Drugs for treatment of BPH Tamsulosin let us discuss drugs used for the treatment of BPH. What is BPH? Bph is the Benign Prostatic Hyperplasia, where we can observe few of the symptoms in the patients, such as increased urinary urgency. So the patient may have increased urinary frequency and urgency to urinate, but at the same time, there is a weak stream of the urine, resulting in the decreased urinary volume.
So in such patients, the urinary frequency is increased, but urinary volume is reduced, resulting in the decreased urinary flow. And this is one of the avoiding problem where the patient cannot store the urine as well as cannot empty the bladder completely. In such conditions, we can use so many types of drugs such as terazocin, tamsulocin, alfuxicin, finasteride, tidalafil.
In this way, so many types of drugs are available for the treatment of BPH, but all these drugs are not working in a similar way. Few of the drugs are going to increase the urinary flow by relaxing smooth muscles at the bladder and urethra. And few of the drugs are going to reduce the prostate size so that they can reduce the urinary frequency. Particularly drugs acting on the hormones are going to reduce the prostate size so that they can reduce the urgency to urinate.
In this way, these drugs may differ by how they are going to relieve the symptoms in the BPH. The drugs which increase the urinary flow are particularly used to treat mild to moderate symptoms of BPH. Whereas those drugs which are going to reduce the prostate size are particularly used to relieve the severe symptoms of BPH, particularly associated with prostate enlargement. And the difference between these drugs is that few of the drugs should not be given with the PDE inhibitors, fast f oot diet stress inhibitors.
But another group of drugs are contraindicated with organic nitrates. So even these drugs are indicated for the same purpose that is the treatment of BPH, but they are having different pharma classical effects and contraindications.
Today in this , let us see what are the different types of drugs used for the treatment of BPH, what are the important side effects, and how they are going to be taken. First of all, let us see what is BPH. Bph is the Benign Prostatic Hyperplasia. Here, the term benign indicates it is not that much harmful, so it is not spreading to the other organs. And Prostatic Hyperplasia, which indicates increased growth of the prostate tissue, which results in few of the symptoms such as decreased urinary volume and increased urinary frequency.
So BPH is one of the avoiding disorder where the patient cannot store the urine within the bladder. At the same time, they cannot empty the bladder completely. So in these patients, we can observe some leaky urine. The urine cannot be stored. And in few of the patients, we can observe enlargement of the prostate. Because of this prostate enlargement, urethral flow is going to be blocked so that urine cannot be passed out even by contraction of the bladder.
And particularly, this prostate enlargement is observed in the elders above 50 years. And in those elders with age greater than 80 years, the prostate enlargement is more pronounced with enhanced symptoms of BPH. That’s why BPH can also be known as benign prosthetic hypertrophy, the enlargement of the prostate tissue, resulting in decreased urinary volume and increased urinary frequency.
So in such conditions, we can use few other drugs which are going to increase the urinary flow. We can use another group of drugs which are going to reduce the prostate size. Particularly, we have three categories of drugs which are indicated for the treatment of BPH. First one is the alpha one blockers and second group is the PDE inhibitors.
Third one is five alpha redactase inhibitors. The alpha one blockers can be easily identified by the suffix ocin. So we have the drugs like teratocin, doxajocin, alfuxicin, tamsulocin, silodocin, and all these are alpha one blockers. Similarly, PDE inhibitors can be recognized by the suffix EFL. We have one of the drug tadalafil, which is indicated for the treatment of BPH.
Finally, five alpha reductase inhibitors can be identified by the suffix steroids because these are acting on the sterile hormones. They are having the suffix steroids. We have the drugs like finasteride and jutasteride. So these are the three groups of drugs which are indicated for the treatment of BPH. Now, let us go one by one and let us see what are the important side effects and how they are going to be taken.
Let us start with the alpha one blockers. These are also called as select two alpha one blockers. Because alpha receptors are of two types, alpha one and alpha two. Here, these drugs are selectively blocking the alpha one receptors. These alpha one receptors are widely distributed on many of the smooth muscles. And particularly with the urinary system, they are specifically expressed at the bladder neck and base.
And they’re also expressed on the urethral smooth mussel, where they’re responsible for contraction of the bladder neck and urethra. But the main location of these alpha one receptors is on the blood vessels where they’re responsible for vasoconstriction. Now, select two alpha one blockers like terazocin, doxazocin.
These two drugs can block the alpha one receptor present at different locations. But since alpha one receptor are mainly located on the blood vessels, they can produce vaso dilatation. That’s why these drugs are introduced as antihypertensives to treat essential hypertension. But later, these drugs are also indicated for the treatment of BPH, where they can relieve the symptoms of BPH by increasing the smooth muscle relaxation and increase the urinary flow.
We have another drug, alpha jocin, but it is mainly indicated for the treatment of BPH. Among the alpha 1 receptor, another subtype is present that is alpha one A receptors. These alpha one A receptors are mainly located on the urinary system, particularly at the bladder, neck and urethra, where they are again responsible for contraction of the smooth muscle. Fugate drugs like Tamchilocin, silodocin, these two drugs are selectively blocking alpha 1A subtype receptors. Thereby, they can produce relaxation of the bladder, neck and urethra.
Thereby, they can increase the urinary flow as well as they can reduce the urinary urgency. These two drugs are somewhat more selective for the treatment of BPH. But we can identify some difference between selective alpha one blockers and alpha one subtype receptor blockers. We can observe two suffix, one is dosing and then the other one is ocin. The suffix dosing is present in selective alpha one blockers such as terazosine, doxazosine, or fuzosine.
These drugs are selectively blocking alpha 1 receptors. So they are alpha 1 blockers, but they are not acting on alpha 1 subtype. That means they are not differentiating the subtype receptor such as alpha 1A, alpha 1B, and alpha 1D. On the other hand, the drugs which are having the suffix oocin, such as tangshilocin, siloedocin, these drugs are selectively blocking alpha 1A subtype receptors.
So they are somewhat more selective towards the urinary system, and they are selectively relieve the symptoms of BPH. That’s why these drugs are somewhat less hypotensive, and they are the first line drugs in the treatment of BPH. These selective alpha one blockers can produce various side effects such as postural hypotension, which is more pronounced with the drugs like terazocin and doxazocin.
And they can also produce some dizziness, confusion, even they can induce a syncope because of postural hypotension. Drugs like terazocin and doxazocin can produce more intense postural hypotension compared with selective alpha one A blockers. That’s why these drugs should be given at bedtime in order to reduce any postural hypotension. On the other hand, drugs like alpha fibrin and tamsulocin, these drugs can be given after a meal, particularly the first meal of the day, because these drugs are not producing significant postural hypotension.
So there is no need to give these drugs at bedtime, but they can be taken at the first meal of the day and the same time should be maintained throughout the therapy in order to produce better therapeutic effects. Similarly, terazocin and doxazocin should not be combined with PDE inhibitors. Fast forward, S3s V inhibitors such as tidalafil, sildenafil, vatdenafil, and evanafil. Because these drugs produce vaso dilatation, which is more pronounced with terazocin and doxazocin. So PDE5 inhibitor should not be combined with terazocin and doxazocin. Now, let us the second group of drugs, PDE inhibitors for the treatment of BPH. Pde 5 inhibitors are particularly used for the treatment of erectile dysfunction.
