T4-BPH

Question 1

What is the patho of BPH?

Answer 1

The bladder holds urine. From the bladder it goes to the urethra. In men, surrounding the urethra, there is an organ called the prostate. BPH is a condition in which the prostate gets too large and impinges on the urethra.

Question 2

What is in the neck of the bladder?

Answer 2

Alpha-1a receptors

Question 3

What are the 2 kinds of drugs to help treat BPH?

Answer 3

Alpha1 blockers

5-alpha-reductase inhibitors

Question 4

What is the MOA of alpha1 blockers?

Answer 4

We can target the Alpha 1a receptors on the bladder. This will dilate the urethra and decrease obstruction of it

Question 5

Do alpha1 blockers decrease the size of the prostate?

Answer 5

NO

Question 6

What are the 4 alpha-1 blocker drugs?

Answer 6

*all end in zosin or sin

• Doxazosin
• Terazosin
• Alfuzosin (alpha1 selective)
• Tamsulosin (alpha1 selective)

Question 7

T/F: Alpha 1 drugs are well tolerated

Answer 7

TRUE

Question 8

What are 3 adverse effects of alpha 1 blockers?

Answer 8

1. Hypotension, dizziness
2. Nasal congestion
3. Abnormal ejaculation

Question 9

Adverse effects of alpha 1 blockers: Which 2 adverse effects are mainly caused by the nonselective drugs?

Answer 9

Hypotension, dizziness
Nasal congestion

*nonselective drugs: doxazosin and terazosin

Question 10

Adverse effects of alpha 1 blockers: which adverse effect is caused by the selective agents?

Answer 10

Abnormal ejaculation

*Alfuzosin and Tamsulosin

Question 11

What is the client teaching regarding alpha1 blockers?

Answer 11

• 1-2 weeks for full effect
• Stand up slowly and stay hydrated (orthostatis hypotension is worse if you’re dehydrated)
• Take at bedtime (to help with orthostatic hypotension [ie. you aren’t getting up if you’re in bed])

Question 12

Which BPH meds can also treat HYPERtension?

Answer 12

Alpha 1 blockers: Doxazosin and terazosin

*these are nonselective and they mainly are the ones that cause HYPOtension. Giving this to someone with HYPERtension will decrease their BP!

Question 13

What would happen if a patient took an alpha blocker and ED med together?

Answer 13

Too much dilation–BP bottoms out

Question 14

What is the MOA of the 5 alpha reductase inhibitors?

Answer 14

• Testosterone is converted to DHT via the 5 alpha reductase enzyme because the 5 alpha reductase enzyme chews off part of the testosterone.
• The prostate has a lot of DHT receptors. DHT ENLARGES the prostate [and also causes male pattern baldness]. The 5-alpha reductase inhibitors inhibit the enzyme that converts testosterone to DHT.
• DHT isn’t made anymore so the prostate is not being enlarged

Question 15

Do 5-alpha reductase inhibitors decrease the size of the prostate?

Answer 15

Yes, overtime

Question 16

What are the two 5-alpha-reductase inhibitors?

Answer 16

*end in ASTERIDE

DutASTERIDE
FinASTERIDE

Question 17

What are the 4 adverse effects associated with 5-alpha reductase inhibitors?

Answer 17

1. Lowers prostate specifc antigen (PSA)–you may have cancer, but your levels look “normal”
2. High grade prostate cancer [deadly!]
3. Ejactulatory problems
4. Gynecomastia

Question 18

5-alpha reductase inhibitors are pregnancy risk category __!

Answer 18

X

Question 19

Why are the 5-alpha reductase inhibitors Preg category X?

Answer 19

• Teratogenix to male fetuses
• PREGS and CHILDREN cannot handle this drug [extemely lipid soluble + teratogenic= BAD..children can’t touch bc we don’t want to mess with the testosterone levels of a child]
• NO blood transfusions by males taking this drug!–your blood could be given to a PREGO
• must wait 1 month before donating after stopping the BPH drug!!!

Question 20

What are the 3 client teachings for 5-alpha-reductase inhibitors?

Answer 20

1. 3-6 months for full effect
2. Can take with or without food
3. PREG category X!