Managing BPH with 5-Alpha Reductase Inhibitors

Oct 1, 2024

Real Life Pharmacology Podcast: 5-Alpha Reductase Inhibitors

Overview

  • Topic: 5-Alpha Reductase Inhibitors
  • Context: Used in managing Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH)

  • Symptoms: Affects urinary function
    • Increased frequency
    • Incomplete bladder emptying
    • Urinary retention
    • Reduced urine flow
    • Potential incontinence

Mechanism of Action

  • Testosterone & Dihydrotestosterone
    • Dihydrotestosterone (DHT) is a potent form of testosterone
    • DHT causes prostate growth, leading to urine blockage
  • 5-Alpha Reductase Inhibitors
    • Prevent conversion of testosterone to DHT
    • Reduces prostate growth/shrinks prostate
    • Alleviates symptoms over time

Key Medications

  • Finasteride and Dutasteride
    • Brand Names:
      • Finasteride: Propecia
      • Dutasteride: Avodart
    • Timeframe for Effectiveness:
      • Weeks to months for noticeable symptom relief
      • 3-6 months trial recommended

Side Effects

  • Common Side Effects:
    • Sexual dysfunction
    • Impotence
  • Other Considerations:
    • May cause weakness and fatigue due to testosterone blockage

Additional Uses

  • Propecia (Finasteride) for Hair Loss
    • Used at 1mg dose
    • Helps with male pattern baldness
    • Timeframe: May take up to a year for results

Pregnancy Considerations

  • Risk Factor: Category X (significant birth defects risk)
  • Caution: Pregnant caregivers should avoid handling crushed tablets

Drug Interactions

  • Anticholinergic Medications: Can exacerbate BPH symptoms
    • Examples: Diphenhydramine (Benadryl), Hydroxyzine, Tricyclic antidepressants
    • Often found in sleep aids (e.g., Tylenol PM)

Summary

  • 5-Alpha Reductase Inhibitors are crucial in managing BPH
  • Require patient education on time for effectiveness and potential side effects
  • Important to consider drug interactions and pregnancy risks when prescribing

Resources

  • Website: meded101.com for pharmacology education

These notes summarize the essential points from a podcast episode focusing on 5-Alpha Reductase Inhibitors and their application in BPH treatment. They cover the mechanism, key drugs, usage, side effects, and important precautions.