Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Applied Pharmacology > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

α-blockers : Examples

A
  • Doxazosin
  • Tamsulosin
  • Alfuzosin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

α-blockers : Indications

A

1) 1st line in BPH

2) Add-on treatment in resistant hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

α-blockers : MOA

A
  • α1-adrenoceptors are found mainly in smooth muscle, including in blood vessels and the urinary tract (the bladder neck and prostate in particular).
  • Stimulation induces contraction; blockade induces relaxation.
  • α1-blockers therefore cause vasodilatation and a fall in blood pressure (BP), and reduced resistance to bladder outflow.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

α-blockers : Adverse Effects

A
  • Postural hypotension
  • Dizziness
  • Syncope
    (most prominent after 1st dose)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

α-blockers: Contraindications

A
  • Existing postural hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

α-blockers: Interactions

A
  • Other anti-hypertensive (may be intentionally used for therapeutic aim)
  • -> omit 1 dose of other anti-hypertensives when starting this medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

α-blockers : Prescribing

A
  • Oral

- Best to take at night time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

α-blockers: Monitoring

A
  • Efficacy dependent on urinary symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

α-blockers: Patient Education

A
  • Explain about side effect after 1st dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antimuscarinics - Examples

A
  • Oxybutynin
  • Tolterodine
  • Solifenacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antimuscarinics - Indications

A
  • Reduce urinary frequency, urgency and urge incontinence in overactive bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antimuscarinics - MOA

A
  • Antimuscarinic drugs bind to muscarinic receptors, where they act as a competitive inhibitor of acetylcholine.
  • Contraction of the smooth muscle of the bladder is under parasympathetic control.
  • Blocking muscarinic receptors therefore promotes bladder relaxation, increasing bladder capacity.
  • In patients with overactive bladder, this may reduce urinary frequency, urgency and urge incontinence.
  • Antimuscarinics help in overactive bladder through antagonism of the M3 receptor, which is the main muscarinic receptor subtype in the bladder.
  • Solifenacin is more selective for the M3 receptor, which may reduce side effects.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antimuscarinics - Adverse Effects

A
  • Dry mouth
  • Tachycardia, constipation + blurred vision
  • Urinary retnetion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antimuscarinics - Contraindications

A
  • UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Antimuscarinics - Caution

A
  • Elderly especially with dementia
  • Angle-closure glaucoma : dangerous rise in intraocular pressure
  • Arrhythmias
  • Urinary retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Antimuscarinics - Interactions

A
  • Tricyclic antidepressants (causes more adverse effects)
17
Q

Antimuscarinics - Prescribing

A
  • only prescribe for urge incontinence after an adequate trial of bladder retraning
18
Q

Antimuscarinics - Monitoring

A
  • Review within a month of starting therapy to check response and SE
19
Q

Antimuscarinics - Patient education

A
  • Medication relaxes bladder
  • reduces how often they need to pass water
  • Explain SE - dry mouth
  • Safety net- in elderly, stop if there is drowsiness and confusion
20
Q

Phosphodiesterase (type 5) inhibitors : Examples

A

Sildenafil

21
Q

Phosphodiesterase (type 5) inhibitors: Indications

A

1) Erectile dysfunction

2) Primary pulmonary hypertension

22
Q

Phosphodiesterase (type 5) inhibitors : MOA

A
  • PDE type 5 (PDE-5) is found predominantly in the smooth muscle of the corpus cavernosum of the penis and arteries of the lung.
  • For an erection to occur, sexual stimulation is required.
  • This releases nitric oxide (NO), which stimulates cyclic guanosine monophosphate (cGMP) production, causing arterial smooth muscle relaxation, vasodilatation and penile engorgement.
  • As PDE-5 is responsible for the breakdown of cGMP, inhibition of this enzyme by sildenafil increases cGMP concentrations, improving penile blood flow and erection quality.
  • Sildenafil does not cause an erection without sexual stimulation.
  • In the pulmonary vasculature, sildenafil causes arterial vasodilatation by similar mechanisms and so is used to treat primary pulmonary hypertension.
23
Q

Phosphodiesterase (type 5) inhibitors : Adverse Effects

A

SE due to vasodilator:

  • Flushing
  • Headache
  • Dizziness
  • Nasal congestion

More serious:

  • Hypotension
  • Tachycardia
  • Palpitation
  • Visual disorders (colour distortion)
24
Q

Phosphodiesterase (type 5) inhibitors : Contraindication

A
  • Stroke
  • ACS
  • Cardiovascular disease
25
Q

Phosphodiesterase (type 5) inhibitors : Caution

A
  • Hepatic or renal impairment
26
Q

Phosphodiesterase (type 5) inhibitors : Interactions

A

Should not be prescribe with:
- nitrated or nicorandil
(increases nitric oxide conc, increased vasodilation)

Caution with other vasodilators:

  • α-blockers
  • CCB

Cytochrome P450 inhibitors:

  • e.g. amiodarone, diltiazem + fluconazole
  • SE increased
27
Q

Phosphodiesterase (type 5) inhibitors : Prescribing

A
  • Take 1 hour before sex (max 1 dose a day)

- if taken with food, onset of effect is delayed

28
Q

Phosphodiesterase (type 5) inhibitors : Monitoring

A
  • Review for therapeutic efficacy and SE

- Pulmonary hypertension - review regularly with a specialist

29
Q

Phosphodiesterase (type 5) inhibitors : Patient Education

A
  • Explain: drug will not produce an erection without sexual stimulation but only helps them have and maintain it.
30
Q

5α-reductase inhibitors: Examples

A

Finasteride

31
Q

5α-reductase inhibitors: Indications

A

BPH

  • 2nd line after α-blockers
  • improve LUTs (urinary retention, poor floor)
32
Q

5α-reductase inhibitors: MOA

A
  • 5α-reductase inhibitors reduce the size of the prostate gland.
  • They do this by inhibiting the intracellular enzyme 5α-reductase, which converts testosterone to its more active metabolite dihydrotestosterone.
  • As dihydrotestosterone stimulates prostatic growth, inhibition of its production by 5α-reductase inhibitors reduces prostatic enlargement and improves urinary flow.
  • However, it can take several months for this effect to become evident clinically.
  • For this reason, an α-blocker is usually preferred for initial therapy, with a 5α-reductase inhibitor added if the response is poor or if the prostate is particularly bulky.
33
Q

5α-reductase inhibitors: Adverse Effects

A
  • Impotence + reduced libido
  • Gynaecomastia
  • Hair growth
  • Breast cancer
34
Q

5α-reductase inhibitors: Contraindications

A
  • Pregnant women
35
Q

5α-reductase inhibitors: Interactions

A

None

36
Q

5α-reductase inhibitors: Prescribing

A
  • Oral
37
Q

5α-reductase inhibitors: Monitoring

A
  • Follow-up 3-6 months to review LUTs and SE

- Continue check-ups every 6-12 months while on treatment

38
Q

5α-reductase inhibitors: Patient Education

A
  • Main of treatment is to reduce the bulk of the prostate gland
  • -> relive compression on the tube and easier to pass urine
  • May take upto 6 months for symptoms to improve
  • SE: less keen to have sex, inability to get or keep an erection

Applied Pharmacology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions