Genitourinary Flashcards
What are the indications for Alpha blockers?
- First line treatment of BPE
- Add on treatment for resistant hypertension
What is the MOA for alpha blockers?
- Highly selective for a1 adrenoceptrs
- Blocking this receptor causes vasodilation and a fall in BP
- This causes reduction to bladder outflow
What are examples of Alpha blockers?
Doxasozin and tamulosin
What clinical tip can be used with alpha blockers?
Men with both hypertension and BPE can be started earlier on an alpha blocker to treat both conditions with the same drug
What are common side effects of alpha blockers?
- Postural hypertension
- Dizziness
- Syncope
What is a warning with alpha blockers?
Should be used in caution with other antihypertensives as it can increase the risk of postural hypertension
What are the indications for antimuscarinics?
Treatment of overactive bladder
- To reduce urinary frequency
- Urgency and urge incontinence
What are some examples of antimuscarinics?
oxybutynin, tolterodine, solifenacin
What is the MOA of antimuscarinics?
- Bind to muscarinic receptors, competitive inhibitor of acetylcholine
- This promotes bladder relaxation, increasing bladder capacity
- This helps reduce urinary frequency, urgency and urge incontinence
What are the common side effects of antimuscarinics?
- Dry mouth (very common side effect)
- Tachycardia
- Constipation
- Blurred vision
What are the warnings of antimuscarinics?
- Angle-closure glaucoma
- Arrythmias
- Urinary retention
What clinical tip can be given for the common side effect of antimuscarinics?
Things to help dry mouth include:
- Chewing gum
- Sucking on sugar free sweets
What are PDE-5 inhibitors used for?
Erectile dysfunction
What are contraindications of PDE-5 inhibitors?
- People with hypotension
- Recent MI or stroke
- Severe heart disease
What is the MOA of PDE-5 inhibitors ?
- The enzyme phosphodiesterase type 5 is blocked
- This increases cGMP concentrations, improving penile blood flow and erection quality
This still requires sexual stimulation
