Drugs for GU Disorders - Konorev Flashcards Preview

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Flashcards in Drugs for GU Disorders - Konorev Deck (61)
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1

Cause of epithelial tissue hyperplasia

androgens

2

Cause of stromal tissue hyperplasia

estrogens

3

aromatase

converts androgens to estrogens

4

Tx: dynamic prostatic pathogenic factors

selective alpha-1 andrenergic antagonists

5

Tx: static prostatic pathogenic factors

5alpha-reductase inhibitors

6

second generation alpha-1 andrenergic antagonists

-terazosin
-doxazosin
-alfuzosin

7

third generation alpha-1 andrenergic antagonists

-tamulosin
-silodosin

8

5alpha-reductase inhibitors

-finasteride
-dutasteride

9

benefits of using alpha-1 and antagonisis over 5alpha-reductase inhibitors

-faster acting
-effective reduction of LUTS
-ass'd w/ less sexual dysfxn

10

alfuzosin

-second generation alpha-1 and antagonist
-more uroselective (d/t PK not selectivity)
-doesn't need titration

11

AE: doxazosin

-may cause orthostatic hypotension
-first does syncope
-dizziness

12

AE: terazosin

-may cause orthostatic hypotension
-first does syncope
-dizziness

13

tamsulosin

-alpha-1A selective (prostatic sm), some 1B activation (vasculature)
-used in BPH pts who have significant orthostatic hypotension

14

silodosin

-highly alpha-1A selective
-no orthostatic hypotension
-severe ejaculatory dysfxn

15

AE: alpha-1 antagonists

-syncope, dizziness, hypotension (2nd gen)
-ejaculatory dysfxn (3rd gen)
-nasal congestion
-flu-like s/s

16

DI: alpha-1 antagonists + PDE5 inhibitor

marked systemic hypotension

17

DI: alpha-1 antagonists + cimetidine, diltiazem

decreased alpha-1 antagonists metabolism

18

DI: alpha-1 antagonists + carbamazepine, phenytoin

increased metabolism

19

MOA: finasteride

-selective type II reductase inhibitor
-inhibits DHT synthesis from T

20

MOA: Dutasteride

-non-selective ( type I and II) reductase inhibitor
-inhibits DHT synthesis from T

21

Type I enzyme reductase locations

skin, hair follicles, liver

22

Type II enzyme reductase locations

prostate, genital tissue, scalp
-responsible for epithelial tissue enlargement in prostate

23

MOA: 5alpha-reductase inhibitors

- reduce DHT formation
-prevent AR activation
-shrink prostate

24

negative aspects of 5alpha-reductase inhibitors

-need 6-12 m to develop effect
-more pronounced sexual dysfunction
-"second-line" agent

25

when to use 5ARi over A1AAs

-severe prostatic enlargement (40g or >)
-andrenergic ant contraindications
-pts with high PSA (>1.4 ng/ml)

26

drug classes that exacerbate BPH

-T replacement therapy
-alpha-and agonists
-antimuscarininc drugs

27

types of organic ED

-hormonal
-neurologic
-vascular

28

Oral phosphodiesterase type 5 inhibitors

-sildenafil
-vardenafil
-tadalafil

29

injectable or intraurethral prostaglandins

alprostadil

30

unapproved ED tx agents

-phentolamine
-papaverine
-trazodone