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33 Cards in this Set
- Front
- Back
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Doxazosin, terazosin and alfuzosin
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For symptomatic BPH relief.
MOA: Antagonists of alpha-1 adrenergic receptors. - Relax prostate smooth muscle at bladder neck to allow urination - Don’t shrink prostate size/don’t correct underlying problem - Antagonize vascular a1 adrenergic receptors - Must titrate dose to reduce side effects - Adverse: CV: syncope, orthostatic hypotension common Nasal: congestion Penis: impairs ejaculation * Contraindicated in patients with angina or heart failure |
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What would you predict to be an effect of activating a1 adrenergic receptors?
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Vasoconstriction
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TAMSULOSIN and silodosin
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Uroselective andrenergic antagonists.
- MAO: selective α1A antagonists – α1A is concentrated in prostate & penis - Less α1B adrenergic affinity (in blood vessels) = Less hypotension, less vascular - Less α1D affinity = less nasal congestion - Ejaculation still possible problem Silodosin - requires dose adjustment (renal or hepatic failure) |
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An elderly man with BPH needs relief; which best explains why tamulosin wouldn’t promote dizziness or syncope?
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Doesn’t block a1b vascular receptors.
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FINASTERIDE and dutasteride
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MAO: Competitive enzyme inhibitors of 5α-reductase reduce dihydrotesterone (DHT) production
- DHT major androgen promoting prostate hyperplasia – for BPH treatment only - Prototypical: finasteride, dutasteride - Finasteride – selective inhibitor 5α-reductase II - Dutasteride –non-selective inhibitor 5α-reductase used more severe BPH - Adverse Decrease serum PSA ; can mask cancer detection Impotence/libido decreases in some patients Rare– slight increase risk male breast cancer |
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Aminoglutethimide and Ketoconazole for Prostate Cancer:
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FLUTAMIDE; androgen receptor antagonists:
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Leuprolide and Goserelin
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GnRH agonists:
- For prostate cancer - Decreases LH/FSH release from pituitary - Continuous administration decreases sex steroid production via negative feedback –takes weeks to shut down - Given with androgen receptor antagonist - Adverse: Impotence, hot flushes & bone loss can occur - Patients often need biphosphate therapy to guard against osteoporosis. |
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Degarelix
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GnRH antagonist:
- For prostate cancer - Competitive antagonist at pituitary GnRH receptor - Rapidly reduces gonadotropin & testosterone levels - These patients often need biphosphate therapy to guard against osteoporosis |
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Blood flow in flaccid vs. erect penis:
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Nitric oxide and cGMP mechanism of penile erection:
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Steps to an erection:
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Steps to detumescence:
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Testosterone deficiency can cause?
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1. Loss of libido
2. Fatigue 3. Erectile dysfunction * When testing testosterone levels, evaluate morning and free testosterone. |
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Requirements for an erection:
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Requirements for an erection:
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Erectile dysfunction can be classified in what 3 ways?
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1. Organic
- Problems with blood flow - Medications - Nerve damage - Surgery - Systemic diseases - Lifestyle factors 2. Psychogenic - Lack of interest - Performance anxiety - Stress 3. Mixed |
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Sildenafil, tadalafil (Viagra, Cialis); PDE5 inhibitors to treat impotence:
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Direct vasodilators for impotence:
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Treatment for premature ejaculation:
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Fibrocystic and benign epithelial/proliferative changes:
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- Most common disorder of the breast
- Most common cause of breast masses in women ages 25-50 years - Clinical: lumpy breasts (bilateral usually) with midcycle tenderness - Calcifications and densities on mammograms - Pathogenesis: may related to increased activity or increased sensitivity to estrogen - Nonproliferative versus proliferative |
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Characteristics of non-proliferative fibrocystic change in breast tissue:
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Characteristics of non-proliferative fibrocystic change in breast tissue:
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Characteristics of proliferative breast disease without atypia:
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Sclerosing adenosis; a type of proliferative breast disease without atypia:
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Characteristics of proliferative disease of the breast with atypia:
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Characteristics of an intraductal papilloma:
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Characteristics of fibroadenoma:
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Over 95% of breast carcinomas are what type?
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Adenocarcinomas
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Characteristics of DCIS Comedocarcinoma type:
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Characteristics of lobular carcinoma in situ:
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Molecular classifications of breast cancers:
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Characteristics of invasive lobular carcinoma:
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