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Case 11: Male Reproductive System > Bladder & drugs > Flashcards

Bladder & drugs Flashcards

1
Q

What is the 3 functions of the bladder

A

Micturition
Storage of urine
Temperature control

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2
Q

What is the innervation of the bladder

A

Sympathetic & parasympathetic

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3
Q

From where does the sympathetic nervous system originate from

A

Superior & inferior hypogastric plexus

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4
Q

From where does the parasympathetic nervous system originate from

A

Pelvic splanchnic nerve S2-4

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5
Q

What is the 2 functions of the sympathetic nervous system

A

Relaxation of detrusor via B2
Contraction of trigone & sphincter via a1

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6
Q

What innervation is responsible for sensation of distended or irritated bladder

A

Parasympathetic

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7
Q

What is the 2 functions of the parasympathetic nervous system

A

Contraction of detrusor via M3
Relaxation of trigone & sphincters via M3

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8
Q

What is the 3 autonomic nervous system neurotransmitters

A

Acetylcholine
Norepinephrine/epinephrine
Non-acetylcholine like serotonin & dopamine

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9
Q

What is the 5 basic steps & sites of drug action

A
  1. Synthesis of transmitter
  2. Storage of transmitter
  3. Release of transmitter
  4. Interaction of transmitter w/ receptor on effector cells
  5. Removal/degradation/recycling of transmitter
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10
Q

What is the steps w/ cholinergic receptor & drug interactions

A
  1. Synthesis of acetylcholine inhibited by hemicholinium
  2. Storage of acetylcholine in vesicle that protects from degradation
  3. Release of acetylcholine blocked by botulinum toxin or stimulated by spider venom
  4. Interaction of acetylcholine w/ receptor on effector cells
  5. Degradation & recycling of acetylcholine
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11
Q

What is the effect of organophosphate poisoning on the bladder

A

Acetylcholine increase the tone of detrusor muscle that cause expulsion of urine/urinary urgency

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12
Q

What is 3 drugs that are cholinergic agonist & their effects

A
  1. Bethanechol: use in urinary retention
  2. Physostigmine: increase bladder motility
  3. Neostigmine: prevent postoperative abdominal distention & urinary retention
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13
Q

What is 3 examples of cholinergic antagonist

A
  1. Selectively block muscarinic receptors of parasympathetic nerves
  2. Ganglionic blockers blocking nicotinic receptors of parasympathetic & sympathetic
  3. Neuromuscular blocking agent interfere with/ transmission of efferent impulses to skeletal muscle & used as smooth muscle relxant anesthesia
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14
Q

What is the 2 effects of drugs on the bladder

A
  1. Urinary retention
  2. Urinary incontinence
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15
Q

What 2 drugs cause urinary retention

A
  1. Anti cholinergic: atropine & oxybutinin (used in overactive bladder)
  2. Drugs w/ anti cholinergic side effect: tricyclic antidepressant (imipramine in children)
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16
Q

What 3 substances cause urinary incontinence

A
  1. Diuretics
  2. Alcohol
  3. Caffeine
17
Q

What is the 2 drugs used in BPH

A
  1. 5 alpha reductase inhibitor
  2. A1 adrenergic antagonists
18
Q

What is the effect of a1-adrenergic antagonist

A

Relieve outlet obstruction of bladder by reducing tension of prostatic smooth muscle

19
Q

What is 2 side effects of a1-adrenergic antagonist

A

Orthostatic hypotension after 1st dose
Dizziness

20
Q

What is the indication of a1-adrenergic antagonist

A

Hypertension
BPH

21
Q

How long does it take for a1-adrenergic antagonist to have an effect

A

2-4 weeks

22
Q

What does a1-adrenergic antagonist not affect

A

PSA levels
Size of prostate

23
Q

What is an example of a1-adrenergic antagonist drug

A

Doxazosin

24
Q

What is the effect of 5 alpha reductase inhibitor

A

Reduce the size of prostate gland & PSA

25
Q

What is 2 side effects of 5 alpha reductase inhibitors

A

Decreased libido
Ejaculatory or erectile dysfunction

26
Q

How long does it take for 5 alpha reductase inhibitors to work

A

6-12 months

27
Q

What is an example of 5 alpha reductase inhibitor

A

Finasteride

28
Q

What is the ideal treatment for BPH

A

Combination therapy due to synergic effect

Case 11: Male Reproductive System (9 decks)

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