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Basic Training Study Guide > Enablex > Flashcards

Enablex Flashcards

1
Q

___ is characterized by symptoms of urgency to urinate, with or without urinary incontinence, and usually frequent voiding (8 or more times per day)

A

OAB - Overactive Bladder

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2
Q

What is Urinary Incontinence?

A

Involuntary Urinary Leakage

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3
Q

It is estimated that __% of the US Population have OAB but only __% of all patient’s w/symptoms receive treatment.

A

16% of all US population have OAB

15% receive treatment

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4
Q

OAB occurs from overstimulation of ____?

A

Detrusor Muscle

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5
Q

During and OAB episode, the ____ which are located in the detrusor muscle are over stimulated and cause contractions.

A

Muscarinic Receptors

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6
Q

Define Micturition

A

Urination Process

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7
Q

OAB can result from idiopathic detrusor over activity or neurogenic detrusor overactivity. Define both types.

A

Idiopathic - spontaneous, unpredictable

Neurogenic - controlled by Nervous system

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8
Q

___ is a term meaning the urgency without leakage

A

OAB dry

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9
Q

___ is a term meaning the urgency with leakage of urine.

A

OAB wet

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10
Q

___ is leakage from a strong sudden urge to urinate due to involuntary detrusor muscle contractions.

A

Urge UI

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11
Q

___ is involuntary leakage of urine due to weakened pelvic floor muscles however the patient lacks the urge to urinate.

A

stress UI

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12
Q

___ is a combination or Urge UI and stress UI

A

Mixed UI

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13
Q

Name 8 key parts of the Human Urinary System in males and females.

A
  1. Kidneys
  2. Ureters
  3. Inguinal Ligament
  4. Bladder
  5. Urethra
  6. Prostate
  7. Penis
  8. Vagina
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14
Q

____ is a vital organ and plays a major role in removal of waste products from blood by way of urinary outflow.

A

Kidneys

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15
Q

The ___ is where the process of filtration actually occurs inside the kidneys.

A

Nephron

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16
Q

Urine is created in 3 steps inside the kidney’s nephron. What are they?

A
  1. Filtration
  2. Reabsorption
  3. Secretion
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17
Q

__ are a pair of thin fibrous tubes beginning in the kidney and ending in the bladder. Their job is to transport urine from the kidney to the bladder for storage.

A

Ureters

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18
Q

Where is the urine stored before being emptied.

A

Bladder

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19
Q

___ extends from the lower floor of the bladder and acts as a “valve” that keeps the bladder closed until the act of voiding.

A

Urethra

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20
Q

In a healthy urinary system, the first urge of voluntary bladder emptying occurs at a volume of ___ and fullness is sensed between ___ and ___ (which is normal bladder capacity)

A

150ml

400ml to 500ml

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21
Q

The bladder is constructed of 4 different layers, what are they in order from outer to inner

A
  1. Peritoneum
  2. Detrusor Muscle
  3. Sub Mucosa
  4. Epithelium
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22
Q

Over stimulation of the __ muscle can lead to involuntary contractions that characterize OAB.

A

Detrusor Muscle

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23
Q

___ is the outermost layer of the bladder. It is made up of fatty fibrous tissue and blood vessels.

A

Peritoneum

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24
Q

___ is made up of smooth muscle fibers that contract to expel urine from the bladder.

A

Detrusor muscle

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25
Q

___ is a layer of connective tissue and blood vessels inside the bladder that loosely bind the epithelium to the detrusor muscle

A

Sub Mucosa

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26
Q

___ is a water tight mucous lining that protects the body from poisons found in the urine

A

Epithelium

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27
Q

Contraction within the bladder is mediated by the __ neurotransmitter.

A

AcH - Acetylcholine.

28
Q

The neurotransmitter AcH specifically binds to the ___ receptor site which ultimately starts the process of the detrusor muscle contractions.

A

M3

29
Q

The ___ is an elastic tube that begins in the bladder neck and ends in either the penis or just above the vagina.

A

Urethra

30
Q

The male urethra passes through the ___, which is located between the ___ and ___.

A

Prostate

Internal and External Sphincter

31
Q

The ____ is a direct continuation of the detrusor muscle which surrounds the urethra. It is under the control of the autonomic nervous system and serves as a seal for urine that can open and close.

A

Internal Sphincter

32
Q

____ is a voluntary muscle, controlled by the somatic nervous system, that encircles the urethra and provides a water tight seal or can release urine by relaxing when necessary.

A

External Sphincter

33
Q

The ____ nervous sytem is the body’s own emergency system which also serves to help decrease the contractility of the detrusor muscle.

A

Sympathetic

34
Q

The ____ nervous system is the body’s system that helps calm and relax. In turn, this system plays an important role in promoting the body’s secretions by increasing the contractility of the detrusor muscle by relaxing it.

A

Parasympathetic

35
Q

Urination is controlled by the ____ center in the brain.

A

Micurition Center

36
Q

Modern pharmacology therapy for OAV is based on Muscarinic _____ that inhibit AcH’s action on the ___ receptor

A

Antagonist

M3

37
Q

There are 5 muscarinic receptor subtypes M1 to M5, however the ___ receptor is responsible for the Micturition process.

A

M3

38
Q

___ is the muscarinic receptor for vision

A

M5

39
Q

___ is the muscarinic receptor for cardiac

A

M2

40
Q

___ is the muscarinic receptor for the Central Nervous System (CNS)

A

M1

41
Q

___ is the muscarininc receptor for the urinary system

A

M3

42
Q

__ is the muscarininc receptor thats in the forebrain but the function is unknown.

A

M4

43
Q

What is the dose/dosage recommended for Enablex?

A

Starting dose of 7.5mg once daily but after two weeks of therapy, can be increased to 15mg once daily if necessary.

44
Q

How soon can dosage be increased of Enablex and to what dose?

A

after two weeks of therapy at 7.5mg and it can be increased to 15mg

45
Q

One characteristic where Enablex blows the competion away is?

A

M3 Receptor affinity

46
Q

___ is the study of how a drug is processed by the body (what the body does to the drug) and what are the four steps?

A

Pharmacokinetics

  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion
47
Q

After oral administration of Enablex is given to healthy patients. How long till maxium blood levels (Cmax) are reached? How long till steady state concentration is reached?

A

Cmax is 7hours

Steady State Concentration at 6days

48
Q

Does food have an effect on Enablex?

A

No

49
Q

Approximately what % of Enablex is bound to plasma proteins in patients who take the drug?

A

98%

50
Q

Should Enablex dosing be adjusted for poor metabolizers?

A

No

51
Q

Enablex has a half-life of ____? and ___% is excreted in the urine and __% in the feces.

A

13 to 19 hour half life
60% urine
40% feces

52
Q

Patients with a mild hepatic impairment do not require dose changes, but with a moderate hepatic impairment the recommended dosing is ___mg and severe hepatic impairements should not take Enablex.

A

7.5mg

53
Q

The most common adverse events or side effects of Enablex are ____ and ____?

A

Dry Mouth

Constipation

54
Q

Enablex is very safe, however it’s competitor _____ saw significant effects on the brain and memory (some as much as 10yrs of aging on the brain). This is due to it’s decreased affinity for the M3 receptor.

A

Oxybutynin ER

55
Q

In the urinary system, what prevents kidney reflux?

A

Ureters

56
Q

What transports urine out of the body?

A

Urethra

57
Q

What filters waste products from the blood?

A

Kidneys

58
Q

What stores urine in the body?

A

Bladder

59
Q

____ and ____ form the lower urinary tract?

A

Bladder and Urethra

60
Q

List the 3 steps in the excretion of urine.

A
  1. Filtration
  2. Reabsorption
  3. Secretion
61
Q

List the sequence in order of the 3 muscle actions that make up the micturition reflex.

A
  1. Internal Sphincter relaxes
  2. Detrusor Muscle contracts
  3. External Sphincter relaxes
62
Q

___ is the primary source of urge incontinence?

A

Spasmodic Detrusor Muscle

63
Q

The ____ nervous system controls the Micturition reflex

A

Autonomic

64
Q

How does a muscarinic antagonist contorl UI?

A

Binds and blocks the M3 receptor site so that AcH cannot stimulate m3 muscarinic receptor which in turn prevents overstimulation of detrusor muscle.

65
Q

Enablex is contraindicated for what 3 types of patients?

A
  1. Patients with narrow angle glaucoma
  2. Patients at risk or with Urinary or Gastric retention
  3. Patients that are hypersensitive to the drug ingredients
66
Q

Enablex is a ____ type of drug

A

Anti-Cholinergic

67
Q

Doctors should advise patients not to ____ until they konw how Enablex affects them.

A

Drive or operate heave machinery.

Basic Training Study Guide (5 decks)

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