A 63-year-old man presents to a family medicine clinic with an 8-month history of progressive weak urinary stream, hesitancy and nocturia twice nightly. His International Prostate Symptom Score (IPSS) is 18 and he wants rapid relief. He has no medical conditions requiring regular medication, takes no over-the-counter products, and has no known drug allergies. He has an ophthalmology appointment confirming a visually significant cataract in the right eye, with extraction scheduled in 6 weeks. On examination, the prostate is smooth, symmetric, mildly enlarged and non-nodular. Urinalysis is normal, PSA is 2.1 ug/L (0-4.0), creatinine is normal, post-void residual is 60 mL, and ultrasound estimates prostate volume at 30 mL.
| Heart rate | 72/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 128/78 mm Hg |
Question 1 of 30
Which one of the following is the most appropriate initial medication for this patient?
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