Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal System > Bladder, Incontinence and Drugs > Flashcards

Bladder, Incontinence and Drugs Flashcards

1
Q

Stimulation of Muscarinic M3 receptor of the bladder causes?

A

Bladder contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stimulation of Muscarinic Nicotinic receptor of the bladder causes?

A

Contraction of the external sphincter’s striated smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sympathetic stimulation of B3 adrenergic receptors of the bladder detrusor muscle cause?

A

Relaxation of the bladder smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sympathetic stimulation of alpha-1 adrenergic receptors of the urethral smooth muscle cause?

A

Contraction of urethral smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definition Card:

The uncontrolled leakage of urine, which can be continuous or intermittent, is called?

A

Incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Definition Card:

Sudden and unexpected experience of immediate need to void

A

Urgency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Definition Card:

Awakening to void at night

A

Nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Definition Card:

Daytime frequency is defined by urinating how many times per day?

A

8 or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definition Card:

Difficulty in the initiation of voiding

A

Hesitancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Definition Card:

Application of abdominal pressure (Valsalva maneuver) to initiate and maintain voiding

A

Straining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definition Card:

the discomfort or burning sensation with voiding

A

Dysuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most commonly prescribed antimuscarinic drugs used for the tx of urinary incontinence?

A
  1. Tolterodine

2. Oxybutynin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does the adverse CNS effects of Trospium compare to the other anticholonergic drugs?

A

Trospium has less adverse CNS effects

  • Because it does not cross the BBB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the receptor specificity for darifenacin? Is it more clinically useful?

A

Greater M3 selectivity

  • clinical studies have not recorded a substantially better profile for this
    drug in clinical use, as compared to the other, non-selective, drugs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Unique metabolism of Trospium?

A

All of the Anticholinergic are CYP3A4 metabolized except for Trospium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Route of administration of the anticholinergics?

A

All oral

  • Tolterodine and Oxybutynin are available in extended release forms due to their shorter half-lives compared to the others
  • Oxybutynin is also available transdermally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the major side effect that causes patients to withdraw from taking their anticholinergic incontinence medication?

A

Dry mouth (xerostomia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Contraindications for Anticholinergics for incontinence

especially in elderly taking many medications

A
  1. Glaucoma
  2. Urinary and gastric obstruction
  3. Need for mental alertness (Operating machinery?)
  4. Alzheimer’s type dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adverse effects of anti-cholinergics used for incontinence

A
  1. blurred vision
  2. Dry mouth (xerostomia)
  3. CV effects: Palpitations, tachycardia, prolonged QT interval
  4. Drowsiness
  5. GI effects: Constipation and alters absorption of other drugs
  6. Facial flushing
  7. Urinary retention, especially in BPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When would botox be useful to tx urinary incontinence?

A

In patients who responded to anticholinergic drugs but couldn’t tolerate the adverse effects

  • Not as much in those who were unresponsive to the anticholinergics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Function of botox in regards to its use in preventing incontinence

A
  1. Inhibits the afferent cholinergic impulses (via inhibition of vessicular release of excitatory neurotransmitters)
  2. Causes a phenotypic change within the urothelial tissue to ablate the excitatory effect of local chemical mediators that signal via the cholinergic system to make the bladder hyper-responsive in the first instance.
22
Q

Mirabegron

  • classification?
  • use?
  • MOA?
A

Beta-3 Adrenergic AGONIST
- used to tx: Incontinence, urgency, and frequency

-MOA: Binds B3 and causes relaxation of the detrusor muscle

23
Q

MOA and use of Phenylephrine?

A

Alpha-1 adrenergic AGONIST
- used to treat stress incontinence (urine loss w/ couching, sneezing, or laughing)

-Alpha-1 stimulation causes profound constriction of urethral smooth muscle

24
Q

Metabolism of sympathomimetic drugs used to treat incontinence

A

Mirabegron

  • undergoes extensive metabolic metabolism
  • (CYP3A4&raquo_space; CYP2D6)
25
Q

Elimination of sympathomimetic drugs used to treat incontinence?

A

Urinary

  • May need to dose adjust with renal dysfunction!
26
Q

Side effects of sympathomimetic drugs used to treat incontinence?

A
  1. HTN
  2. Tachycardia/arrhythmia
  3. Anxiety, Restlessness, insomnia
27
Q

Use and MOA of methionine?

A

An adjunctive agent in the treatment of urinary incontinence to reduce odor emanating from the leaked urine.

  • creates ammonia-free urine by acidifying urine pH
28
Q

Adverse effects of Methionine?

A

Drowsiness, nausea, and vomiting

29
Q

Use of Bovine Collagen?

A

Incontinence die to intrinsic sphincter deficiency

  • for PTs failing other therapies for > 12 months
30
Q

MOA of Bovine collagen?

A

Forms a soft network of fibers increasing the tissue bulk around the urethral lumen

31
Q

Adverse rxns of Bovine collagen? (6)

A
  1. Urinary retention
  2. Hematuria
  3. Worsening incontinence
  4. erythema
  5. Urticaria
  6. Abscess formation
32
Q

What drugs are used to tx urinary retention?

A
  1. Bethanechol- direct muscarinic agonist and
  2. Neostigmine - acetylcholinesterase inhibitor
  • both ORAL (several times daily due to short T1/2)
33
Q

Adverse effects of Bethanechol? (5)

A
  1. CV: Lightheadedness, synscope
  2. GI: Diarrhea, stomach cramps
  3. Neurologic: Dizziness
  4. Opthalmic: Excessive tear production
  5. Renal: Urgency
34
Q

Adverse effects of Neostigmine? (4)

A
  1. AV block, Brady-arrhythmia
  2. Cardiac Arrest, Cardiac dysrhythmia
  3. Hypotension, Syncope
  4. Tachycardia
35
Q

Adverse effect of opiates?

A

Urinary retention
- mainly with epidural/intrathecal

  • Cholinomimetics (Bethanechol and neostigmine) may be useful to reverse this adverse effect
36
Q

Alpha-1 Blockers used to tx BPH?

A

“Sins”

  1. Prazosin (short acting)
  2. Alfuzosin (short acting)
  3. Terazosin (Long acting)
  4. Doxazosin (Long acting)
  5. Tamsulosin (partially selective)
  6. Silodosin (partially selective)
37
Q

PDE-5 inhibitor used to tx BPH?

A

Tadalifil (Cialis)

38
Q

5-alpha reductase inhibitors used to tx BPH?

A
  1. Finasteride

2. Dutasteride

39
Q

Site of action of Alpha-1 blockers to tx BPH?

A 
Alpha-1a = lower GU tract, whereas 
alpha-1d = detrussor muscle of the urinary bladder.
40
Q

MOA of Alpha-1 blockers to tx BPH?

A

alpha-1 blockers cause relaxation of the smooth
muscle in the prostatic and penile urethra,
- thereby permitting easier urination

41
Q

Common side effects of Alpha-1 Blockers?

A
  1. Orthostatic hypotension
  2. syncope
  3. Xerostomia
  4. Nausea
  5. Asthenia (lethargy)
  6. headache
  7. insomnia
  8. drowsiness (somnolence)
42
Q

ADME of Alpha-1 Blockers?

A
  • Oral (once daily)
  • CYP metabolism
  • Prazosin (effect varies patient to patient-dose titrate)
43
Q

What are the partially active Alpha-1a Blockers and what are the additional side effects?

A

Tamsulosin and Sildosin

  • Diminished effects on CV function
  • Increased sexual (ejaculation) dysfunction
44
Q

MOA of PDE-5 inhibitor used to tx BPH?

A

PDE5 inhibitors decrease the breakdown of cGMP by inhibition of PDE5
=> prolonged high levels of cGMP necessary for erections or for flow of urine from the urinary bladder.

45
Q

Adverse effects and contraindications of Tadalifil (Cialis)

A

AE:

  1. Nasopharyngitis
  2. Upper Res. Tract Infection (URTIs)
  3. Hearing and Vision loss
  • Contras: Concurrent organic NITRATES
    1. Profound Hypotension
    2. Exacerbated by Alcohol consumption
46
Q

MOA of 5-alpha-reductase inhibitors?

A

5-alpha-reductase (competitive) inhibitors reduce the dihydrotestosterone-driven proliferation of the prostate

  • provide relief for urinary evacuation by reducing the
    prostate from pressing on and constricting urine flow along the urethra.
  • Finasteride inhibits Type 2
  • Dutasteride inhibits Both Types 1 and 2
47
Q

Route of administration and metabolism of 5-alpha-reductase inhibitors?

A

Orally (once daily)

- CYP3A4 hepatic metabolism

48
Q

Adverse effects and Contras for 5-alpha-reductase inhibitors?

A

AE:

  1. Ejaculatory dysfunction
  2. ED
  3. Decreased libido
  4. Gynecomastia
  5. Decreases PSA levels (prob if using to monitor for cancer)
    - Contra: Pegnancy (category X)
49
Q

What is Beta-sitosterol? Use?

A

Herbal used for BPH
- provide symptomatic relief, while not
significantly shrinking the prostate size.

50
Q

What is Saw-Palmetto? Use?

A

Herbal

- not enough evidence to support its use for BPH

Renal System (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions