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Benign Prostatic Hyperplasia Care Implementation

📄 Words: 329
📝 Subject: Pharmacology
📑 Pages: 2
✍️ Type: Essay
Table of Contents
  1. Patient Case
  2. Care Plan
  3. Implementation of the Care Plan
  4. References

Patient Case

The patient’s medication intake needs prioritization as the primary concern should be focused on BPH as this pathology is not currently under control:

  1. Chief complaints relate to BPH.
  2. PSA > 4ng/ml.
  3. AUA Symptom Score = 20.
  4. Uroflowmetry < 10 ml/sec.
  5. The size of the prostate is 35 g (> 20-25g).
  6. Postvoid residual bladder 300 ml (instead of 50 ml).

First-generation antihistamines, including diphenhydramine (Claritin-D), antidepressants of the tricyclic line (Amitriptyline), beta-blockers, and alcohol worsen the symptoms of benign prostatic hyperplasia by increasing outlet obstruction (Langan, 2019). The main concern of the patient should be refused a cat (or use second-generation (Loratadine, Cetirizine, etc.) and daily alcohol intake, changing the group of antidepressants and switching beta-blockers to ACE inhibitors or angiotensin II receptor antagonists (monitor new symptoms: cough).

Care Plan

  1. The goals of pharmacotherapy are to manage the treatment of patients with plural comorbidities and avoid their influence on each other. Daily intake of first-generation antihistamines is not recommended as they do not have selectivity on alpha adrenoreceptors.
  2. Non-drug therapies for this patient are decreasing the daily intake of alcohol and caffeine, limiting salt intake (which can increase BP), and limiting fluid intake 1 to 2 hours before sleep.
  3. Pharmacotherapeutic alternatives for the patient are switching to selective alpha-adrenergic blockers (Tamsulosin, Alfuzosin, Silodosin) that do not cause orthostatic hypotension; however, they can cause retrograde ejaculation. Tadalafil, a 5-alpha reductase inhibitor, might suit the patient the most as he also has complaints about ED. Alpha-reductase inhibitors (Finasteride, Dutasteride) are proven to stop the prostate from further increasing in size. Surgical treatment is also available for the patient, most commonly transurethral resection of the prostate (TURP) (Langan, 2019). The patient has the following indications for the surgery: refractory urinary retention and recurrent urinary tract infection.

Implementation of the Care Plan

The educational materials for the patient are written by McVary (2020). The material provides a patient with more detailed data about his disease and guides him in giving proper advice.

References

Langan, R. C. (2019). Benign prostatic hyperplasia. Primary Care: Clinics in Office Practice, 46(2), 223-232.

McVary, K. T. (2020). Patient education: Benign prostatic hyperplasia (BPH) (Beyond the basics). UpToDate.

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Reference

NursingBird. (2023, January 29). Benign Prostatic Hyperplasia Care Implementation. https://nursingbird.com/benign-prostatic-hyperplasia-care-implementation/

Work Cited

"Benign Prostatic Hyperplasia Care Implementation." NursingBird, 29 Jan. 2023, nursingbird.com/benign-prostatic-hyperplasia-care-implementation/.

References

NursingBird. (2023) 'Benign Prostatic Hyperplasia Care Implementation'. 29 January.

References

NursingBird. 2023. "Benign Prostatic Hyperplasia Care Implementation." January 29, 2023. https://nursingbird.com/benign-prostatic-hyperplasia-care-implementation/.

1. NursingBird. "Benign Prostatic Hyperplasia Care Implementation." January 29, 2023. https://nursingbird.com/benign-prostatic-hyperplasia-care-implementation/.


Bibliography


NursingBird. "Benign Prostatic Hyperplasia Care Implementation." January 29, 2023. https://nursingbird.com/benign-prostatic-hyperplasia-care-implementation/.