DRUGS! Flashcards
mechanism of action of sulfonamides
inhibits folate synthesis
mechanism of action of quinolones
DNA replication inhibitor
mechanism of action of penicillins
cell wall inhibitors
mechanism of action of cephalosporins
cell wall inhibitors
mechanism of action of nitrofurantoin
inhibits enzymes, damages DNA
indication for alprostadil
erectile dysfunction
indication for sildenafil
erectile dysfunction
indication for tadalafil
erectile dysfunction
indication for leuprolide
prostate cancer
indication for flutamide
prostate cancer
indication for finasteride
BPH
indication for prazosin, terazosin, tamsulosin, alfuzosin
symptomatic BPH
mechanism of action of finasteride
5-a reductase inhibitor - prevents conversion of testosterone to dihydrotestosterone
mechanism of action of prazosin, terazosin, tamsulosin, alfuzosin
a1-antagonists/blockers - relax smooth muscle of the bladder neck and prostate to improve urine flow
indication for tolterodine tartrate, oxybutynin, trospium chloride
overactive urinary bladder disease aka URGE INCONTINENCE
mechanism of action of tolterodine tartrate, oxybutynin, trospium chloride
block muscarinic receptors in the bladder which lowers intravesicular pressure, which increases bladder capacity and reduces frequency of bladder contractions
side effects of tolterodine tartrate, oxybutynin, trospium chloride
dry mouth, constipation, blurred vision
mechanism of action of leuprolide
GnRH analogs - occupy GnRH receptors in the pituitary, leading to desensitization and subsequent inhibition of release of FSH and LH - so androgen synthesis is reduced
mechanism of action of flutamide
Synthetic, nonsteroidal antiandrogens - compete with natural androgens for binding to androgen receptor, thus preventing translocation of androgens into nucleus
–causes increased SERUM testosterone levels
side effects/adverse reactions of flutamide
gynecomastia, GI distress, liver failure
side effects of leuprolide
impotence
hot flashes
bone pain
gynecomastia
side effects/adverse reactions of a1-antagonists (blockers)
dizziness, orthostatic hypotension, tachycardia, sexual dysfunction. “floppy iris syndrome”
side effects/adverse reactions of sildenafil, tadalafil
HA, flushing, dyspepsia, nasal congestion, color blindness (sildenafil only)
side effects/adverse reactions of alprostadil
hypotension, dizziness, syncope, priapism, penile/urethral/testicular pain
indications for nitrofurantoin
UTI w/ E. coli, gram-positive cocci, prostatitis
side effects/adverse reactions of nitrofurantoin
GI disturbances, acute pneumonitis, neurologic problems….chronic use of nitrofurantoin may result in interstitial pulmonary fibrosis
side effects/adverse reactions of TMP-SMX
Skin rash
Nausea
Hematologic (anemia, leukopenia, thrombocytopenia)
side effects/adverse reactions of fluoroquinolones
PHOTOTOXICITY, increased risk of TENDINITIS/TENDON RUPTURE, GI disturbances, HA, dizziness, QT PROLONGATION
side effects/adverse reactions of penicillins
hypersensitivity; diarrhea; nephritis, neurotoxicity, decreased coagulation
Which anticholinergic medication is available in a patch formulation to help decrease the dry mouth side effect, and is thus more tolerated?
Oxybutynin
Beside the “can’t shit, spit, see, or pee” side effects of anticholinergics, what else do we worry about with the elderly?
Clouds their sensorium
can lead to QT prolongation
In the treatment of prostate cancer, flutamide is always given in combination with:
Leuprolide
Side effects of finasteride?
decrease ejaculate and libido, ED
gynecomastia
How long does it take for the prostate size to be reduced with the treatment of finasteride?
6-12 months
Which alpha-blocker has the most selective to the prostate and less BP lowering effects?
Tamsulosin
Due to its tendency to retain sodium, which alpha blocker is usually administered with a diuretic?
Prazosin
Outpatient treatment of pyelonephritis?
Quinolone
What’s the criteria for recurrent UTI prophylaxis? And what do you use?
> 3 episodes/ year
TMP/SMX, nitrofurantoin, cephalexin - single dosing at bedtime or at time of sexual intercourse
Which drugs are used for a 3 day regimen for UTI treatment?
cephalexin, ciprofloxacin
Which drugs are used for 7 days to treat a UTI?
Nitrofurantoin
Which drug is only a single dose treatment for a UTI?
TMP/SMX - worry about resistant strains
Indications for Ciprofloxacin?
UTIs (complicated and non complicated), prostatitis, pyelonephritis
What are contraindications of nitrofurantoin?
anuria
oliguria
renal function with creatinine clearance 38 weeks pregnancy
