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Pre Reg > Chapter 7 BNF (Genito-Urinary System) > Flashcards

Chapter 7 BNF (Genito-Urinary System) Flashcards

1
Q

What Drugs are First Line in Urge Urinary Incontinence?

A 
Oxybutynin
Tolterodine 
Darifenacin
Solifenacin
Trospium
Fesoterodine 
Flavoxate
Propiverine
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2
Q

What is second line in urge urinary incontinence?

A

Mirabegron (QT)

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3
Q

Whats first line in Stress incontinence in women?

A

Duloxetine

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4
Q

What is first line treatment in Nocturnal Enuresis?

A

Enuresis Alarms (lower refractory rate)

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5
Q

What is second line in Nocturnal Enuresis?

A

Desmopressin in over 5 years old?

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6
Q

What are the counselling points with nocturnal enuresis?

A

restrict fluid intake 1 hr before and 8 hours after

stop in vomiting/diarrhoea

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7
Q

What is the first line in acute urinary retention?

A

Cathetarisation

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8
Q

What are the side effects of alpha blockers?

A

hypotension

intra-operative floppy iris syndrome

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9
Q

What are the counselling points with alpha blockers?

A

Take first dose at bedtime to avoid first dose postural hypotension

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10
Q

What are the side effects of Finestaride?

A

Male breast cancer

depression and suicidal thoughts (MHRA Alert)

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11
Q

What is the advice on finestaride regarding contraception and pregnancy?

A

wear condom if partner is pregnant or likely to become pregnant

women of child bearing age avoid handling finasteride tablets (and Dulasteride caps)

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12
Q

What are the fraser guidelines when prescribing to under 16 years.

Can provide contraception without parental consent if:

A

she understands the advice
cannot be persuaded to tell parents
likely to continue having sex
mental and physical health at risk

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13
Q

which progestogens can be offered to females suffering from acne, breast symptoms, breakthrough bleeding with other progestogens?

A

Norgestimate
Desogestrel
Drosperinone
Gestodene

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14
Q

What Progestogens are available in POP?

A

Desogestrel
Norethisterone
Levonogestrel

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15
Q

When should the combined oral contraceptive be started

A

any time during cycle

if day 6 or later, use protection for 7 days

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16
Q

What patients should be offered Phasic preparations?

A

Women without withdrawal bleeding and women with breakthrough bleeding on monophasic

17
Q

What is considered low strength oestrogen?

A

20mg ethinylestradiol

18
Q

What are the risk factors for VTE? how many does the patient need for oestrogens to be avoided?

A 
Type of progestogen: Deso, Gesto, Drospe 
BMI >30
Smoking 
Primary relative under 45 with VTE 
Long-term immobilisation 
Age >35 years
19
Q

What are the risk factors for ATE? how many does the patient need for oestrogens to be avoided?

A

Diabetes
Hypertension
Migraine without aura

20
Q

How is the POP taken?

A

once daily on a continuous basis, starting on day one of the cycle

if started day 5 or later, use protection for 2 days

21
Q

Cancer side effects of COC and POP?

A

COC - Cervical and Breast

POP - Breast

22
Q

Cancer benefits of COC?

A

Reduce Ovarian and Endometrial Cancer

23
Q

COC: What to do when 1 pill missed?

A

Take one asap and next one at normal time

24
Q

COC: What to do when 2 pills missed?

A

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

25
Q

What time interval is the COC considered a ‘missed pill’

A

24hours (Zoely/ Qlaira 12 hrs)

26
Q

After how long is the POP consider a ‘missed pill’

A

3 hours (desogestrel 12 hours)

27
Q

POP: What to do when 1 pill

A

Take ASAP, condom for 2 days

EHC if unprotected sex happens before 2 pills are taken

28
Q

Whats the course of action for Evra patches detached for over 24hours or delayed application at beginning of cycle?

A

Apply new patch ASAP

Start a ‘new day 1 cycle’ + condom 7 days

29
Q

Whats the course of action for delayed application of Evra Patches mid cycle?

A

<48 hours - apply new patch and continoue

> 48hours - start new day 1 cycle and condom for 7 days

30
Q

What regular contraception can be used with patients taking and enzyme inducer?

A

Copper IUD
Progestogen on injections

until 4 weeks after drug

31
Q

What EHC can be used for patients taking and enzyme inducer?

A

Copper IUD

3mg levonorgestrel

32
Q

which contraception is affected by drugs that raise pH?

A

Ulipristal

33
Q

Whats first line EHC?

A

Copper IUD
5 days after unprotected intercourse

5 days after earlist calculated ovulation

34
Q

What BMI and weight should be offered Ulipristal or 3mg levonogesterel

A

70kg or 26kg/m2

35
Q

When is levonorgestrel cautioned?

A

Crohns disease
past ectopic pregnancy
ciclosporin

36
Q

When Ulipristal cautioned?

A

severe asthma

severe liver impairment

37
Q

How long must precaution be taken with hormonal contraception after Ulipristal?

A

COC: 14 DAYS (16 Qlaira)

POP: 9 AYS ( 14 parenteral)

38
Q

How long should patients wait before starting regular Hormonal contraception?

A

5 days

39
Q

What do home pregnancy tests test for?

A

Human chorionic gonadotropin

Pre Reg (37 decks)

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