Term
| Medications That May Exacerbate LUTS |
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Definition
- Anticholinergic activity (antihistamines, antidepressants, OAB medications) -- lessen detrusor muscle contractions
- Sympathomimetic agonists (appetite suppressants, decongestants) -- block relaxation of the internal urethral sphincter
- Dihydropyridine CCBs -- relax smooth muscle
- Symptoms may also be increased with caffeine and alcohol
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Term
| Alpha1 Blockers for BPH: Drugs, MOA, Place in therapy |
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Definition
- Terazosin, Doxazosin, Tamsulosin, Alfuzosin, Silodosin
MOA
Inhibit alpha-adrenergic mediated contraction of prostatic smooth muscle -- relief of bladder outlet obstruction
1st Line of prescribed medical therapy |
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Term
| Long Acting Alpha1 Blockers and Long Acting Alpha-1a Blockers |
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Definition
Long Acting Alpha1 Blockers
- Terazodin
- Doxazosin
- Alfuzosin
Long Acting Alpha-1a Blockers
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Term
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Definition
SE Common With All Alpha-Blockers
- Dizziness
- Fatigue or Somnolence
- Nasal Congestion
SE More Common With Tamsulosin, Silodosin
SE More Common With Terazosin, Doxazosin
- Dizziness
- Hypotension
- Syncope
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Term
| 5-Alpha Reductase Inhibitors: Drugs, Clinical Improvement |
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Definition
Finasteride (Type 2)
Dutasteride (Type 1 and 2)
- Reduce DHT levels in serum and prostate
- Reduces prostate size
- Increases peak urinary flow
- Reduces BPH symptoms
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Term
| Which class of drug has more symptom relief in BPH: 5-alpha reductaste inhibitors or Alpha-Blockers? |
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Definition
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Term
| Which class of drugs do you see faster symptom improvement: 5-alpha reductase inhibitors or alpha-blockers? |
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Definition
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Term
| Which class of drugs has a greater average point improvement in AUA-SS: 5-alpha reductase inhibitors or alpha-blockers? |
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Definition
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Term
| 5-Alpha Reductaste Inhibitors: SE |
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Definition
- Decreased libido
- Ejaculatory dysfunction
- Erectile dysfunction
- Breast changes (lumps, pain, nipple discharge)
- Lowers PSA by about 50%
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Term
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Definition
- Decrease fluid intake at bedtime
- Decrease caffeine and alcohol intake
- Avoid cold medications with alpha-sympathomimetic/anticholinergic drugs
- Use a voiding diary to record symptoms
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Term
| 5-Alpha Reductase Inhibitors: CI |
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Definition
Pregnant Women
- patients should be cautioned that pregnant women should not handle crushed or broken tablets
- patients should be advised not to donate blood until at least 6 months since last dose to avoid transfer to pregnant females
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Term
| ACh Agonists: Receptor Activity in the Bladder |
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Definition
| Contracts bladder smooth muscle |
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Term
| ACh Antagonists: Receptor Activity in the Bladder |
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Definition
| Relax bladder smooth muscle |
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Term
| Alpha-1 Adrenergic Agonists: Receptor Activity in the Bladder, Urethra, Prostate |
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Definition
| Contracts urethra, bladder neck, prostate tissue |
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Term
| Alpha-1 Adrenergic Antagonists: Receptor Activity in the Bladder, Urethra, Prostate |
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Definition
| Relax urethra, bladder neck, prostate tissue |
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Term
| Clinical LUTS/BPH: Voiding (Obstructive) Signs/Symptoms |
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Definition
- Hesitancy
- Straining
- Weak Flow
- Terminal Dribbling
- Prolonged Voiding
- Incomplete Emptying
- Retention
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Term
| Clinical LUTS/BPH: Storage (Irritative) Signs/Symptoms |
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Definition
- Frequency
- Urgency
- Nocturia
- Urge Incontinence
- Small Voided Volume
- Dysuria
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Term
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Definition
- Urinary Retention
- Renal Impairment
- UTI
- Overflow Incontinence
- Worsening Symptoms
- Gross Hematuria
- Bladder Stones
- Bladder Damage
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Term
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Definition
Mild = 0-7
Moderate = 8-19
Severe = 20-35 |
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Term
| Prostate Specific Antigen (PSA) Levels |
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Definition
Normal PSA < 4.0 ng/ml
Elevated PSA > 4.0 ng/ml |
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Term
| Factors that increase PSA Levels |
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Definition
- Prostatitis
- BPH
- DRE
- Ejaculation in last 24 hrs
- Catheterization
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