prostate and ED (application)

Question 1

Acute / Chronic Bacterial Prostatitis (Antibiotics)

Answer 1

First-line antibiotics
- Ciprofloxacin
- Levofloxacin
- TMP-SMX (Bactrim)

Question 2

why are Acute / Chronic Bacterial Prostatitis (Antibiotics) used?

Answer 2

They penetrate prostate tissue well, which is essential because the prostate is difficult for many drugs to reach

Question 3

when to use Acute / Chronic Bacterial Prostatitis (Antibiotics) Ciprofloxacin
Levofloxacin
TMP-SMX (Bactrim)?

Answer 3

Suspected bacterial prostatitis

Question 4

bacterial prostatitis clues

Answer 4

Fever
Perineal pain
Painful ejaculation
Dysuria
Urinary obstruction symptoms

Question 5

treatment duration of Acute / Chronic Bacterial Prostatitis (Antibiotics) (Ciprofloxacin
Levofloxacin
TMP-SMX (Bactrim)

Answer 5

4–6 weeks (sometimes up to 12 weeks) because penetration is poor.

Question 6

when to choose Cipro/ Levo, TMP-SMX, Doxycycline

Answer 6

Question 7

Young male + STI risk tx

Answer 7

doxycycline

Question 8

BPH (Benign Prostatic Hyperplasia) patho

Answer 8

Pathophysiology
Two main problems:
1️⃣ Smooth muscle constriction of prostate/urethra
2️⃣ Enlarged prostate from DHT

So treatments target one of these two mechanisms.

Question 9

Older male + UTI organisms tx

Answer 9

fluoroquinolone

Question 10

tx for BPH (Benign Prostatic Hyperplasia)

Answer 10

Alpha-Blockers
Examples
- Tamsulosin
- Alfuzosin
- Silodosin
- Terazosin
- Doxazosin

Question 11

why do alpha blockers work
(- Tamsulosin
- Alfuzosin
- Silodosin
- Terazosin
- Doxazosin)?

Answer 11

Block alpha-1 receptors → relax prostate & bladder neck → improve urine flow.

Question 12

when to use Alpha- Blockers
- Tamsulosin
- Alfuzosin
- Silodosin
- Terazosin
- Doxazosin

Answer 12

First-line symptomatic treatment for BPH Best when patient has:
- Weak urinary stream
- Hesitancy
- Dribbling
- Urinary obstruction

Question 13

key features of alpaha blockers
- Tamsulosin
- Alfuzosin
- Silodosin
- Terazosin
- Doxazosin

Answer 13

Fast symptom relief
Does NOT shrink prostate

Question 14

5-Alpha-Reductase Inhibitors examples

Answer 14

Finasteride
Dutasteride

Question 15

major SE of alpaha blockers
- Tamsulosin
- Alfuzosin
- Silodosin
- Terazosin
- Doxazosin

Answer 15

Orthostatic hypotension
Ejaculatory dysfunction
Headache

Question 16

why do 5-Alpha-Reductase Inhibitors work?
Finasteride
Dutasteride

Answer 16

Block conversion of testosterone → DHT
↓ DHT → shrinks prostate.

Question 17

when to use 5-Alpha-Reductase Inhibitors
Finasteride
Dutasteriden

Answer 17

Best for:
Large prostate (>40 g)
Long-term disease control

Question 18

5-Alpha-Reductase Inhibitors (Finasteride
Dutasteride) key features

Answer 18

Takes 6–12 months to work
Decreases prostate size

Question 19

5-Alpha-Reductase Inhibitors (Finasteride
Dutasteride) SE

Answer 19

Erectile dysfunction
Decreased libido
Gynecomastia

Question 20

important exam pearl with 5-Alpha-Reductase Inhibitors (Finasteride
Dutasteride)

Answer 20

PSA drops ~50% after 6 months.

Question 21

PDE-5 Inhibitors (Tadalafil) when to use?

Answer 21

BPH + erectile dysfunction

Question 21

PDE-5 Inhibitors ex

Answer 21

Tadalafil (Cialis)

Question 22

PDE-5 Inhibitors (Tadalafil) why they work?

Answer 22

Improve smooth muscle relaxation and blood flow.

Question 23

PDE-5 Inhibitors (Tadalafil) exam clues

Answer 23

Male with:
LUTS
Erectile dysfunction

Question 24

Combination Therapy ex

Answer 24

Tamsulosin + Finasteride

Question 25

why does combination therapy (Tamsulosin + Finasteride) work?

Answer 25

Targets both mechanisms - Smooth muscle relaxation - Prostate shrinkage

Question 26

when to use combination therapy (Tamsulosin + Finasteride)?

Answer 26

Moderate–severe BPH.

Question 27

combination therapy (Tamsulosin + Finasteride) effects

Answer 27

Reduces: BPH progression Urinary retention Incontinence risk

Question 28

Treatment Algorithm

Answer 28

Step 1 AUA score ≤ 7 ➡️ Watchful waiting Step 2 AUA score > 7 ➡️ Start medication: Alpha blocker (most common) OR 5-ARI if prostate enlarged OR PDE-5 inhibitor Step 3 Persistent symptoms ➡️ Combination therapy

Question 29

Acute prostatitis drug

Answer 29

Ciprofloxacin / Levofloxacin

Question 30

Fluoroquinolone allergy drug

Answer 30

TMP-SMX

Question 31

STI prostatitis drug

Answer 31

Doxycycline

Question 32

BPH symptoms drug

Answer 32

Alpha blocker

Question 33

BPH + ED drug

Answer 33

Tadalafil

Question 33

Large prostate tx

Answer 33

Finasteride / Dutasteride

Question 34

Severe BPH drug

Answer 34

Alpha blocker + 5-ARI