Prostate Health PHARMACIST VIEW

Transcription

1 Prostate Health PHARMACIST VIEW

2 Prostate Definition Prostate is a gland made of fibromuscular tissue. It is about 4 cm and surrounds the neck of the bladder and the urethra. It produces seminal fluid.

3 Prostate

4 Prostatitis Prostatitis- inflammation of the prostate. Bacterial- ascending infection of the urinary tract. Inflammatory response in which the prostate becomes inlarged and tender. Clinical manifestations- Malaise Low back pain High fever Chills Inability to empty the bladder, urinary retention.

5 Treatment ( bacterial prostatitis ) Long term antibiotic therapy: Fluoroquinolone, sulfamethoxazoletrimethoprim. Severe- Hospitalization IV antibiotics: Gentamycin, tobramycin, ampicillin. Chronic bacterial Prostatitis Fluoroquinolone and surgery

6 Nonbacterial Prostatitis Symptoms-milder but are persistent and annoying. Reflux of urine in the ejaculatory ducts as result of high pressure voiding. Dull ache, continuous in the scrotal and penile regions. Pain during urination. Treatment: alpha adrenergic blockers. Exp: terazosin, doxazosin, tamsulosin. Skeletal muscle relaxants, anti inflammatory drugs and sitz bath.

7 BPH Benign Prostatic Hyperplasia Age-associated prostate gland enlargement that can cause urination difficulty. Age dependent: 80% of men will have prostatic enlargement before the age of 80 years. Around 40 to 45 years of age, hyperplasia begins and continues slowly. Symptoms: Considered obstructive Weak urinary stream, prolonged voiding, abdominal straining, hesitancy, intermittency, incomplete bladder emptying.

8 Complications of BPH Progressive bladder distention. Bladder and Kidney infections

9 Evaluation and Treatment International prostate symptom score (I-PSS) Allows practitioners to quantitate an individuals BPH symptoms There is no way to reverse progressive BPH Hyperplasia is not always progressive Digital Rectal examination-dre s are used to screen men over the age of 40. If there is marked enlargement, moderate to severe symptoms, or complications a transrectal ultrasonography is used.

10 Evaluation and Treatment Prostate specific antigen If necessary hyperplastic tissue may be removed surgically to prevent serious consequences of urethral obstruction. Transurethral resection Laser therapy Microwave thermotherapy Larger glands can be removed (prostatectomy)

11 Medication Therapy Alpha-adrenergic blockers- prazosin and terazosin Used to relax smooth muscle of the bladder and prostate Anti Androgens- Finasteride, blocks androgens at the prostate cellular level and cause the prostate gland to shrink.

12 Cancer of the Prostate Poorly understood Disease of aging 80% of all prostate cancers are diagnosed in men older than 65 years of age. Most of the androgen-metabolizing enzymes undergo a significant age dependent alteration. Dietary Factors High intake of fat Vitamins can help: vitamin A, vitamin D, Lycopene

13 Cancer of the Prostate Hormones- Prostate cancer develops in an androgen-dependent epithelium. Steroid use causal relationship. Vasectomy Familial Factors- genetic predisposition. Prostatic cancer is thought to metastatsize by local extension and through lyphatic and blood vessels. ( lymph nodes, bones, lungs, liver and adrenal glands.)

14 Cancer of the Prostate Manifestations: usually no symptoms until it is far advanced. Similar to BPH Staging of prostate Cancer Stage A (Very early ) Stage B (Localized) Stage C (Regionalized) Stage D( Advanced )

15 Evaluation and Treatment Screening: DRE s, PSA blood test, and TRUS Diagnosis is confirmed through tissue biopsy and microscopic examination of tissue. Lymph node biopsy, bone scans. No treatment Surgical treatment: total prostactomy, TURP. Non surgical: radiation therapy, hormone therapy, chemotherapy *Currently the overall 5 year survival rate of all stages of prostate cancer is up to 92%

16 Prevention Diet- Avoid Saturated fat Use olive oils Avoid refined sugars Increase Antioxidants Vitamin E Selenium Eat fruits and vegetable (lycopene found in tomatoes Vitamin D Fiber

17 Prostate Health Medications Prostatitis: Antibiotic Therapy Flouroquinolones- Ciprofloxacin Sulfa based medications-bactrim Gentamycin (IV use only) Anti-Inflammatory Ibuprofen Pain relievers- Acetaminophen Others- Anti Axiety

18 BPH Alpha-adrenergic blockers- prazosin, terazosin, silodosin Used to relax smooth muscle of the bladder and prostate Anti Androgens- Finasteride, blocks androgens at the prostate cellular level and cause the prostate gland to shrink Jalyn dutasteride and tamsulosin Cialis

19 Herbal Remedies Saw Palmetto Beta-Sitosterol Do Not Take Anti Histamines Testosterone

20 Questions