TL is a 53 y/o male currently taking the following medications and supplements:
metformin, glipizide, lisinopril, rosuvastatin, fish oil, magnesium, saw palmetto,
cinnamon and turmeric. Which natural product is TL most likely taking for symptoms of
BPH? - ️️Saw palmetto - natural products sh...
Benign Prostatic Hypertension (BPH)
Quiz
TL is a 53 y/o male currently taking the following medications and supplements:
metformin, glipizide, lisinopril, rosuvastatin, fish oil, magnesium, saw palmetto,
cinnamon and turmeric. Which natural product is TL most likely taking for symptoms of
BPH? - ✔️✔️Saw palmetto - natural products should generally not be recommended
for treatment of BPH symptoms.
* Saw Palmetto is used but is likely to be ineffective
Which medication used for the treatment of BPH is contraindicated with isosorbide
dinitrate? - ✔️✔️Tadalafil - PDE-5 inhibitor is C/I with nitrates and riociguat (drug used
for PAH)
Patients with BPH should be counseled to avoid which of the following products that can
worsen symptoms? SATA - ✔️✔️Testosteron
Diphenhydramine
Pseudoephedrine
Caffeine
NOT: Ibuprofen
* Meds/supplements that cause urinary retention (ie. antihistamines), vasoconstriction
due to alpha-agonist activity (ie. decongestants), diuresis or stimulation of prostate
growth can worsen BPH symptoms
A male patient with prostate enlargement was prescribed Cardura. What counseling
points should be provided? SATA - ✔️✔️It is important to stand up slowly after sitting
Take the medication at bedtime
The dose should be slowly increased
* Non-selective alpha-1 blockers should be taken at bedtime and titrated slowly to
reduce orthostasis
* Cardura XL can leave a ghost tablet that is seen in the stool but not Cardura (IR)
Which best describes the mechanism of action of Proscar? - ✔️✔️Inhibits 5 alpha-
reductase
JB takes tadalafil for erectile dysfunction and metformin and sitagliptin for type 2
diabetes. Which side effect is he most at risk for if tamsulosin is added for BPH? -
✔️✔️Hypotension
* Selective alpha-1A blockers cause less dizziness and BP changes than the non-
selective agents but additive effects can occur, which warrants caution
* If tadalafil is being used for BPH, then an alpha-1 blocker is not recommended
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