Genitourinary

Question 1

generic name and class

ditropan, gelnique top gel, oxytrol TD patch

Answer 1

generic: oxybutynin
class: antimuscarinics

drugs to stop peeing

Question 2

indication

oxybutynin

Answer 2

overactive bladder and neurogenic bladder

primary hyperhidrosis – off label

Question 3

MOA

oxybutynin

Answer 3

competitive muscarinic receptor antagonist; antispasmodic

Question 4

major contraindication

oxybutynin

Answer 4

hypersensitivity, gastric retention, glaucoma, urinary retention

Question 5

common ADRs

oxybutynin

Answer 5

constipation, xerostomia, blurred vision

Question 6

rare but serious ADRs

oxybutynin

Answer 6

prolonged QTc interval, seizures, tachycardia

Question 7

key counseling points

oxybutynin

Answer 7

• anticholinergic
• impaired cognitive function in elderly

Question 8

other antimuscarinics in top 300

generic - brand

Answer 8

• tolterodine - detrol
• darifenacin - enablex
• solifenacin - vesicare

Question 9

indication

mirabegron

Answer 9

overactive bladder and neurogenic detrusor overactivity (adolescents)

Question 9

generic name and class

myrbetriq

Answer 9

generic: mirabegron
class: beta 3 adrenergic receptor agonists

drugs to stop peeing

Question 10

MOA

mirabegron

Answer 10

Activates β3-adrenergic receptors resulting in relaxation of the detrusor smooth muscle and increasing bladder capacity.

Question 11

major contraindications

mirabegron

Answer 11

hypersensitivity

Question 12

common ADRs

mirabegron

Answer 12

hypertension

Question 13

rare but serious ADRs

mirabegron

Answer 13

• atrial fibrillation
• angioedema
• hallucinations
• increased liver function enzymes

Question 14

key counseling points

mirabegron

Answer 14

monitor BP and HR and contact HCP for fast heartbeat or elevations in BP, bladder irritation or difficulty with urination

Question 15

other beta 3 AR agonist in top 300

generic - brand

Answer 15

vibegron - gemtesa

Question 16

generic name and class

proscar, propecia

Answer 16

generic: finasteride
class: 5-alpha-reductase inhibitors

drugs to help you pee

Question 17

indication

finasteride

Answer 17

benign prostatic hyperplasia, male pattern alopecia

Question 18

MOA

finasteride

Answer 18

inhibits the conversion of testosterone to 5α-dihydrotestosterone (DHT) by 5α-reductase, isoform 2. Results in decreases in static component of BPH (hyperplasia)

Question 19

major contraindication

finasteride

Answer 19

• hypersensitivity
• pregnancy
• use in children

Question 20

common ADRs

finasteride

Answer 20

• impotence
• reduced libido
• gynecomastia
• dizziness

Question 21

rare but serious ADRs

finasteride

Answer 21

• heart failure
• angioedema
• allergic skin rxns
• male breast cancer
• prostate cancer (high grade)

Question 22

key counseling points

finasteride

Answer 22

• 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.

Question 23

other 5-ARI in top 300

generic - brand

Answer 23

dutasteride - avodart

Question 24

generic name and class | flomax

Answer 24

generic: tamsulosin class: alpha blockers | drugs to help you pee

Question 25

indication | tamsulosin

Answer 25

BPH

Question 26

MOA | tamsulosin

Answer 26

selectively block postsynaptic α1-adrenergic receptors, specifically alpha-1A (prostate) and alpha-1D (bladder neck) reducing dynamic muscle tone.

Question 27

major contraindications | tamsulosin

Answer 27

hypersensitivity

Question 28

common ADRs | tamsulosin

Answer 28

* dizziness * headache * abnormal ejaculation * rhinitis

Question 29

rare but serious ADRs | tamsulosin

Answer 29

retinal detachment and priapism

Question 30

key counseling points | tamsulosin

Answer 30

orthostatic hypotension with 1st generation drugs. 2nd generation less likely to cause hypotension due to specificity to prostate receptors

Question 31

generic name and class | cialis and adcirca

Answer 31

generic: tadalafil class: phosphodiesterase type 5 inhibitors | drug to help you pee and with sex

Question 32

indication | tadalafil

Answer 32

erectile dysfunction, BPH and pulmonary hypertension

Question 33

MOA | tadalafil

Answer 33

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)

Question 34

major contraindication | tadalafil

Answer 34

* hypersensitivity * concurrent nitrates * concurrent HIV protease inhibitors when used for treating pulm HTN * concurrent guanylate cyclase stimulators

Question 35

common ADRs | tadalafil

Answer 35

* flushing * nausea * headache * visual disturbances * lack of blue/green color discrimination

Question 36

rare but serious ADRs | tadalafil

Answer 36

AMI, seizures, strokes, sudden hearing loss, priapism

Question 37

key counseling points | tadalafil

Answer 37

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.

Question 38

other PDE5 inhibitors in top 300 | generic - brand

Answer 38

* sildenafil - viagra, revatio * vardenafil - levitra, staxyn

Question 39

generic name and class | pyridium, azo, uristat

Answer 39

generic: phenazopyridine class: urinary tract analgesics | drugs to sstop it from hurting when you pee

Question 40

indication | phenazopyridine

Answer 40

dysuria

Question 41

MOA | phenazopyridine

Answer 41

topical analgesic effect on the mucosa of the urinary tract; relieves pain, burning, urgency, and frequency. The precise mechanism of action is not known

Question 42

major contraindications | phenazopyridine

Answer 42

hypersensitivity and renal failure

Question 43

common ADRs | phenazopyridine

Answer 43

GI upset

Question 44

rare but serious ADRs | phenazopyridine

Answer 44

* anaphylaxis * methemoglobinemia * hemolytic anemia * hepatotoxicity * nephrotoxicity

Question 45

key counseling points

Answer 45

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)