A 69-year-old man comes to the physician because of a history of difficulty initiating urination. The patient also reports worsening urinary symptoms over the past year that include hesitancy, straining during urination, poor urinary flow, and waking up once or twice a night to urinate. Digital rectal examination shows a symmetrically enlarged, nontender prostate with a rubbery consistency. Laboratory studies show a prostate-specific antigen level of 2.1 ng/mL (N

Question

A 69-year-old man comes to the physician because of a history of difficulty initiating urination. The patient also reports worsening urinary symptoms over the past year that include hesitancy, straining during urination, poor urinary flow, and waking up once or twice a night to urinate.  Digital rectal examination shows a symmetrically enlarged, nontender prostate with a rubbery consistency. Laboratory studies show a prostate-specific antigen level of 2.1 ng/mL (N < 4). Blood pressure is 142/88 mm Hg and pulse is 70/min.  Serum chemistry studies and urinalysis are normal.  Which of the following medications would be most effective for treating both of this patient's medical issues?

Quizplus · Accepted Answer

Eductional Objective: Benign prostatic hyperplasia is characterized by hyperplasia of the prostatic glands and stroma in the periurethral zone (lateral and middle lobes). Clinical features include irritative symptoms (nocturia, urgency, and urinary incontinence), obstructive symptoms (decreased urinary stream, hesitancy, and terminal dribbling), and an enlarged, smooth prostate. Alpha-1 blockers such as doxazosin, prazosin, and terazosin are useful for the treatment of both benign prostatic hyperplasia and hypertension.

A 69-Year-Old Man Comes to the Physician Because of a History