Term
| 4 ways in which ED may be caused |
|
Definition
| Vascular, nervous, hormonal, psychogenic |
|
|
Term
| Medical conditions that may cause ED |
|
Definition
| HTN, atherosclerosis, hyperlipidemia, DM, psychiatric disorders |
|
|
Term
| Medications that may cause ED |
|
Definition
| Anticholenergics, dopamine, estrogens, CNS depressants, anti-hypertensives |
|
|
Term
| Main treatment for ED, examples and MOA |
|
Definition
Phosphodiesterase 5 inhibitors
Sildenafil, Vardenafil, Tadalafil
Increased effect of NO |
|
|
Term
| Which PDE5 Inhibitor has a duration of 36 hours instead of 2-3 hours |
|
Definition
|
|
Term
| What condition do you need to worry about with PDE5 inhibitors that you see an ophthamlogist for? |
|
Definition
| Nonarteritic anterior ischemic optic neuropathy |
|
|
Term
| Adverse effects of PDE5 inhibitors |
|
Definition
| facial flushing, nasal congestion, abnormal vision, priapism, decreased BP |
|
|
Term
| What medication that you take for BPH should you not take with PDE5 inhibitors? |
|
Definition
| Alpha blockers (may drop BP) |
|
|
Term
| What conditions are considered high risk CV and shouldn't get PDE5's? |
|
Definition
Unstable angina
Uncontrolled HTN
Severe congestive heart failure
MI or stroke in last 2 weeks
Moderate or severe valvular heart disease
Arrhythmias
Obstructive hypertrophic cardiomyopathy |
|
|
Term
| What is the other treatment besides PDE5 that can be used for ED and what is its MOA |
|
Definition
Alprostadil
PGE1
Stimulates adenyl cyclase which increases production of cGMP (more NO) |
|
|
Term
| What are the two forms of alprostadil? |
|
Definition
| Caverject (injection) and Muse (intraurethral) |
|
|
Term
| WHat conditions can't you use alprostadil with due to increased risk of priapism |
|
Definition
| Sickle cell anemia, multiple myeloma, leukemia |
|
|
Term
| What are two causes of BPH? |
|
Definition
Testosterone is converted to DHT
Excessive alpha adrenergic tone |
|
|
Term
| What drugs may aggravate BPH? |
|
Definition
| testosterone replacement, anticholenergics, sympathomimetics (sudafed) |
|
|
Term
| What are the two main categories of treatment for BPH? |
|
Definition
| Alpha blockers and 5-alpha reductase inhibitors |
|
|
Term
| Give an example of an alpha blocker and its MOA |
|
Definition
Terazosin (Tamsulosin 2nd line)
Relax smooth muscle in bladder neck and prostate |
|
|
Term
| Name an alpha1 blocker and an alpha1A blocker and what is the difference? |
|
Definition
Alpha1: terazosin
Alpha1A: tamsulosin
Alpha 1A are better tolerated but more expensive (use if patient can't tolerate alpha 1) |
|
|
Term
| Name a 5-alpha reductase inhibitor and its MOA |
|
Definition
Finasteride
Decreases conversion of testosterone to DHT |
|
|
Term
| What is the difference in onset of action between alpha blockers and 5-alpha reductase inhihibitors for BPH? |
|
Definition
Alpha blockers: 2-4 weeks
5-alpha reductase inhibitors: 6 months |
|
|
Term
| When should you use 5-alpha reductase inhibitors? |
|
Definition
| Increased prostate size (>50 g) |
|
|
Term
| What herbs may be effetive for BPH? |
|
Definition
|
|
Term
| What causes each of the types of incontinence? |
|
Definition
Urge: destrusor hyperactivity
Stress: urethral sphincter incompetence
Overflow: detrusor hypoactivity or urethral obstruction |
|
|
Term
| RIsk factors for incontinence (DIAPPERS) |
|
Definition
| Delerium, infection, atrophic urethritis, pharm, psych, excessive urine output, restricted mobility, stool impaction |
|
|
Term
| Medications that may cause urinary retention |
|
Definition
| Alpha agonists, CCB, narcotics, anticholenergics, antipsychotics, antidepressants |
|
|
Term
| Medications for urge incontinence |
|
Definition
| Anticholenergics, TCA's, topical estrogen |
|
|
Term
| What is the anticholenergic for incontinence? |
|
Definition
|
|
Term
| What are two options for stress incontinence? |
|
Definition
| 5-HT/NE Reuptake inhibitors or alpha agonists (Sudafed) |
|
|
Term
| Treatment for overflow incontinence |
|
Definition
| Cholinomimetics (Bethanechol) |
|
|
