Chapter 65: Urology
Which of the following is the brand name for dutasteride?
Answer d is the correct answer.
Answer a is incorrect. The generic name for Hytrin is terazosin.
Answer b is incorrect. The generic name for Flomax is tamsulosin.
Answer c is incorrect. The generic name for Proscar is finasteride.
Answer e in incorrect. The generic name for Cardura is doxazosin.
An 82-year-old patient is taking 2 mg of terazosin for BPH comes into the pharmacy complaining of dizziness and generalized muscle weakness and persistent LUTS. What would you recommend to his physician?
a. Add finasteride 5 mg daily to his regimen.
b. Switch his terazosin to doxazosin 4 mg.
c. Switch his terazosin to tamsulosin 0.4 mg daily.
d. Lower the dose of his terazosin to 1 mg.
e. Add saw palmetto twice daily.
Answer c is correct. Tamsulosin may afford better tolerability for this patient and would be expected to provide symptom relief relatively quickly, often within 1 week of therapy, as it does not require titration.
Answer a is incorrect. The patient is complaining of dizziness associated with his α-blocker therapy. Adding finasteride will not ameliorate this and, if a 5ARI were added, it may take several months to show benefit in symptom reduction.
Answer b is incorrect. Exchanging one long-acting second-generation agent for another would not be ideal and this patient may continue to experience the same side effects.
Answer d is incorrect. Lowering his dose of terazosin may improve tolerability; however, he still is experiencing symptoms of BPH. If his dose was lowered, he would likely continue to experience his symptoms.
Answer e is incorrect. Based on lack of clinical outcomes, phytotherapy is not recommended by the American Urological Association for treatment of BPH.
What pregnancy category is finasteride?
Answer e is correct. 5-Alpha reductase inhibitors are associated with male birth defects. 5ARIs, including ...