thermoblation

23

what is the main phytotherapeutic used for BPH?
why should it not be used

saw palmetto

not studied by FDA, could be ineffective, side effects, drug interactions

24

what are 4 tx options of BPH

1. alpha blocker
2. 5-alpha reductase inhibitors
3. Combination therapy
4. surgery

25

what are the staging classifications of BPH and treatment for each?

1. mild = watchful waiting
2. moderate to severe = medication

26

what AUASI scores indicate what staging?

mild = 0-7
moderate = 8-19
severe = 20-35

27

mild staged BPH is treated how?

watchful waiting is first line
education
behavioral therapy