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Of nonmalignant prostate prostate caused by excessive

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Unformatted text preview: Affect Sexual Functioning Affect Antihypertensives Diuretics H1 and H2 blockers Phenothiazines and antipsychotics Anxiolytics Ethanol Barbiturates Androgens, estrogens, progestins Others (ketoconazole, opioids) Benign Prostatic Hyperplasia Benign Nonmalignant prostate enlargement (overgrowth of Nonmalignant prostate) prostate) Caused by excessive growth of epithelial (glandular) Caused cells and smooth muscle cells cells Anatomical enlargement of the prostate gland land that Anatomical decreases the outflow of urine. decreases Causes difficult urination. Signs and symptoms – – – – – Urinary hesitancy Urinary urgency Increased frequency of urination Dysuria Nocturia Benign Prostatic Hyperplasia Benign Treatment modalities – Surgery – Watchful waiting – Drug therapy – 5-Alpha-reductase inhibitors (mechanical 5-Alpha-reductase obstruction) obstruction) Finasteride (Proscar) Dutasteride (Avodart) – Alpha1-adrenergic antagonists Finasteride (Proscar) Finasteride Inhibits 5-alpha-reductase Most effective in patients with very large Most prostates (mechanical obstruction) prostates Also sold at lower dosages as Propecia for Also male pattern baldness male Adverse effects – Decreases ejaculate volume and libido – Gynecomastia – Decreases levels of PSA Dutasteride (Avodart) Dutasteride Inhibits 5-alpha-reductase Similar to finasteride – but three Similar but hree differences: differences: – Reduction in circulating DHT is more Reduction complete complete – Harmful to the developing male fetus – Extremely long half-life (5 weeks) Alpha1-Adrenergic Antagonists Alpha Four are approved for treatment of BPD – Terazosin (Hytrin) – Doxazosin (Cardura) – Tamsulosin (Flomax) – Alfuzosin (Uroxatral) All relax the smooth muscle in the bladder neck Blockade of alpha1 receptors relaxes smooth muscle in the bladder neck (trigone and sphincter) (trigone Other Drugs for BPH Other Saw palmetto- herbal remedy Saw – Used widely – Effectiveness not supported Tolterodine (Detrol)...
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