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Reproductive Pharm > Drugs for BPH > Flashcards

Drugs for BPH Flashcards

1
Q

What receptor dominates in the lower bladder, prostate, and penile urethra?

A

Alpha-1-a

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2
Q

What receptor dominates in the upper bladder?

A

Alpha-1-d

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3
Q

What are beta-sitosterols and Saw palmetto?

A

They are natural supplements often taken to treat BPH. There is no proof that they actually work.

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4
Q

What are the potential complications of untreated BPH?

A

Urinary retention

Bladder, urinary tract, and kidney issues

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5
Q

What drugs for BPH belong to Alpha -1 blocker group?

A 
Prazosin
Alfuzosin
Terazosin
Doxazosin
Tamulosin
Silodosin
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6
Q

What is the MOA of the Alpha-1 blockers?

A

They block alpha 1 stimulation and relax the smooth muscle of the urethra and prostate.

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7
Q

What are some common adverse effects of alpha 1 blockers?

A

GI (xerostomia, nausea)

CNS (HA, somnolence, insomnia, dizziness)

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8
Q

What are the disadvantages of alpha-1-a blockage?

A

Abnormal ejaculation

Blocks dopa

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9
Q

What are the advantages of alpha-1-a blockage?

A

decreased CV effects

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10
Q

Which Alpha 1 blocker is the best?

A

Alfuzosin is the best b/c it has the most clinical effect with the least adverse effects.

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11
Q

Your patient who is taking an alpha-1 blocker needs surgery for their cataracts. What complication should you be concerned about?

A

Floppy iris syndrome. Surgery can continue if surgical technique is changed.

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12
Q

Which of the alpha-1 blockers are short acting?

A

Prazosin

Alfuzosin

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13
Q

Which of the alpha 1 blockers are Long acting?

A

Terazosin

Doxazosin

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14
Q

Which alpha 1 blockers are alpha 1a selective?

A

Tamulosin

silodosin

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15
Q

Which alpha 1 blockers are metabolized by CYPs?

A

Alfuzosin
Doxazosin
Tamulosin
Silodosin

Everything except Prazosin, and Terazosin (which is not mentioned)

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16
Q

Which alpha 1 blocker undergoes non-CYP metabolism?

A

Prazosin

17
Q

Which alpha 1 blockers undergo fecal elimination?

A

Prazosin

Doxazosin

18
Q

Which Alpha 1 blockers undergo mixed elimination?

A

Alfuzosin (3:1 fecal:renal)
Terazosin (3:2 hepatic:renal)
Tamulosin (3:2 Renal:fecal)
Silodosin (2:1 fecal:renal)

19
Q

What is the MOA of Tadalafil?

A

Tadalafil is a PDE-5 inhibitor. It prevents the breakdown of cGMP in smooth muscle, which leads to a decrease of intracellular Ca and smooth muscle relaxation. This is used to treat BPH

20
Q

What is the metabolism and elimination of Tadalafil?

A

CYP3A4

Fecal elimination

21
Q

What adverse effects are associated with Tadalafil?

A

All are uncommon:
No-arteritic optic neuropathy
Retincal artery occlusion
Hearing loss

22
Q

What are the contraindications for Tadalafil?

A

Organic Nitrates (hypotension, worse with EtOH)

23
Q

What is the MOA of Finasteride?

A

Specific type 2, 5-alpha-reductase inhibitor. Prevents the conversion of Testosterone to DHT. (competitive inhibition)

24
Q

What is the MOA of Dutasteride?

A

Type 1 and Type 2 5-alpha-reductase inhibitor. (competitive inhibition)

25
Q

What is the difference between type 1 and Type 2 5-alpha-reductase inhibitors?

A

Type 2 is found in the prostate.

26
Q

How are the 5-alpha-reductase inhibitors metabolized?

A

CYP3A4

27
Q

What adverse effects are associated with the 5-alpha-reductase inhibitors?

A 
Pregnancy Cat X
Erectile dysfunction,
Decreased libido, gynecomastia
Increased prostate Cancer
Decreased PSA levels

Reproductive Pharm (17 decks)

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