IC18 eL & IC18

Question 1

How does Finasteride, Dutasteride lead to ED?

Answer 1

Decrease testosterone

Question 2

Classes of drugs used for BPH

Answer 2

Alpha adrenergic antagonist, 5ARI, PDE5i

Question 3

Is PSA is clear-cut indicator of BPH?

Answer 3

No, but it helps to predict progression of BPH

Question 4

Examples of anticholinergics

Answer 4

Antihistamines, tricyclic antidepressants

Question 5

Impact of anticholinergics

Answer 5

Decr bladder muscle contractility

Question 6

Drugs that exacerbate BPH s/sx

Answer 6

Anticholinergics, opioid analgesics, diuretics, a1 agonist

Question 7

Which non-selective alpha adrenergic antagonist is not recommended for BPH?

Answer 7

Prazosin

Question 8

Examples of non-selective alpha adrenergic antagonist for BPH

Answer 8

Doxazosin, terazosin

Question 9

Examples of selective alpha adrenergic antagonist for BPH

Answer 9

Tamsulosin, silodosin, alfuzosin

Question 10

Examples of 5ARI

Answer 10

Finasteride, dutasteride

Question 11

MOA for 5ARI

Answer 11

Inhibits 5α reductase (type II) -> decr conversion of testosterone to DHT

Question 12

MOA for non-selective alpha adrenergic antagonists

Answer 12

Inhibit peripheral vascular & urinary alpha1 receptors

Question 13

MOA of PDE5 inhibitor in BPH

Answer 13

Unknown, maybe smooth muscle relaxation

Question 14

MOA of PDE5 inhibitor in ED

Answer 14

Inhibit PDE 5 enzyme, which induces catabolism of cGMP, enhancing cGMP activity →inducing smooth muscle relaxation→ erection

Question 15

What is Yohimbine and is it used in ED?

Answer 15

α 2-Antagonist; not used in ED due to controversial efficacy

Question 16

Which PDE5i is approved for BPH?

Answer 16

Tadalafil

Question 17

Tx for symptomatic hypogonadism in ED

Answer 17

Testosterone replacement

Question 18

Normal testosterone level

Answer 18

300-1100ng/dL (10.4-38.2 mmol/L)

Question 19

List the 4 PDE5i used in ED

Answer 19

Sildenafil, Vardenafil, Tadalafil, Avanafil

Question 20

DDI for alprostadil

Answer 20

PDE5 inhibitor (it may enhance toxic effects of alprostadil)

Question 21

Two dosage forms for alprostadil

Answer 21

Intraurethral & intracavernosal

Question 22

Causes of tx failure for PDE5i

Answer 22

Administration with food?
Timing and frequency of dosing
Lack of adequate sexual simulation
Titration to maximum dose

Question 23

Monitoring parameters for PDE5i

Answer 23

• Efficacy
• BP
• Side effects
• DDI with CYP3A4 inhibitors
• Changes in cardiac health status

Question 24

Criteria for symptomatic hypogonadism

Answer 24

Decreased libido AND low serum testosterone concentrations

Question 25

Contraindication for testosterone replacement

Answer 25

Prostate cancer