Mens Health

What is Finasteride’s MOA?

Inhibits Type 2 5-alpha reductase which inhibits conversion of testosterone to DHT

What is finasteride’s dosing and it’s best method of administration to maintain efficacy?

1mg PO daily and used continuously

If you wanted to enlarge miniaturized hair follicles, what would you use?

Minoxidil

A total testosterone level of what is positive for low testosterone?

under 300 ng/dl

What must be confirmed of free testosterone in order to confirm low testosterone?

under 5ng/dl

Testosterone replacement therapy should be used only when what?

Hypogonadism is diagnosed

What are contraindications to Testosterone Hormone Therapy?

Prostate cancer, breast cancer, hematocrit over 50%, recent/poorly controlled CVD, and baseline PSA greater than 4ng/dl or PSA greater than 3 in those at high risk for prostate cancer

What is the black box warning for THT?

Gel formulations

What should the goal testosterone level be?

400-700 ng/dl

Men without prostate cancer usually have PSA levels….

under 4ng/mL

Men whose PSA level is 2.5ng/mL or higher should be tested how often?

Annually

What type of medication is typically the first line treatment of choice for patients experiencing ED?

PDE-5 inhibitors

What are two examples of PDE-5 inhibitors?

Sildenafil and Tadalafil

What should be avoided when taking PDE-5 inhibitors and what delays absorption of it?

Grapefruit and food

What should one be cautious about if taking Sildenafil?

Hepatic impairment

What are precautions for all PDE-5 inhibitors?

oral/transdermal nitrates, alpha blockers, severe CAD, and erections lasting over 4 hours

What can be used to treat pulmonary hypertension?

Sildenafil and Tadalafil

What is the dosing for sildenafil when treating pulmonary hypertension?

20mg Po TID

What is the dosing for Tadalafil when treating pulmonary hypertension?

40mg PO once daily

What can be used to treat priapism?

Phenylephrine, blood aspiration, and saline irrigation

If one has moderate BPH with an ED, what should be recommended and its dose?

Tadalafil 5mg

Finasteride and Dutasteride is reserved for those with what?

Prostates >40g

To treat BPH and ED, what combination therapy should be used?

Finasteride and tadalafil

To treat BPH and OAB, what combination therapy should be used?

Tamsulosin and Tolterodine

If you are treating moderate BPH with a small prostate and low PSA, what type of drug should be used?

alpha adrenergic antagonist

If you are treating moderate BPH with a large prostate and high PSA, what type of drug should be used?

5a reductase inhibitor or 5a reductase and alpha adrenergic antagonist

If you are treating moderate BPH with predominant irritative voiding smptoms, what type of drug should be used?

alpha adrenergic antagonists and anticholinergic agent

How many voids in order to be considered nocturia?

2 or more