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Flashcards in Pharmacology Deck (78)
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1

Medications Used for BPH

Alpha-1 blockers
5-alpha-reductase inhibitors
Combo: Dutasterid-Tamulosin (Jalyn)
Tadalafil (Cialis)

2

Examples of Alpha-1 Blockers

Terazosin (Hytrin)
Doxazosin (Cardura)
Alfuzosin (Uroxatrol)
Tamsulosin (Flomax)
Silodosin (Rapaflo)

3

MOA of Alpha-1 Blockers

Relax smooth muscle in the bladder neck & the prostatic capsule & prostatic urethra

4

Reason for Alpha-1 Blockers

Short & long term symptom management

5

Where are alpha-1 receptors located?

Base of the bladder
In the prostate

6

SE of Alpha-1 Blockers

Dizziness
Orthostatic hypotension
Asthenia (muscle weakness)
Nasal congestion
Problems with ejaculation (especially with Tamsulosin (Flomax))

7

Alpha-1 Blockers with More BP Effects

Terozosin (Hytrin)
Doxazosin (Cardura)

8

Alpha-1 Blockers with Less BP Effects

Tamsulosin (Flomax)
Alfuzosin (Uroxatrol)
Silodosin (Rapaflo_

9

Examples of 5-alpha-reductase Inhibitors

Finasteride (Proscar)
Dutasteride (Avodart)

10

Benefits of 5-Alpha-Reductase Inhibitors

Long term decrease in prostate size & decreased need for prostatic surgery

11

MOA of 5-Alpha-Reductase Inhibitors

Competitive inhibitor of both tissue & hepatic 5-alpha reductase
Inhibition of the conversion of testosterone to DHT & suppress serum DHT levels
Decreases prostatic size

12

Efficacy of 5-alpha-reductase Inhibitors

May be up to a year to notice reduction in symptoms
Reduce symptoms scores
Increase maximum urinary flow rate
Reduction in mean prostatic volume
Decreased need for surgery
Decreased development of acute urinary retention

13

Major SE of 5-Alpha-Reductase Inhibitors

Decreased libido
Ejaculatory or erectile problems
Decreases serum PSA by 50%

14

Cialis for BPH

Blocks PDE5 in the prostate & bladder

15

Medications not to Use with Cialis

Nitrates
Alpha-1 Blockers

16

Medications for Erectile Dysfunction

Alprostadil
Tadalafil (Cialis)
Vardenafil (Levitra)
Sildenafil (Viagra)
Avanafil (Stendra

17

Drug Category for Alprostadil (Caverject, Muse)

Prostaglandin
Vasodilator

18

MOA of Alprostadil (Caverject, Muse)

Vasodilation on vascular & smooth muscles
Relaxes trabecular smooth muscle by dilation of cavernosal arteries

19

Onset & Duration of Action of Alprostadil (Caverject, Muse)

Onset: 5-20 minutes
Duration:

20

Contraindications of Alprostadil (Caverject, Muse)

Conditions that predispose the patient to priapism
Anatomic or fibrotic conditions of the penis
For pellets: urethral stricture, perineal pain

21

SE of Alprostadil (Caverject, Muse)

Syncope
Priapism
May cause BP lowering

22

Phosphodiasterase Inhibitors

Tadalafil (Cialis)
Vardenafil (Levitra)
Sildenafil (Viagra)
Avanafil (Stendra)

23

MOA of Phosphodiasterase Inhibitors

Release of nitric oxide (NO) during sexual stimulation
NO produces smooth muscle relaxation & inflow of blood
Enhances the effect of NO by inhibiting phosphodiesterase type 6 (PDE-5)
Do not directly cause penile erections

24

Contraindications of Phosphodiasterase Inhibitors

Men taking nitrates
Caution with alpha-1 blockers (severe hypotension)

25

SE of Phosphodiesterase Inhibitors

Severe hypotension
Flushing
Headaches
Dyspepsia
Transient blue vision with sildenafil (Viagra)
Increase risk for non-arteritis ischemic optic neuropathy
Hearing loss
Priapism

26

Administration of Phosphodiesterase Inhibitors

Take 60 minutes prior to intercourse
Food/alcohol delay onset of action in sildenafil (Viagra) & vardenafil (Levitra)

27

Duration of Action of Phosphodiesterase Inhibitors

Tadalafil (Cialis): up to 36 hours
All others: 8-12 hours

28

Define Primary Hypogonadism

Testes fail to produce testosterone

29

Define Secondary Hypogonadism

Pituitary or hypothalamus malfunctino

30

MOA of Testosterone Replacement

Bind to the androgen receptor
Act in tissues that express the enzyme 5-alpha reductase
Can act as estrogen after converting to estradiol