KINE 2475 Lecture Notes - Lecture 17: Prostate Cancer, Urinary Retention, Doxazosin
Alpha reductase inhibitor: first choice for symptomatic patients with enlarged prostate (>40g) & elevated. Psa > 1. 4ng/ml: these patients are at risk of developing complication of bph, combo therapy with aaa is prescribed, delays disease progression & reduced need for surgery, finasteride & dutasteride, agents inhibits 5a-reductase enzymes. Dutasteride decreases dht more than finasteride: slow progression of disease, decrease risk of disease complications, decrease need for surgery, for patients with severe disease, 5ari + aaa for 6 months. It provides symptom relief & 5ari decreases risk: 5ari reduced prostate size by 25%, increase flow rate by 1. 6-2ml/s, improve voiding symptoms in 30% of patients. In comparision to aaa, 5ari have delayed onset of clinical effect. Less objective improvements of aua symptoms score & urinary flow rate. Due to decrease in dht & inhibition of no synthase: can reduce psa levels 50% in 6-12 months. If increase in psa levels, evaluate for prostate cancer.