7 - GU

Question 1

Two indications for finasteride

Answer 1

BPH

androgenic alopecia in men

Question 2

Councelling for finasteride

What other drug has this councelling

Answer 2

women of childbearing potential should avoid handling crushed or broken tabs
dutasteride capsules

Question 3

How is acute painful urinary retention treated

Answer 3

catherterisation

Catherterisation is not necessary in chronic retention unless renal function is affected

Question 4

Two first line treatments
Two second line treatment
for urinary retention

Answer 4

1st: surgery/ alpha blockers
2nd: dutasteride/finasteride (which metabolise testoserone into its more potent androgen dyhydrotestosterone)
(3rd: taladafil)

Question 5

mode of action of alfuzosin/tamsulosin/doxasosin/prazosin/indoramin

Answer 5

alpha block - relaxes smooth muscles to improve urinary floooooow

Question 6

Parasympathomimetics eg. ……………… may also have a role in urinary retetion but superceeded by catherisiaion

Answer 6

bethanechol

Question 7

what is zoley?

Answer 7

28 day COC (7 placebo days)

Question 8

what age is COC no longer recommended

Answer 8

50

Question 9

what is ‘low strength’ coc

Answer 9

20 microg ethinylestridiol - for high risk patients

Question 10

how long before surgery to stop COC

Answer 10

4 weeks

Question 11

after therapy with depoprovera for how long should you reassess risk

what is a risk?

Answer 11

2 years

oesteroperosis

Question 12

what is jaydess?

Answer 12

3 year pop
only contraceptive

as opposed to minera that is 5 years and also for prevention of primary menoragia and endomerial hyperplasia

Question 13

if a patient is taking enzyme inducing drugs how long do they need to use extra contraception for

Answer 13

4 weeks after

Question 14

what is the adivce for short term and long term use of COC and enzyme inducers

what is the exception

Answer 14

less than 2 months - tricycle (3 packs, 4 day break)
over 2 months - at least 50 micrograms plus tricycling as above

rifampicin and rifabutin - tricycling is not enough- must have IUD

Question 15

what age is the CU IUD approrpaite

Answer 15

over 25 (as those under 25 have increased risk of pelvic inflam disease)

Question 16

when are the critical times for missed pills

Answer 16

at the beginning or end of cycles (elongating the pill free interval)

Question 17

a misssed pill is more than …. hours late

what to do?

Answer 17

24

take the pill - no additional procautions necessary if under 48 hours

Question 18

what to do if 2 pills are missed

Answer 18

abstain/protect for 7 days

if this is beyond the end of the pack just start taking the nect pack immediately

Question 19

when is EHC indicated in missed pill

Answer 19

if 2 or more pills are missed from the first 7 tabs and USI has occured sinice finishing last pack

Question 20

what type of drug is alprostil and what is if for

Answer 20

prostaglandin for erectile dysfunction - use condoms to avoid exporsure to women of child bearing age

Question 21

what is dapoextine?

what is the dose capping interaction?

Answer 21

premature ejactulation SSRI

• up to 30 mg 1-3 hours before sex with macrolides, diltiazem, verapamil, aprepitant, fluconazole and fosamprenavir
• up to 60 for everyone else

Question 22

how long do you treat thrush in preg ladies

Answer 22

7 days

and avoid oral antifungals