Week 4 BPH, ED, Contraceptives, Incontinence Flashcards
(28 cards)
what are the two main drug classes for treating BPH?
Alpha-adrenergic antagonists & 5alpha-inhibitors
what drug class does terazosin, doxazosin & alfuzosin fall into?
alpha adrenergic antagonists, 2nd gen
what drug class does Tamsulosin and Silodosin fall into?
alpha adrenergic antagonists 3rd gen
what is the benefit of using 3rd generation alpha adrenergic blockers over 2nd generation?
Titration is easier and there are less incidents of HoTN as they are more uroselective
onset of action for alpha adrenergic blokers
days to weeks
what are the side effects of 2nd generation alpha adrenergic blockers
dizziness, HoTN, rhinitis, malaise, ejaculation disorders, somnolence
what are DDI’s for 2nd generation alpha adrenergic agents?
decongestants, antihypertensives & diuretics, phosphodiasterase inhibitors
For alfluzosin strong CYP3A4 inhibitors like ketoconazole, itraconazole
What are the drug classes that cause irritative or obstructive voiding symptoms in BPH
anticholinergics, androgens, sympathomimetics, diuretics
what is an acceptable trial duration for alpha adrenergic blockers?
1-2 weeks at full dose
what kind of metabolic adjustment is necessary for the alpha adrenergic blockers?
hepatic but not renal
what time of day is best for dosing the 2nd generation alpha adrenergic blockers?
Nighttime
which of the 2nd generation alpha adrenergic inhibitors requires less titration time?
doxazosin XL because it has less immediate onset and thus less hypotension. titrate over days to weeks
why is alfuzosin more uroselective?
because it does not cross the BBB
why are the3rd generation alpha adrenergic blockers better tolerated?
Because they are more uroselective. however the peripheral effects can be present at high doses
what is one BPH drug that you should tell your opthamologist about and why?
Tamsulosin due to the risk of floppy iris syndrome
what drug classes do finasterideand dutasteride fall into?
5 alpha reductase inhibitor
what lab do you need to monitor for 5 alpha reductase inhibitor?
PSA prostate stimulating hormone
what is considered an adequate trial of 5 alpha reductase inhibitors?
6-12 months
what are side effects of 5 alpha reductase inhibitors?
all androgen related hormones: decreased sex drive, erectile dysfunction, ejaculation disorders, gynecomastia and breast tenderness
what risks are there with 5 alpha reductase inhibitors for pregnant women?
exposure to semen containing drug or exposure to uncoated/broken pills can lead to feminization of male fetus
what is the risk for men taking fisnateride or dutasteride?
decreased risk of prostate cancer but an increased risk of more aggressive cancers
what drugs are associated with erectile dysfunction
Antihypertensives, anidepressants, antipsychotics, anticonvulsants, 5-alpha-reductase inhibitors, opioids
what is the preferred anti hypertensive in cases of ED
ARBs and ACEs
what class o drug is used for the treatment of erectile dysfunction?
phosphodiesterase inhibitors PDE-5 inhibitors
