Genitourinary Flashcards
generic name and class
ditropan, gelnique top gel, oxytrol TD patch
generic: oxybutynin
class: antimuscarinics
drugs to stop peeing
indication
oxybutynin
overactive bladder and neurogenic bladder
primary hyperhidrosis – off label
MOA
oxybutynin
competitive muscarinic receptor antagonist; antispasmodic
major contraindication
oxybutynin
hypersensitivity, gastric retention, glaucoma, urinary retention
common ADRs
oxybutynin
constipation, xerostomia, blurred vision
rare but serious ADRs
oxybutynin
prolonged QTc interval, seizures, tachycardia
key counseling points
oxybutynin
- anticholinergic
- impaired cognitive function in elderly
other antimuscarinics in top 300
generic - brand
- tolterodine - detrol
- darifenacin - enablex
- solifenacin - vesicare
indication
mirabegron
overactive bladder and neurogenic detrusor overactivity (adolescents)
generic name and class
myrbetriq
generic: mirabegron
class: beta 3 adrenergic receptor agonists
drugs to stop peeing
MOA
mirabegron
Activates β3-adrenergic receptors resulting in relaxation of the detrusor smooth muscle and increasing bladder capacity.
major contraindications
mirabegron
hypersensitivity
common ADRs
mirabegron
hypertension
rare but serious ADRs
mirabegron
- atrial fibrillation
- angioedema
- hallucinations
- increased liver function enzymes
key counseling points
mirabegron
monitor BP and HR and contact HCP for fast heartbeat or elevations in BP, bladder irritation or difficulty with urination
other beta 3 AR agonist in top 300
generic - brand
vibegron - gemtesa
generic name and class
proscar, propecia
generic: finasteride
class: 5-alpha-reductase inhibitors
drugs to help you pee
indication
finasteride
benign prostatic hyperplasia, male pattern alopecia
MOA
finasteride
inhibits the conversion of testosterone to 5α-dihydrotestosterone (DHT) by 5α-reductase, isoform 2. Results in decreases in static component of BPH (hyperplasia)
major contraindication
finasteride
- hypersensitivity
- pregnancy
- use in children
common ADRs
finasteride
- impotence
- reduced libido
- gynecomastia
- dizziness
rare but serious ADRs
finasteride
- heart failure
- angioedema
- allergic skin rxns
- male breast cancer
- prostate cancer (high grade)
key counseling points
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.
other 5-ARI in top 300
generic - brand
dutasteride - avodart
generic name and class
flomax
generic: tamsulosin
class: alpha blockers
drugs to help you pee
indication
tamsulosin
BPH
MOA
tamsulosin
selectively block postsynaptic α1-adrenergic receptors, specifically alpha-1A (prostate) and alpha-1D (bladder neck) reducing dynamic muscle tone.
major contraindications
tamsulosin
hypersensitivity
common ADRs
tamsulosin
- dizziness
- headache
- abnormal ejaculation
- rhinitis
rare but serious ADRs
tamsulosin
retinal detachment and priapism
key counseling points
tamsulosin
orthostatic hypotension with 1st generation drugs. 2nd generation less likely to cause hypotension due to specificity to prostate receptors
generic name and class
cialis and adcirca
generic: tadalafil
class: phosphodiesterase type 5 inhibitors
drug to help you pee and with sex
indication
tadalafil
erectile dysfunction, BPH and pulmonary hypertension
MOA
tadalafil
Inhibition of phosphodiesterase type 5 (PDE5) increases 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)
major contraindication
tadalafil
- hypersensitivity
- concurrent nitrates
- concurrent HIV protease inhibitors when used for treating pulm HTN
- concurrent guanylate cyclase stimulators
common ADRs
tadalafil
- flushing
- nausea
- headache
- visual disturbances
- lack of blue/green color discrimination
rare but serious ADRs
tadalafil
AMI, seizures, strokes, sudden hearing loss, priapism
key counseling points
tadalafil
Take 30 min-4 h prior to anticipated sexual activity, but not more
frequently q24h. Sexual stimulation is required to initiate response; the
inhibition of PDE5 has no effect in the absence of sexual stimulation.
other PDE5 inhibitors in top 300
generic - brand
- sildenafil - viagra, revatio
- vardenafil - levitra, staxyn
generic name and class
pyridium, azo, uristat
generic: phenazopyridine
class: urinary tract analgesics
drugs to sstop it from hurting when you pee
indication
phenazopyridine
dysuria
MOA
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
major contraindications
phenazopyridine
hypersensitivity and renal failure
common ADRs
phenazopyridine
GI upset
rare but serious ADRs
phenazopyridine
- anaphylaxis
- methemoglobinemia
- hemolytic anemia
- hepatotoxicity
- nephrotoxicity
key counseling points
Drug may discolor urine and sclera to red or orange, causing staining
of undergarments and contact lenses. Take drug with food to minimize
gastric irritation. Limit to 2 days of therapy. (Young women misuse)
