7 - GU Flashcards
Two indications for finasteride
BPH
androgenic alopecia in men
Councelling for finasteride
What other drug has this councelling
women of childbearing potential should avoid handling crushed or broken tabs
dutasteride capsules
How is acute painful urinary retention treated
catherterisation
Catherterisation is not necessary in chronic retention unless renal function is affected
Two first line treatments
Two second line treatment
for urinary retention
1st: surgery/ alpha blockers
2nd: dutasteride/finasteride (which metabolise testoserone into its more potent androgen dyhydrotestosterone)
(3rd: taladafil)
mode of action of alfuzosin/tamsulosin/doxasosin/prazosin/indoramin
alpha block - relaxes smooth muscles to improve urinary floooooow
Parasympathomimetics eg. ……………… may also have a role in urinary retetion but superceeded by catherisiaion
bethanechol
what is zoley?
28 day COC (7 placebo days)
what age is COC no longer recommended
50
what is ‘low strength’ coc
20 microg ethinylestridiol - for high risk patients
how long before surgery to stop COC
4 weeks
after therapy with depoprovera for how long should you reassess risk
what is a risk?
2 years
oesteroperosis
what is jaydess?
3 year pop
only contraceptive
as opposed to minera that is 5 years and also for prevention of primary menoragia and endomerial hyperplasia
if a patient is taking enzyme inducing drugs how long do they need to use extra contraception for
4 weeks after
what is the adivce for short term and long term use of COC and enzyme inducers
what is the exception
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
what age is the CU IUD approrpaite
over 25 (as those under 25 have increased risk of pelvic inflam disease)
when are the critical times for missed pills
at the beginning or end of cycles (elongating the pill free interval)
a misssed pill is more than …. hours late
what to do?
24
take the pill - no additional procautions necessary if under 48 hours
what to do if 2 pills are missed
abstain/protect for 7 days
if this is beyond the end of the pack just start taking the nect pack immediately
when is EHC indicated in missed pill
if 2 or more pills are missed from the first 7 tabs and USI has occured sinice finishing last pack
what type of drug is alprostil and what is if for
prostaglandin for erectile dysfunction - use condoms to avoid exporsure to women of child bearing age
what is dapoextine?
what is the dose capping interaction?
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
how long do you treat thrush in preg ladies
7 days
and avoid oral antifungals
