A 64-year-old man comes to the office due to 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. He feels the symptoms are bothersome but are not affecting his quality of life. The patient has no other medical conditions and does not use tobacco, alcohol, or illicit drugs. Blood pressure is 125/78 mm Hg and pulse is 70/min. Physical examination shows a mildly enlarged, smooth prostate but is otherwise unremarkable. Serum chemistry studies and urinalysis are normal. Prostate-specific antigen level is 3.5 ng/mL, The patient is started on a new medication. After 6 months of therapy, his urinary symptoms improve and prostate volume decreases by 20%. Which of the following medications is most likely responsible for the decreased prostate volume in this patient?

Question

A 64-year-old man comes to the office due to 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.  He feels the symptoms are bothersome but are not affecting his quality of life.  The patient has no other medical conditions and does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 125/78 mm Hg and pulse is 70/min.  Physical examination shows a mildly enlarged, smooth prostate but is otherwise unremarkable.  Serum chemistry studies and urinalysis are normal.   Prostate-specific antigen level is 3.5 ng/mL, The patient is started on a new medication.  After 6 months of therapy, his urinary symptoms improve and prostate volume decreases by 20%.  Which of the following medications is most likely responsible for the decreased prostate volume in this patient?

Quizplus · Accepted Answer

Eductional Objective: 5-alpha reductase inhibitors (eg, finasteride, dutasteride) block the conversion of testosterone to dihydrotestosterone in the prostate.  These drugs reduce prostate volume in patients with benign prostatic hyperplasia and relieve the fixed component of bladder outlet obstruction.

A 64-Year-Old Man Comes to the Office Due to Worsening