gen Flashcards
What are the brand names of Oxybutynin?
Ditropan, Gelnique Top Gel, Oxytrol TD patch
What drug class is Oxybutynin in?
Antimuscarinic
What are the indications for Oxybutynin?
Overactive or neurogenic bladder
(Primary hyperhidrosis - Off-label)
What is the mechanism of action of Oxybutynin?
Competitive muscarinic receptor antagonist; antispasmodic
What are the major contraindications for Oxybutynin?
Hypersensitivity to oxybutynin, Gastric retention, Glaucoma, Urinary retention
What are the black box warnings for Oxybutynin?
None
What are the common adverse drug reactions for Oxybutynin?
Constipation, Xerostomia, Blurred vision
What are the rare but serious adverse drug reactions for Oxybutynin?
Prolonged QTc interval, Seizures, Tachycardia
What are the key counseling points for Oxybutynin?
Anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Impaired cognitive function - elderly (think of etiology of Alzheimer’s)
What are the brand names of Tolterodine?
Detrol, Detrol LA
What drug class is Tolterodine in?
Antimuscarinic
What is the indication for Tolterodine?
Bladder muscle dysfunction, overactive
What is the mechanism of action of Tolterodine?
Competitive muscarinic receptor antagonist, has a high binding affinity for the cholinergic muscarinic receptors that mediate contraction of the urinary bladder and salivation. The drug exerts its significant effects on the lower urinary tract by increasing the residual urine and decreasing detrusor pressure.
What are the major contraindications for Tolterodine?
Hypersensitivity to tolterodine, fesoterodine; Gastric retention; Uncontrolled narrow-angle glaucoma; Urinary retention
What are the black box warnings for Tolterodine?
None
What are the common adverse drug reactions for Tolterodine?
Xerostomia
What are the rare but serious adverse drug reactions for Tolterodine?
Tachycardia, QTc prolongation, Angioedema, Hallucinations
What are the key counseling points for Tolterodine?
Avoid activities requiring mental alertness or coordination until drug effects are realized, as this drug may cause blurred vision, dizziness, and drowsiness. Swallow extended-release capsule whole; do not crush, break, or chew. In the presence of a high environmental temperature, heat prostration can occur with drug use (fever and heat stroke due to decreased sweating). If symptoms occur, the drug should be discontinued and supportive measures instituted.
What is the brand name of Fesoterodine?
Toviaz
What drug class is Fesoterodine in?
Antimuscarinic
What is the brand name of Trospium?
Santura
What drug class is Trospium in?
Antimuscarinic
What is the brand name of Darifenacin?
Enablex
What drug class is Darifenacin in?
Antimuscarinic
What is the indication for Darifenacin?
Overactive bladder
What is the mechanism of action of Darifenacin?
Competitive muscarinic receptor antagonist. Muscarinic receptors play an important role in several major cholinergically mediated functions, including contractions of the urinary bladder smooth muscle and stimulation of salivary secretion.
What are the major contraindications for Darifenacin?
Hypersensitivity to darifenacin, Gastric retention, Glaucoma, Urinary retention
What are the black box warnings for Darifenacin?
None
What are the common adverse drug reactions for Darifenacin?
Constipation, Xerostomia, Blurred vision
What are the rare but serious adverse drug reactions for Darifenacin?
Angioedema
What are the key counseling points for Darifenacin?
The drug may cause anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Heat prostration (due to decreased sweating) can occur when used in a hot environment. Can be taken with or without food. Seek medical attention for signs and symptoms of angioedema (swelling of tongue or laryngopharynx, difficulty breathing, etc).
What are the brand names of Solifenacin?
Vesicare, Vesicare LS
What drug class is Solifenacin in?
Antimuscarinic
What are the indications for Solifenacin?
Overactive bladder, Neurogenic detrusor overactivity
What is the mechanism of action of Solifenacin?
Competitive muscarinic receptor antagonist. Muscarinic receptors play an important role in several major cholinergically mediated functions, including contractions of the urinary bladder smooth muscle and stimulation of salivary secretion.
What are the major contraindications for Solifenacin?
Hypersensitivity to solifenacin, Gastric retention, Uncontrolled glaucoma, Urinary retention
What are the black box warnings for Solifenacin?
None
What are the common adverse drug reactions for Solifenacin?
Constipation, Xerostomia, Blurred vision
What are the rare but serious adverse drug reactions for Solifenacin?
Angioedema, QTc prolongation, Exfoliative dermatitis
What are the key counseling points for Solifenacin?
This drug may cause anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Heat prostration (due to decreased sweating) can occur when used in a hot environment and/or exercise.
What is the brand name of Mirabegron?
Myrbetriq
What drug class is Mirabegron in?
β3 Adrenergic Receptor Agonist
What are the indications for Mirabegron?
Overactive bladder, Neurogenic detrusor overactivity (children/adolescents)
What is the mechanism of action of Mirabegron?
Activates β3-adrenergic receptors resulting in relaxation of the detrusor smooth muscle and increasing bladder capacity.
What are the major contraindications for Mirabegron?
Hypersensitivity
What are the black box warnings for Mirabegron?
None
What are the common adverse drug reactions for Mirabegron?
Hypertension (NOTE - Vibegron does NOT have this same concern)
What are the rare but serious adverse drug reactions for Mirabegron?
Atrial fibrillation, Angioedema, Hallucination, Increased liver function enzymes
What are the key counseling points for Mirabegron?
Monitor BP and HR and contact HCP for fast heartbeat or elevations in BP, bladder irritation or difficulty with urination.
What is the brand name of Vibegron?
Gemtesa
What drug class is Vibegron in?
β3 Adrenergic Receptor Agonist
What are the brand names of Finasteride?
Proscar, Propecia
What drug class is Finasteride in?
5-α-Reductase Inhibitor
What are the indications for Finasteride?
Benign prostatic hyperplasia (BPH), Male pattern alopecia
(Hirsutism - Off-label)
What is the mechanism of action of Finasteride?
Inhibits the conversion of testosterone to 5α-dihydrotestosterone (DHT) by 5α-reductase, isoform 2. Results in decreases in static component of BPH (hyperplasia).
What are the major contraindications for Finasteride?
Hypersensitivity to finasteride, Pregnancy (including women of child bearing age coming in contact), Use in children
What are the black box warnings for Finasteride?
None
What are the common adverse drug reactions for Finasteride?
Impotence, Reduced libido, Gynecomastia, Dizziness
What are the rare but serious adverse drug reactions for Finasteride?
Heart failure, Angioedema, Allergic skin reactions, Male breast cancer, Prostate cancer (high grade)
What are the key counseling points for Finasteride?
Delayed effects (3 months alopecia, 3-6 month BPH), absorption through skin or from semen can prevent development of genitalia in an unborn male. Avoid blood donation as recipient may be pregnant.
What is the brand name for Dutasteride?
Avodart
What drug class is Dutasteride in?
5-α-Reductase Inhibitor
What is the indication for Dutasteride?
Benign prostatic hyperplasia
What is the mechanism of action of Dutasteride?
Inhibits the conversion of testosterone to 5α-dihydrotestosterone (DHT) by 5α-reductase, isoform 1 and 2.
What are the major contraindications for Dutasteride?
Hypersensitivity to dutasteride, Pregnancy, Use in children
What are the black box warnings for Dutasteride?
None
What are the common adverse drug reactions for Dutasteride?
Gynecomastia, Impotence, Reduced libido, Dizziness
What are the rare but serious adverse drug reactions for Dutasteride?
Heart failure, Angioedema, Allergic skin reactions
What are the key counseling points for Dutasteride?
Symptoms may not improve for up to 6 months after starting treatment. Do not donate blood while taking or for 6 months after stopping dutasteride, as it may be transfused to a pregnant woman. Women who are pregnant or may become pregnant should avoid touching or handling this medicine. This medicine can get into the body through the skin and may prevent development of genitalia in an unborn male baby.
What is the brand name for Tamsulosin?
Flomax
What drug class is Tamsulosin in?
α1-Adrenergic Blocker
What are the indications for Tamsulosin?
Benign prostatic hyperplasia
(Neurogenic bladder; Bladder outlet obstruction - Off-label)
What is the mechanism of action of Tamsulosin?
Selectively block postsynaptic α1-adrenergic receptors, specifically α-1a (prostate) and α-1D (bladder neck) reducing dynamic muscle tone.
What are the major contraindications for Tamsulosin?
Hypersensitivity to tamsulosin
What are the black box warnings for Tamsulosin?
None
What are the common adverse drug reactions for Tamsulosin?
Dizziness, Headache, Abnormal ejaculation, Rhinitis
What are the rare but serious adverse drug reactions for Tamsulosin?
Retinal detachment, Priapism
What are the key counseling points for Tamsulosin?
Orthostatic hypotension with 1st generation drugs. 2nd generation less likely to cause hypotension due to specificity to prostate receptors. Administer 30 mins after same meal daily as fasting increases bioavailability by 30%.
What is the brand name for Prazosin?
Minipress
What drug class is Prazosin in?
α1-Adrenergic Blocker
What is the brand name for Terazosin?
Hytrin
What drug class is Terazosin in?
α1-Adrenergic Blocker
What is the mechanism of action of Terazosin?
Selectively block postsynaptic α1-adrenergic receptors. Total peripheral resistance is reduced through arterial and venous dilations. Reflex tachycardia that occurs with other vasodilators is infrequent because there is no presynaptic α2-receptor blockade. Increases urine flow in BPH by relaxing smooth muscle tone in the bladder neck and prostate.
What are the major contraindications for Terazosin?
Hypersensitivity to terazosin
What are the black box warnings for Terazosin?
None
What are the common adverse drug reactions for Terazosin?
Asthenia, Dizziness
What are the rare but serious adverse drug reactions for Terazosin?
Hepatotoxicity
What are the key counseling points for Terazosin?
Avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause dizziness and somnolence. Rise slowly from a sitting/lying position, as this drug may cause orthostatic hypotension. May experience syncope or loss of consciousness with 1st dose. Take drug at bedtime to minimize side effects, especially the 1st dose. Avoid sudden discontinuation of drug, as this may cause rebound hypertension. Avoid alcohol while taking this drug.
What are the brand names for Doxazosin?
Cardura, Cardura XL
What drug class is Doxazosin in?
α1-Adrenergic Blocker
What are the indications for Doxazosin?
Benign prostatic hyperplasia, Hypertension
What is the mechanism of action of Doxazosin?
Selectively blocks postsynaptic α1-adrenergic receptors, reducing peripheral resistance through arterial and venous dilations. Reflex tachycardia that occurs with other vasodilators is infrequent because there is no presynaptic α2-receptor blockade.
What is the mechanism of action of Doxazosin?
Selectively blocks postsynaptic α1-adrenergic receptors, reducing peripheral resistance through arterial and venous dilations. Reflex tachycardia that occurs with other vasodilators is infrequent because there is no presynaptic α2-receptor blockade. Increases urine flow by relaxing smooth muscle tone in the bladder neck and prostate.
What are the major contraindications for Doxazosin?
Hypersensitivity to doxazosin or other quinazolines
What are the black box warnings for Doxazosin?
None
What are the common adverse drug reactions for Doxazosin?
Dizziness, Fatigue, Malaise
What are the rare but serious adverse drug reactions for Doxazosin?
Hepatotoxicity, Priapism
What are the key counseling points for Doxazosin?
Initial dose should be taken with breakfast, particularly with sustained-release products. Avoid activities requiring coordination until drug effects are realized, as drug may cause vertigo or dizziness. Rise slowly from a sitting/lying position, as this drug may cause orthostatic hypotension. Syncope or loss of consciousness is possible with first dose or dose increases, especially if patient is in an upright position. Report priapism to HCP immediately.
What is the brand name for Silodosin?
Rapaflo
What drug class is Silodosin in?
α1-Adrenergic Blocker
What is the brand name for Alfuzosin?
Uroxatral
What drug class is Alfuzosin in?
α1-Adrenergic Blocker
Which of the following are first generation α-blockers? (Alfuzosin, Doxazosin, Silodosin, Tamsulosin, Terazosin, Prazosin)
Doxazosin, Terazosin, Prazosin
Which of the following are second generation α-blockers? (Alfuzosin, Doxazosin, Silodosin, Tamsulosin, Terazosin, Prazosin)
Alfuzosin, Silodosin, Tamsulosin
What are the brand names for Tadalafil?
Cialis, Adcirca
What drug class is Tadalafil in?
Phosphodiesterase 5 Inhibitor
What are the indications for Tadalafil?
Erectile dysfunction, Benign prostatic hyperplasia, Pulmonary hypertension (High-altitude pulmonary edema, prevention & treatment - Off-label)
What is the mechanism of action of Tadalafil?
Inhibition of phosphodiesterase type 5 (PDE5), increasing cyclic guanosine monophosphate (c-GMP); results in vascular smooth muscle relaxation resulting in increased blood flow into the corpus cavernosum (ED) and vasodilation in the pulmonary bed (Pulm HTN).
What are the major contraindications for Tadalafil?
Hypersensitivity to PDE5 inhibitors, Concurrent nitrates, Concurrent HIV protease inhibitors when used for treating pulmonary HTN, Concurrent guanylate cyclase stimulators
What are the black box warnings for Tadalafil?
None
What are the common adverse drug reactions for Tadalafil?
Flushing, Nausea, Headache, Visual disturbances, Lack of blue/green color discrimination
What are the rare but serious adverse drug reactions for Tadalafil?
AMI, Seizures, Strokes, Sudden hearing loss, Priapism
What are the key counseling points for Tadalafil?
Take 30 min-4h prior to anticipated sexual activity, but not more frequently than q24h. Sexual stimulation is required to initiate response; the inhibition of PDE5 has no effect in the absence of sexual stimulation.
What is the nickname for Tadalafil?
The weekender
What are the brand names for Sildenafil?
Viagra, Revatio
What drug class is Sildenafil in?
Phosphodiesterase 5 Inhibitor
What are the indications for Sildenafil?
Erectile dysfunction, Pulmonary hypertension
What is the mechanism of action of Sildenafil?
Inhibition of phosphodiesterase type 5 (PDE5) increases the amount of cyclic guanosine monophosphate (cGMP) enhancing erectile function and pulmonary vascular relaxation. Penile erection during sexual stimulation is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic GMP in smooth muscle cells. Cyclic GMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum and vasodilation in the pulmonary bed.
What are the major contraindications for Sildenafil?
Hypersensitivity to phosphodiesterase inhibitors, Concurrent nitrates, Concurrent HIV protease inhibitors when used for treating pulmonary HTN, Concurrent guanylate cyclase stimulators
What are the black box warnings for Sildenafil?
None
What are the common adverse drug reactions for Sildenafil?
Flushing, Nausea, Headache, Visual disturbances, Lack of blue/green color discrimination
What are the rare but serious adverse drug reactions for Sildenafil?
AMI, Seizures, Strokes, Sudden hearing loss, Priapism
What are the key counseling points for Sildenafil?
Take 30 min-4h prior to anticipated sexual activity, but do not take more frequently than once q24h.
What is the nickname for Sildenafil?
Little blue pill, Vitamin V
What are the brand names for Vardenafil?
Levitra, Staxyn
What drug class is Vardenafil in?
Phosphodiesterase 5 Inhibitor
What is the indication for Vardenafil?
Erectile dysfunction
What is the mechanism of action of Vardenafil?
Inhibition of phosphodiesterase type 5 (PDE5) increases the amount of cyclic GMP. Penile erection during sexual stimulation is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic GMP in smooth muscle cells. Cyclic GMP causes smooth muscle relaxation, increasing blood flow into the corpus cavernosum.
What are the major contraindications for Vardenafil?
Hypersensitivity to PDE inhibitors, Concurrent nitrates, Concurrent guanylate cyclase stimulators
What are the common adverse drug reactions for Vardenafil?
Flushing, Headache
What are the rare but serious adverse drug reactions for Vardenafil?
AMI, Seizures, Strokes, Sudden hearing loss, Priapism, Nonarteritic anterior ischemic optic neuropathy (NAION)
What are the key counseling points for Vardenafil?
Take 60 min prior to anticipated sexual activity. Do not take more frequently than once q24h. The orally disintegrating tablet should be placed on tongue immediately upon removal from packaging; the tablet should be taken whole and not crushed or split; do not take with any liquids. Oral tablet can be taken without regard to food. Advise patients that lifestyle modification (stopping smoking, weight loss) can also improve sexual functioning. Seek medical attention if chest pain, erection lasting > 4h, tinnitus, dizziness, shortness of breath.
What is the brand name for Avanafil?
Stendra
What drug class is Avanafil in?
Phosphodiesterase 5 Inhibitor
What is the nickname for Avanafil?
The quickie
What is the brand name for Phenazopyridine (Rx)?
Pyridium
What are the brand names for Phenazopyridine (OTC)?
Azo, Uristat
What drug class is Phenazopyridine in?
Urinary Tract Analgesic
What is the indication for Phenazopyridine?
Dysuria (Diagnostic aid, for ureteral or bladder visualization - Off-label)
What is the mechanism of action of Phenazopyridine?
Topical analgesic effect on the mucosa of the urinary tract; relieves pain, burning, urgency, and frequency. The precise mechanism of action is not known.
What are the major contraindications for Phenazopyridine?
Hypersensitivity to phenazopyridine, Renal failure
What are the black box warnings for Phenazopyridine?
None
What are the common adverse drug reactions for Phenazopyridine?
GI upset
What are the rare but serious adverse drug reactions for Phenazopyridine?
Anaphylaxis, Methemoglobinemia, Hemolytic anemia, Hepatotoxicity, Nephrotoxicity
What are the key counseling points for Phenazopyridine?
Drug may discolor urine and sclera to red or orange, causing staining of undergarments and contact lenses. Take drug with food to minimize GI upset.
