Podcast
Questions and Answers
Which subtype of alpha-1 receptors predominates in the human prostate?
Which subtype of alpha-1 receptors predominates in the human prostate?
- α2
- α1B
- α1A (correct)
- α1D
What is the primary effect of adrenergic stimulation of α1A receptors in the bladder neck?
What is the primary effect of adrenergic stimulation of α1A receptors in the bladder neck?
- Decrease bladder neck closure
- Decrease urine flow
- Increase bladder neck closure (correct)
- Increase bladder hypertrophy
In patients with bladder outlet obstruction, which subtype of alpha-1 receptors increases with bladder hypertrophy?
In patients with bladder outlet obstruction, which subtype of alpha-1 receptors increases with bladder hypertrophy?
- α1A
- α1D (correct)
- α1B
- α2
Which drug class can interact with PDE5 inhibitors and result in significant blood pressure lowering?
Which drug class can interact with PDE5 inhibitors and result in significant blood pressure lowering?
What is a common side effect associated with the use of Tamsulosin?
What is a common side effect associated with the use of Tamsulosin?
What is the mechanism of action of uro-selective alpha-1A-adrenergic antagonists like tamsulosin and silodosin in the treatment of lower urinary tract symptoms in BPH?
What is the mechanism of action of uro-selective alpha-1A-adrenergic antagonists like tamsulosin and silodosin in the treatment of lower urinary tract symptoms in BPH?
Which of the following statements is true regarding the selectivity of Tamsulosin?
Which of the following statements is true regarding the selectivity of Tamsulosin?
What is the impact of Silodosin's selectivity for alpha-1A-adrenoceptors over alpha-1B-adrenoceptors?
What is the impact of Silodosin's selectivity for alpha-1A-adrenoceptors over alpha-1B-adrenoceptors?
Which of the following is a common side effect associated with Tamsulosin use?
Which of the following is a common side effect associated with Tamsulosin use?
When initiating Terazosin and Doxazosin therapy, what precaution is important due to their mechanism of action?
When initiating Terazosin and Doxazosin therapy, what precaution is important due to their mechanism of action?
Which of the following best describes the typical voiding symptoms associated with LUTS/BPH?
Which of the following best describes the typical voiding symptoms associated with LUTS/BPH?
What is the main reason storage symptoms are often more bothersome than voiding symptoms in LUTS/BPH?
What is the main reason storage symptoms are often more bothersome than voiding symptoms in LUTS/BPH?
Which of the following is true about the histology of the prostate gland?
Which of the following is true about the histology of the prostate gland?
What is the underlying cause of BPH according to the text?
What is the underlying cause of BPH according to the text?
Which side effect is commonly associated with Tamsulosin use?
Which side effect is commonly associated with Tamsulosin use?
Which side effect is less common with 'uroselective' alpha-adrenergic receptor antagonists?
Which side effect is less common with 'uroselective' alpha-adrenergic receptor antagonists?
Which alpha-adrenergic receptor antagonist is associated with improved ejaculation?
Which alpha-adrenergic receptor antagonist is associated with improved ejaculation?
Which PDE 5 inhibitor could potentiate the hypotensive effects of Terazosin and Doxazosin?
Which PDE 5 inhibitor could potentiate the hypotensive effects of Terazosin and Doxazosin?
When initiating treatment with Terazosin or Doxazosin, what adverse effect should be considered due to potential drug interactions?
When initiating treatment with Terazosin or Doxazosin, what adverse effect should be considered due to potential drug interactions?
Which is a common side effect of Tamsulosin use?
Which is a common side effect of Tamsulosin use?
How does penile fibrosis affect the penis?
How does penile fibrosis affect the penis?
What is the consequence of untreated Clinical BPH?
What is the consequence of untreated Clinical BPH?
Which component of BPH involves the compression of the urethra due to hyperplastic prostatic tissue?
Which component of BPH involves the compression of the urethra due to hyperplastic prostatic tissue?
What is a common side effect associated with Tamsulosin?
What is a common side effect associated with Tamsulosin?
How do PDE-5 inhibitors interact with other drugs commonly used for erectile dysfunction?
How do PDE-5 inhibitors interact with other drugs commonly used for erectile dysfunction?
What is the main impact of PDE5 inhibition on smooth muscle relaxation in the urinary tract?
What is the main impact of PDE5 inhibition on smooth muscle relaxation in the urinary tract?
How does Tamsulosin affect ejaculation in patients with BPH?
How does Tamsulosin affect ejaculation in patients with BPH?
Which drug class commonly interacts with PDE5 inhibitors and can lead to significant blood pressure lowering?
Which drug class commonly interacts with PDE5 inhibitors and can lead to significant blood pressure lowering?
What is the primary mechanism of action for initiating Terazosin and Doxazosin in patients with BPH?
What is the primary mechanism of action for initiating Terazosin and Doxazosin in patients with BPH?
What is a common side effect associated with the use of Tamsulosin in BPH patients?
What is a common side effect associated with the use of Tamsulosin in BPH patients?
Which enzyme converts testosterone into DHT?
Which enzyme converts testosterone into DHT?
In which of the following conditions does DHT play a causative role?
In which of the following conditions does DHT play a causative role?
Which form of 5-Alpha Reductase is primarily active in reproductive tissues and the hair follicle?
Which form of 5-Alpha Reductase is primarily active in reproductive tissues and the hair follicle?
Which enzyme is responsible for converting testosterone into DHT by reducing a double bond in the 'A-ring' of testosterone?
Which enzyme is responsible for converting testosterone into DHT by reducing a double bond in the 'A-ring' of testosterone?
What is the primary role of DHT in musculoskeletal development?
What is the primary role of DHT in musculoskeletal development?
Which enzyme is NOT involved in the conversion of testosterone into DHT?
Which enzyme is NOT involved in the conversion of testosterone into DHT?
Where is the Type I form of 5-Alpha Reductase mostly active?
Where is the Type I form of 5-Alpha Reductase mostly active?
What is the primary biological function of DHT?
What is the primary biological function of DHT?
WHat is the Brand for Silenafil
WHat is the Brand for Silenafil
What is the Brand name for Tadalafil
What is the Brand name for Tadalafil
What is the brand name for avanafil
What is the brand name for avanafil
What is the brand name for Vardenadil
What is the brand name for Vardenadil
Which PDE5 has the longest half life
Which PDE5 has the longest half life
Which of this PDE5 can be taken once a day?
Which of this PDE5 can be taken once a day?
Viagra has the shortest half life out of all the PDE5
Viagra has the shortest half life out of all the PDE5
Which PDE5 can be taken with food without any effect?
Which PDE5 can be taken with food without any effect?
Acetylcholine acts at the muscarinic receptors on the vascular endothelial cells to increase the production of nitric oxide
Acetylcholine acts at the muscarinic receptors on the vascular endothelial cells to increase the production of nitric oxide
What is the role of Protein Kinase G (PKG) in the relaxation of penile vascular smooth muscle?
What is the role of Protein Kinase G (PKG) in the relaxation of penile vascular smooth muscle?
Which action of Protein Kinase G (PKG) contributes to muscle relaxation?
Which action of Protein Kinase G (PKG) contributes to muscle relaxation?
What is the consequence of PKG opening K+ channels on vascular smooth muscle cells?
What is the consequence of PKG opening K+ channels on vascular smooth muscle cells?
How does PKG's action on K+ channels affect Ca++ levels in the smooth muscle cell?
How does PKG's action on K+ channels affect Ca++ levels in the smooth muscle cell?
What effect does PKG have on the interaction between myosin and actin in smooth muscle cells?
What effect does PKG have on the interaction between myosin and actin in smooth muscle cells?
What is the primary effect of Protein Kinase G (PKG) opening K+ channels on the plasma membrane of vascular smooth muscle cells?
What is the primary effect of Protein Kinase G (PKG) opening K+ channels on the plasma membrane of vascular smooth muscle cells?
How does Protein Kinase G (PKG) action impact the attachment between myosin and actin in smooth muscle cells?
How does Protein Kinase G (PKG) action impact the attachment between myosin and actin in smooth muscle cells?
What is the consequence of hyperpolarizing the smooth muscle cell by opening K+ channels?
What is the consequence of hyperpolarizing the smooth muscle cell by opening K+ channels?
What effect does Protein Kinase G (PKG) have on the sequestration of Ca++ in the endoplasmic reticulum of vascular smooth muscle cells?
What effect does Protein Kinase G (PKG) have on the sequestration of Ca++ in the endoplasmic reticulum of vascular smooth muscle cells?
How does activation of myosin light chain phosphatase by Protein Kinase G (PKG) affect smooth muscle contraction?
How does activation of myosin light chain phosphatase by Protein Kinase G (PKG) affect smooth muscle contraction?
How do PDE5 inhibitors facilitate smooth muscle relaxation?
How do PDE5 inhibitors facilitate smooth muscle relaxation?
What is the role of myosin phosphatase in smooth muscle relaxation?
What is the role of myosin phosphatase in smooth muscle relaxation?
What is the mechanism of action of PDE5 inhibitors in promoting muscle relaxation?
What is the mechanism of action of PDE5 inhibitors in promoting muscle relaxation?
How does the activation of myosin phosphatase counteract contractile force in smooth muscle cells?
How does the activation of myosin phosphatase counteract contractile force in smooth muscle cells?
What effect does increased cGMP levels have on myosin phosphatase activity?
What effect does increased cGMP levels have on myosin phosphatase activity?
Which protein is involved in smooth muscle contraction and is targeted by myosin phosphatase?
Which protein is involved in smooth muscle contraction and is targeted by myosin phosphatase?
How do PDE5 inhibitors affect the downstream activation of PKG in the smooth muscle cell?
How do PDE5 inhibitors affect the downstream activation of PKG in the smooth muscle cell?
What is the primary function of activating myosin phosphatase in smooth muscle cells?
What is the primary function of activating myosin phosphatase in smooth muscle cells?
How do PDE5 inhibitors affect smooth muscle relaxation?
How do PDE5 inhibitors affect smooth muscle relaxation?
What is the primary role of phosphodiesterase 5 (PDE5) in the body?
What is the primary role of phosphodiesterase 5 (PDE5) in the body?
What happens when cGMP levels are increased in smooth muscle cells?
What happens when cGMP levels are increased in smooth muscle cells?
How does inhibiting PDE5 affect cGMP levels in cells?
How does inhibiting PDE5 affect cGMP levels in cells?
What is the significance of cGMP degradation in cellular processes?
What is the significance of cGMP degradation in cellular processes?
Which enzyme is responsible for breaking down cGMP in the body?
Which enzyme is responsible for breaking down cGMP in the body?
What downstream effect does increased cGMP levels have on smooth muscle relaxation?
What downstream effect does increased cGMP levels have on smooth muscle relaxation?
Which of the following is a contraindication for using PDE5 inhibitors?
Which of the following is a contraindication for using PDE5 inhibitors?
What is a potential risk associated with the longer half-life of tadalafil in terms of drug interactions?
What is a potential risk associated with the longer half-life of tadalafil in terms of drug interactions?
How does prolonged usage of PDE5 inhibitors affect the risk of priapism?
How does prolonged usage of PDE5 inhibitors affect the risk of priapism?
Which factor contributes to the potential dangerous hypotension when PDE5 inhibitors are co-administered with alpha-adrenergic receptor antagonists?
Which factor contributes to the potential dangerous hypotension when PDE5 inhibitors are co-administered with alpha-adrenergic receptor antagonists?
What is the potential consequence of not treating priapism caused by PDE5 inhibitors?
What is the potential consequence of not treating priapism caused by PDE5 inhibitors?
What is the recommended minimum time to leave for absorption after taking sildenafil or valdenafil?
What is the recommended minimum time to leave for absorption after taking sildenafil or valdenafil?
How long should men using tadalafil (Cialis® as needed) wait for absorption after intake?
How long should men using tadalafil (Cialis® as needed) wait for absorption after intake?
What is the primary role of cGMP in smooth muscle relaxation?
What is the primary role of cGMP in smooth muscle relaxation?
How does activation of myosin light chain phosphatase by Protein Kinase G (PKG) affect smooth muscle contraction?
How does activation of myosin light chain phosphatase by Protein Kinase G (PKG) affect smooth muscle contraction?
Which enzyme is responsible for breaking down cGMP in the body?
Which enzyme is responsible for breaking down cGMP in the body?
Which type of cells are NOT part of the supporting stroma of the prostate?
Which type of cells are NOT part of the supporting stroma of the prostate?
Among the components of the prostate's supporting stroma, which one is primarily responsible for muscle contraction?
Among the components of the prostate's supporting stroma, which one is primarily responsible for muscle contraction?
Which cell type in the prostate's supporting stroma is likely to be involved in immune responses and inflammation?
Which cell type in the prostate's supporting stroma is likely to be involved in immune responses and inflammation?
Which component of the prostate's stroma plays a key role in maintaining blood vessel integrity?
Which component of the prostate's stroma plays a key role in maintaining blood vessel integrity?
Among the listed supporting stroma components, which one is NOT directly involved in facilitating nutrient exchange in the prostate tissue?
Among the listed supporting stroma components, which one is NOT directly involved in facilitating nutrient exchange in the prostate tissue?
What is the primary reason for Tamsulosin's minimal interaction with alpha-1b receptors?
What is the primary reason for Tamsulosin's minimal interaction with alpha-1b receptors?
Which uroselective alpha-blocker is associated with an enhanced safety profile due to its specific targeting of alpha-1 receptors?
Which uroselective alpha-blocker is associated with an enhanced safety profile due to its specific targeting of alpha-1 receptors?
What distinguishes Silodosin from other alpha-blockers in terms of receptor selectivity?
What distinguishes Silodosin from other alpha-blockers in terms of receptor selectivity?
Which characteristic makes Doxazosin and Terazosin unique among the uroselective alpha-blockers?
Which characteristic makes Doxazosin and Terazosin unique among the uroselective alpha-blockers?
Which factor contributes to Alfuzosin's effectiveness in managing BPH symptoms?
Which factor contributes to Alfuzosin's effectiveness in managing BPH symptoms?
What makes Tamsulosin favorable in terms of side effect prevention compared to non-uroselective alpha-blockers?
What makes Tamsulosin favorable in terms of side effect prevention compared to non-uroselective alpha-blockers?
Which alpha-blocker has the slowest absorption rate among the mentioned drugs?
Which alpha-blocker has the slowest absorption rate among the mentioned drugs?
Which alpha-blocker is known for its association with a low incidence of ejaculatory dysfunction?
Which alpha-blocker is known for its association with a low incidence of ejaculatory dysfunction?
Which alpha-blocker is often prescribed off-label for the treatment of urinary hesitancy and urgency incontinence?
Which alpha-blocker is often prescribed off-label for the treatment of urinary hesitancy and urgency incontinence?
Among the mentioned alpha-blockers, which one offers sustained-release formulations eliminating the need for frequent dose titration?
Among the mentioned alpha-blockers, which one offers sustained-release formulations eliminating the need for frequent dose titration?
Which alpha-blocker interacts with both alpha-1a and alpha-1b receptors, providing broader coverage but less preferred in BPH due to postural hypotension?
Which alpha-blocker interacts with both alpha-1a and alpha-1b receptors, providing broader coverage but less preferred in BPH due to postural hypotension?
Which alpha-blocker exhibits a shorter half-life of approximately 8 hours, necessitating twice daily dosing?
Which alpha-blocker exhibits a shorter half-life of approximately 8 hours, necessitating twice daily dosing?
Study Notes
Alpha-1 Receptors and Bladder Function
- Alpha-1 receptors are located in the bladder neck, prostate, and urethra
- Alpha-1A receptors are more common in women than men
- Alpha-1 receptors are rare in the detrusor muscle
Subtypes of Alpha-1 Receptors
- Alpha-1A receptors: prevail in the bladder neck, lead to an increase in bladder neck closure upon adrenergic stimulation
- Alpha-1B receptors: less common in the bladder neck, but increase with bladder hypertrophy
- Alpha-1D receptors: predominate in the spinal cord and afferent nerves, blockade decreases LUTS symptoms
Receptor Sites in the Urinary Tract
- Bladder neck (internal urethral sphincter): alpha-1A receptors
- Prostate: alpha-1A receptors (predominate in prostate stromal smooth muscle)
Pharmacologic Treatment Options for BPH
- Alpha-1 receptor antagonists: target alpha-1A receptors, leading to smooth muscle relaxation and improvement in urine flow
- Uro-selective alpha-1 adrenergic antagonists: exhibit selectivity for alpha-1A receptors, reducing side effects
Treatment of BPH
- Alpha-1 receptor antagonists: block alpha-1A receptors, leading to smooth muscle relaxation and improvement in urine flow
- Tamsulosin: exhibits a modest degree of selectivity for alpha-1A receptors, shows 162/1 selectivity for alpha-1A receptors vs. alpha-1B receptors
- Silodosin: shows 162/1 selectivity for alpha-1A receptors vs. alpha-1B receptors
Lower Urinary Tract Symptoms (LUTS) Associated with BPH
- Storage symptoms: urinary frequency, urgency, nocturia, and incontinence
- Voiding symptoms: slow urinary stream, straining to void, urinary intermittency, and hesitancy
Anatomy of the Prostate Gland
- The prostate has four distinct regions: anterior fibromuscular zone, and glandular peripheral, central, and transitional zones
- The prostate has two basic compartments: glandular (secretory) epithelium and supporting stroma
Benign Prostatic Hyperplasia (BPH)
- Occurs when both stromal and secretory epithelial cells of the prostate (mainly in the transitional zone surrounding the urethra) proliferate
- Can slow the flow of urine even if the overall size of the gland is nearly normal
Consequences of Untreated Clinical BPH
- Acute urinary retention
- Urinary tract infection
- Bladder calculi
- Renal impairment
- Bladder damage
- Hematuria
PDE5 Inhibitors
- Inhibit the breakdown of cGMP, leading to smooth muscle relaxation
- Phosphodiesterase type 5 (PDE5) inhibitors: sildenafil, tadalafil, and vardenafil
- Locations of PDE5 enzyme: detrusor smooth muscle layers, bladder neck, prostatic stromal smooth muscle cell layers, and vascular smooth muscle layers
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Description
Test your knowledge on the typical manifestations of Lower Urinary Tract Symptoms (LUTS) and Benign Prostatic Hyperplasia (BPH) including storage and voiding symptoms. Explore topics such as glandular epithelial cells, stroma histology of the prostate gland, and anatomy of the prostate.
