Chapter 7 BNF (Genito-Urinary System) Flashcards
What Drugs are First Line in Urge Urinary Incontinence?
Oxybutynin Tolterodine Darifenacin Solifenacin Trospium Fesoterodine Flavoxate Propiverine
What is second line in urge urinary incontinence?
Mirabegron (QT)
Whats first line in Stress incontinence in women?
Duloxetine
What is first line treatment in Nocturnal Enuresis?
Enuresis Alarms (lower refractory rate)
What is second line in Nocturnal Enuresis?
Desmopressin in over 5 years old?
What are the counselling points with nocturnal enuresis?
restrict fluid intake 1 hr before and 8 hours after
stop in vomiting/diarrhoea
What is the first line in acute urinary retention?
Cathetarisation
What are the side effects of alpha blockers?
hypotension
intra-operative floppy iris syndrome
What are the counselling points with alpha blockers?
Take first dose at bedtime to avoid first dose postural hypotension
What are the side effects of Finestaride?
Male breast cancer
depression and suicidal thoughts (MHRA Alert)
What is the advice on finestaride regarding contraception and pregnancy?
wear condom if partner is pregnant or likely to become pregnant
women of child bearing age avoid handling finasteride tablets (and Dulasteride caps)
What are the fraser guidelines when prescribing to under 16 years.
Can provide contraception without parental consent if:
she understands the advice
cannot be persuaded to tell parents
likely to continue having sex
mental and physical health at risk
which progestogens can be offered to females suffering from acne, breast symptoms, breakthrough bleeding with other progestogens?
Norgestimate
Desogestrel
Drosperinone
Gestodene
What Progestogens are available in POP?
Desogestrel
Norethisterone
Levonogestrel
When should the combined oral contraceptive be started
any time during cycle
if day 6 or later, use protection for 7 days
What patients should be offered Phasic preparations?
Women without withdrawal bleeding and women with breakthrough bleeding on monophasic
What is considered low strength oestrogen?
20mg ethinylestradiol
What are the risk factors for VTE? how many does the patient need for oestrogens to be avoided?
Type of progestogen: Deso, Gesto, Drospe BMI >30 Smoking Primary relative under 45 with VTE Long-term immobilisation Age >35 years
What are the risk factors for ATE? how many does the patient need for oestrogens to be avoided?
Diabetes
Hypertension
Migraine without aura
How is the POP taken?
once daily on a continuous basis, starting on day one of the cycle
if started day 5 or later, use protection for 2 days
Cancer side effects of COC and POP?
COC - Cervical and Breast
POP - Breast
Cancer benefits of COC?
Reduce Ovarian and Endometrial Cancer
COC: What to do when 1 pill missed?
Take one asap and next one at normal time
COC: What to do when 2 pills missed?
Take one asap, condom for 7 days (Zoely/Qlaira 9 days)
Omit pill free interval if missed in last 7 days
EHC if missed in first 7 days and unprotected sex occurs
