diuretics + drugs affecting urinary tract/ bladder

Question 1

Finasteride is a drug used to treat _____.

Answer 1

BPH

Question 2

Finasteride blocks the hormone ___________, which is decreasing the size of the prostate - this is relieving the BPH itself and the _________ associated with it.

Answer 2

-testosterone

-obstruction

Question 3

What are the 3 hormonal side effects of finasteride?

Answer 3

-gynecomastia
-decreased libido + ejaculation volume
-low PSA levels

Question 4

What are the 4 contraindications of Finasteride?

Answer 4

pregnancy
female
liver impairment
urinary system obstruction

Question 5

Up to how long can it take Finasteride to have a therapeutic effect?

Answer 5

up to 12 months

Question 6

oxybutynin is an antispasmodic used to treat spasms in the urinary tract and urge incontinence due to overactive or neurogenic bladder. But what other drug class does this medication belong to?

Answer 6

anticholinergic drug class

Question 7

what are 2 complications of oxybutynin related to the urinary retention effects?

Answer 7

overdistension of the bladder and UTI

Question 8

what are the 6 side effects of oxybutynin?

Answer 8

-anticholinergic effects
-somnolence
-fever
-headache
-dizziness
-heat exhaustion

Question 9

what is the most important electrolyte to monitor while a patient is on furosemide or hydrochlorothiazide, due to the risk of dysrhythmias?

Answer 9

potassium

Question 10

what are some foods rich in potassium?

Answer 10

-bananas
-raisins
-potatoes
-citrus fruit

Question 11

Furosemide is a loop diuretic and hydrochlorothiazide is a thiazide diuretic, they block the absorption of sodium + chloride. this leads to what? (3)

Answer 11

-sodium + chloride excretion

-increased urine output

-potassium excretion

Question 12

electrolyte imbalances
hyperglycemia
hyperuricemia
orthostatic hypotension
dehydration

are all side effects of furosemide and hydrochlorothiazide. But which side effect does furosemide have that hydrochlorothiazide does not?

Answer 12

ototoxicity

Question 13

when is a better time of day to take diuretics, in the morning or before bed?

Answer 13

in the morning

Question 14

if you’re giving furosemide IV, why is it important to not push or set the pump to infuse too rapidly?

Answer 14

because if the dose is too high or you give this medication too rapidly, it can cause ototoxicity

Question 15

If your patient is pregnant and/ or has a sulfa allergy can they take hydrochlorothiazide?

Answer 15

NO

both of these are contraindicated

Question 16

If you take an NSAID with furosemide it will ______ the diuretic effects.

Answer 16

decrease

Question 17

when taking a loop or thiazide diuretic, while also taking digoxin, if you become hypokalemic what are at risk of developing?

Answer 17

digoxin toxicity

Question 18

Spironolactone is a potassium _______ diuretic.

Answer 18

sparing

Question 19

Why may patients experience endocrine related side effects like menstrual irregularities or gynecomastia while taking spironolactone?

Answer 19

because its a steroid and also produces effects similar to progesterone and testosterone

Question 20

if hyperkalemia develops in your patient, what 3 things are you going to do?

Answer 20

-take an apical pulse
-EKG/ECG
-monitor for dysrhythmias

Question 21

A patient taking spironolactone needs to be educated on avoiding what?

Answer 21

-potassium supplements
-potassium rich foods

Question 22

HTN, edema, and hyperkalemia are indications to use what medication?

Answer 22

spironolactone, a potassium sparing diuretic

Question 23

If you have a sulfa allergy, which diuretics shouldn’t you take?

Answer 23

Thiazide and Loop diuretics both contain sulfa

Question 24

Acetazolamide is a mild diuretic that increases the amount of sodium and bicarbonate that is excreted through the urine. What drug class does this medication belong to?

Answer 24

carbonic anhydrase inhibitor

Question 25

Since Acetazolamide is excreting all of that bicarb. what is one of the biggest side effects that could occur?

Answer 25

metabolic acidosis

Question 26

Which drug is used to treat open angle glaucoma because it decreases aqueous humor formation and IOP?

Answer 26

Acetazolamide

Question 27

Mannitol is an osmotic diuretic that ____ ___ into the renal tubules to be excreted.

Answer 27

draws water

Question 28

What 3 conditions are indicated for osmotic diuretic use?

Answer 28

-glaucoma -increased IOP -to induce renal excretion of toxins, like from Rhabdo.

Question 29

Mannitol is not generally used, and is actually contraindicated in fluid overload conditions like HF + pulmonary edema because why?

Answer 29

it could cause an exacerbation of these conditions

Question 30

Mannitol is ONLY given IV and it is important that the drug crystals are _______ in _______ water.

Answer 30

-dissolved -warm

Question 31

Fosfomycin is an anti-infective used to treat _____.

Answer 31

UTI

Question 32

Does Fosfomycin treat gram negative or gram positive bacteria to lead to cell death? **fosNOmycin**

Answer 32

gram negative bacteria

Question 33

What are 3 non-pharmacological things a patient can do while having a UTI to help get rid of this infection?

Answer 33

-proper hygiene -stay hydrated -proper diet

Question 34

How does phenazopyridine relieve the pain, urgency, burning, frequency or discomfort associated with infection, trauma, surgery or procedures as a urinary tract analgesic?

Answer 34

this drug coats the urinary tract mucosa

Question 35

Which side effect needs to be reported and the medication discontinued and which side effect is expected? 1. jaundice -- 2.red/ orange urine that stains

Answer 35

jaundice needs to be reported and medication needs to be discontinued red/orange urine is an expected side effect

Question 36

pentosan polysulfate sodium is a bladder protectant. But this drug also has _______ + ________ effects that makes monitoring for bleeding super important as this patients nurse.

Answer 36

anticoagulant + fibrinolytic

Question 37

which medication coats the bladder mucosal wall to protect it from solutes in the urine in conditions like interstitial cystitis? **protects from PP**

Answer 37

pentosan polysulfate sodium

Question 38

pentosan polysulfate sodium should be taken on an ______ ________, either 1 hour before meals or 2 hours after, to help with GI disturbances and with absorption.

Answer 38

empty stomach

Question 39

Doxazosin is an alpha adrenergic blocker so it is ________ arterioles and veins in the bladder and urinary tract, via sympathetic relaxation.

Answer 39

dilating

Question 40

It is important to apply safety precautions to patients taking doxazosin due to what 3 side effects?

Answer 40

-postural dizziness -vertigo -hypotension

Question 41

While a patient is on doxazosin it it important to monitor their cardiopulmonary status due to what 2 side effects?

Answer 41

tachycardia + palpitations

Question 42

why do you have to educate the patient whos taking oxybutynin about the risk of heat exposure?

Answer 42

due to the anticholinergic effects - they won't be producing sweat to regulate body temperature