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Clinical Management STEP 3a: Addition of an antimuscarinic or beta-3 agonist If the patient has symptoms of both obstruction and irritation as well as bother ! In multiple studies the combination of antimuscarinics were more efficacious in reducing voiding frequency, nocturia, or IPSS compared to α-blockers or placebo alone. ! The β3 agonist class is newly available and has not been studied in combination with an AB. ! Neither antimuscarinics or β3 agonists have been studied in combinations with PDE5i medications. Oelke M, et al. Eur Urol. 2013;64(1):118-140. PMID: 23541338. Rosenberg MT, et al. Publication pending.
Antimuscarinics – Immediate Release exact mechanism of action unknown (may work on efferent or afferent pathway) Drug Frequency Dose Oxybutynin IR 2 – 4 times per day 5 mg Tolterodine IR Twice per day 1 -2 mg Trospium Chloride Twice per day 20 mg Physcians’ Desk Reference. 64st ed. Montvale, NJ: Thomson PDR; 2010.
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Gaining Ground in Men’s Genitouri
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Accreditation This program has been
Page 5 and 6: Learning Objectives ! Explain the s
Page 7 and 8: Matt T. Rosenberg, MD Disclosures S
Page 9 and 10: Disclosures ! Faculty of this CE ac
Page 11 and 12: Get Social with Us CMEOutfitters.co
Page 13 and 14: Georgia Association of Physician As
Page 15 and 16: Matt T. Rosenberg, MD Disclosures S
Page 17 and 18: In what percentage of your patients
Page 19 and 20: Function of the Prostate Normal Fun
Page 21 and 22: Benign Prostatic Hyperplasia ! A co
Page 23 and 24: Predominant Symptoms ! The enlarged
Page 25 and 26: Definition of OAB International Con
Page 27 and 28: How to differentiate the etiology o
Page 29 and 30: Common Comorbidities in BPH-LUTS Co
Page 31 and 32: Audience Response Question Fact: ED
Page 33 and 34: BPH-LUTS and ED Common Pathophysiol
Page 35 and 36: What to Keep in Mind in the Evaluat
Page 37 and 38: The Evaluation of LUTS: History, Ph
Page 39 and 40: Medications Can Cause or Exacerbate
Page 41 and 42: Laboratory Tests ! Urinalysis ! Inf
Page 43 and 44: Audience Response Question The most
Page 45 and 46: The Purpose of the Voiding Diary !
Page 47 and 48: Rosenberg MT, et al. Publication Pe
Page 49 and 50: STEP 1: Informed Surveillance If th
Page 51 and 52: Clinical Management Step2a: Alpha B
Page 53 and 54: Clinical Management Step2b: Phospho
Page 55: Rosenberg MT, et al. Publication Pe
Page 59 and 60: ! Dry Mouth ! Constipation ! Headac
Page 61 and 62: Beta 3 Agonists Drug Mirabegron Dos
Page 63 and 64: Clinical Management Step3b: Adding
Page 65 and 66: 5 Alpha Reductase Inhibitors (5ARI)
Page 67 and 68: Rosenberg MT, et al. Publication Pe
Page 69 and 70: Clinical Connections: Summary ! Tre
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