Benign prostate hypertrophy

ATC C02CA G04CB01 Use antihypertensive, aj-antagonist, treatment 6f benign prostatic hypertrophy... 

GR is a 68-year-old African-American male who presents to the emergency department with dizziness and loss of speech that began 1 hour ago. His past medical history is significant for hypertension, diabetes mellitus, hypercholesterolemia, and benign prostatic hypertrophy (BPH). Social history is significant for smoking 1 pack per day for the last 38 years. Current medications include metoprolol 50 mg twice daily, insulin NPH 20 units twice daily, and simvastatin 20 mg daily. 

Postrenal ARF is due to obstruction of urinary outflow. Causes include benign prostatic hypertrophy, pelvic tumors, and precipitation of renal calculi.7 Rapid resolution of postrenal ARF without structural damage to the kidney can occur if the underlying obstruction is corrected. Postrenal ARF accounts for less than 10% of cases of ARF.6... 

Address other medical conditions that frequently coexist with insomnia and can worsen a patient s symptoms (e.g., psychiatric disorders, benign prostatic hypertrophy). 

The answer is b. (Idardman, p 1453. Katzung, p 705.) Finasteride is a competitive inhibitor of the steroid 5-reductase, causing reduction in plasma and prostate dihydrotestosterone. Males with benign prostatic hypertrophy (BPH) that are treated with finasteride are found to have decreased prostate size. A change in symptoms related to urination occurs in about one-third of patients... 

BPH—benign prostatic hypertrophy BPM—breaths per minute beats per minute BUN—blood urea nitrogen C—mean plasma concentration Cmi]X—maximum plasma concentration Cmm—minimum plasma concentration C albicans—Candida albicans C. bofulinum—Clostridium frotu/irtum C. difficile—Clostridium difficile C. jejuni—Campylobacter jejuni C. neoformans—Cryptococcus neoformans Ca—calcium... 

Urinary hesitancy and retention are commonly reported, especially with low-potency FGAs and clozapine, and men with benign prostatic hypertrophy are especially prone. 

Terazosin is an alpha-adrenoreceptor blocker that causes vasodilation and is used in the management of hypertension and benign prostatic hypertrophy. Beta-blockers and alpha-blockers can interact to induce hypotension since both act to reduce the blood pressure. Patients already on beta-blockers and who are started on alpha-blockers such as terazosin should be advised to take the terazosin dose at night to reduce the implications (falls) of first-dose hypotension. 

Benign prostatic hypertrophy Patients with benign prostatic hypertrophy may develop acute urethral obstruction. Priapism or excessive sexual stimulation may develop. Oligospermia may occur after prolonged administration or excessive dosage. 

Anticholinergic activity Do not use in patients with urinary retention, glaucoma, or myasthenia gravis unless adequate overriding measures are taken. Males with benign prostatic hypertrophy are at particular risk of having urinary retention. In patients with a family history of glaucoma, measure intraocular pressure before... 

Therapeutic uses Conditions of catecholamine excess such as pheochromocytoma Peripheral vascular disease Benign prostatic hypertrophy Same as phenoxybenzamine Primary hypertension Benign prostatic hypertrophy... 

Because of its anticholinergic properties, disopyramide should not be used in patients with glaucoma. Urinary retention and benign prostatic hypertrophy are also relative contraindications to disopyramide therapy. Patients with myasthenia gravis may have a myasthenic crisis after disopyramide administration as a result of the drug s local anesthetic action at the neuromuscular junction. The elderly patient may exhibit increased sensitivity to the anticholinergic actions of disopyramide. 

Saw palmetto Serenoa repens) is a dwarf American palm native to the extreme southeastern United States. A lipidosterolic extract of its berries contains fatty acids (especially lauric acid), phytosterols, monocylglycerides, and polysaccharides. Fatty acids constitute more than 80% of the extract and are thought to be the most clinically effective component. It is widely used to treat benign prostatic hypertrophy (BPH). Tlie berries themselves are less well absorbed than the extract and are therefore believed to be less effective. 

Testosterone metabolism. The lipido-ste-rol extract (LSESr, Permixon) was studied in primary cultures of epithelial cells and fibroblasts separated from benign prostate hypertrophy and prostate cancer tissues. The extract inhibited the formation of the T metabolites androstenedione 5 4 and 5 a-DHT The lipophilic extracts of fruits inhibited T 5p-reductase (EC 1.3.99.5) (5(xR). For fatty acid-like 5(xR inhibition a strongly polar end-group and a molecular skeleton allowing nonpolar interactions with the enzyme were required. The result indicated that 5pR activity in prostatic tissue may be influenced by the lipid environ-... 

Lubrano, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Urol... 

Mattei, F. M., M. Capone, and A. Acconcia. Serenoa repens extract in the medical treatment of benign prostatic hypertrophy. Urologia 1988 55 547-552. 

Minimal benefit for benign prostatic hypertrophy if the prostate is not very large response is not immediate... 

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