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Advanced Pharmacology > GU > Flashcards

GU Flashcards

1
Q

Symptoms of Cystisis

A
  1. urgency 2. frequency 3. Dysuria 4. Pressure/fullness in the suprapubic area 5. Back pain
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2
Q

The provider is assessing a patient who is presenting with symptoms of uncomplicated cystitis what would be the first line treatment?

A
  1. Bactrim (3days) 2. Marcobid (5 days) 3. Fosfomycin (1 gram, once)
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3
Q

The provider is assessing a patient who is presenting to the ER with symptoms of uncomplicated cystitis, they can not take any of the first line treatments, what would the prescriber use?

A
  1. Ciprofloxacin (3 days) 2. Levofloxican (3 days)
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4
Q

A patient presents with complicated cystitis, what would the provider prescribe?

A
  1. Ciprofloxacin (7 days) 2. Levofloxacin (7 days)
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5
Q

A patient presents to the ER with signs of polynephritis, what does the provider prescribe?

A
  1. Ciprofloxacin (10-14 days) 2. Levofloxacin (10-14 days)
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6
Q

What is an alternative therapy that can be used to treat cystitis and polynephritis

A

Amoxicillin- Clavulanate (Augmentin)

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7
Q

Symptoms of polynephritis

A
  1. Flank pain 2.Nausea 3. Vomiting 4. Fever (100.4)
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8
Q

Along side an antibiotic for treatment of cystitis a provider might prescribe a urinary analgesic, what are their names?

A
  1. Phenzapyridine (Pyridium) 200 mg TID 2. Azo OTC 100 mg 3. Flovxate (Uripas) 100-200 TID-QID
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9
Q

What are the adverse effects of taking AZO?

A

Discolors the urine red/orange

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10
Q

If you are prescribed floxvate (Uripas) how should you take this medication?

A

After meals

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11
Q

When a prescriber is treating an elderly patient for a UTI what are some considerations they may think about?

A
  1. UTI’s are commonly asymptomatic, but are considered a strong diagnostic finding is a patient has altered mentation. 2. Elderly are at increased risk for UTIs due to immobility, cormobities, etc.
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12
Q

When a provider is assessing and treating a pregnant women for a UTI what are some clinical considerations should the provider know

A
  1. Usually Asymptomatic (7%), polynephritis develops in 30%. 2. Untreated UTI’s can contribute to prematurity or still born births
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13
Q

What is the treatment for UTI’s in pregnant women and is considered safe for the fetus?

A

Amoxicillin

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14
Q

What are other agents the provider could prescribe to a pregnant woman with a UTI?

A
  1. Cephalexin 2. Macrobid 3. Sulfonamides
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15
Q

What is the preferred time frame for a prescriber to treat a pregnant woman with nitrofurantoin (Macrobid)

A

Only the second and third trimester, stop at 38 weeks or if the mother is about to give birth. Patient will receive too much of this medication

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16
Q

What is the preferred time frame for a prescriber to use a sulfonamide to treat a UTI in a pregnant patient and why?

A

ONLY THE SECOND TRIMESTER. Women can not take this medication in the first trimester because it is a folic acid inhibitor and the baby needs folic acid for brain and spinal cord development

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17
Q

Special Considerations when it comes to children with UTI’s

A

treat them quickly because there is an increased risk of renal scarring in children under 5 years old

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18
Q

Preferred treatment of UTI’s for children

A

Augmentin, Bactrim, cephalexin or cefpodximine

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19
Q

What is the chief organism behind acute bacterial prostatitis

A
  1. E. coli 2. Pseudomonas (sometimes strep and staph)
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20
Q

What are the chief organisms behind chronic bacterial prostatitis

A
  1. E.coli 2. pseudomonas 3. Klebsilla 4. Enterococcus
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21
Q

What is the treatment the provider will prescribe to a patient who is at risk for sexual transmitted diseases with prostatitis?

A

Cefetriaxzone IM+ Doxycycline for 10 days

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22
Q

What is the treatment the provider will prescribe to a patient who is not at risk for sexually transmitted infections with prostatitis

A
  1. Ciprofloxacin (10-14 days) 2. Levofloxacin (10-14 days)
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23
Q

Diagnostic tool used for Benign Prostatic Hyperplasia

A

American Urological Association Index

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24
Q

When assessing a patient with BPH the provider uses the AUASI to properly diagnosis the patient, upon assessment the patient is know to be in the mild stage, what is the points scored?

A

Mild 0-7 points

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25
Q

When assessing a patient with BPH the provider uses the AUASI to properly diagnosis the patient, upon assessment the patient is know to be in the moderate stage, what is the points scored?

A

Moderate 8-19

26
Q

When assessing a patient with BPH the provider uses the AUASI to properly diagnosis the patient, upon assessment the patient is know to be in the severe stage, what is the points scored?

A

Severe 20-35

27
Q

What is the treatment for a patient in the mild stage of BPH

A
  1. Watchful waiting 2. Lifestyle changes
28
Q

What are some of the lifestyle changes the provider can educate the patient on with a diagnosis of BPH?

A
  1. Limit fluid intake before bed 2. Avoid mild diuretics like caffeine and alcohol 3. Avoid constipation 4. Increase physical activity
29
Q

What is the second line treatment for a patient with BPH?

A

Alpha Adrenergic Blockers and 5-a reductase inhibitors and phosphodiesterase inhibitors

30
Q

What are the names of Alpha Adrenergic Blockers

A
  1. Terazosin (hytrin) 2. Doxazosin (Cardura) 3. Prazosin (Minipress) 4. Tamsulosin ( Flomax) Silodosin (Rapaflo)
31
Q

What are the adverse effects a patient needs to educated on when prescribed and alpha adrenergic blocker?

A
  1. Hypotension 2. Intraoperative floppy iris syndrome
32
Q

Alpha Adrenergic Blockers MOA:

A

Treat acute symptoms of BPH

33
Q

5 Alpha Reductase inhibitor names:

A
  1. Finasteride (Proscar) 2. Dutasteride ( Avodart)
34
Q

Why do providers prescribe 5-alpha reductase inhibitors?

A

To prevent the procession of BPH

35
Q

What are the adverse effects of 5- alpha reductase inhibitors

A
  1. PSA level suppression 2. increased risk of prostate cancer
36
Q

Before a provider starts a patient on a 5 alpha reductase inhibitor what lab should the provider request

A

A PSA level

37
Q

What is the phosphodieasterase inhibitor used in BPH

A

Tadalifil (Cialis)

38
Q

What is the third line treatment for BPH

A

Alpha adrenergic blockers and 5-alpha reductase inhibitors combined : Dutasteride/Tamsulosin (Jalyn)

39
Q

What are the risk factors for Erectile Dysfunction

A
  1. Advanced Age 2. Cardiovascular Disease 3. Cigarette smoking 4. DM 5. History of pelvic surgery 6. hormone disorders 7. Hyperchloestermia 8. Hypertension 9. illicit drug use (cocaine, meth) 10. Medications (antihistamines, benzo’s, SSRI) 11. Neurologic conditions (AZ, Parkinsons, MS) 12. Obesity 13. Venous Leakage 14. physiological conditions 15. Sedentary lifestyle
40
Q

What is the preferred treatment for erectile dysfunction

A

phosphodiesterase inhibitors

41
Q

MOA of phosphodiesterase inhibitors

A

promote penile erection by inhibiting the breakdown of one of the messengers involved in erectile response

42
Q

What are the names of phosphodiesterase inhibitors a provider will prescribe

A
  1. Sidinifil ( Viagra) 2. Tadalifil (Cialis) 3. Vardenafil (Levitra) 4. Avanifil (Stendra)
43
Q

Adverse effects of phosphodiesterase inhibitors

A
  1. flushing 2. headache 3. Dyspepsia
44
Q

Contraindications to be mindful of when prescribing a phosphodiesterase inhibitor

A

Can not mix with nitrates due to the vasodilation additive effect

45
Q

Over Active Bladder Diagnosis

A
  1. The presence of urgency with or without nocturia 2. GU exam and urinary analysis 3. Past medical history 4. Evaluate urethra, bladder and pelvic floor muscles
46
Q

First line treatment for OAB

A
  1. Bladder training
47
Q

Second line treatment for OAB

A
  1. Anticholenergics and Antimuscarinics
48
Q

What are the names of the Anticholinergic/Antimuscarinics used to treat OAB

A
  1. Oxybutynin (Oxytrol Transdermal Patch) 2. Tolterodone ER (Detrol LA) 3. Trospium extended release (Trospium ER) 4. Solifenacin 5. Darifenacin hydrobromide (Enablex) 6. Festerodine (Tovaiz)
49
Q

Contraindications when prescribing second line treatment for OAB

A
  1. dementia 2. AZ 3. Uncontrolled tachycardia 4. MG 5. Gastric retention 6. Narrow Angle Glaucoma
50
Q

If you can not use the second line treatment for OAB you can use a Beta 3- adrenoreceptor agonist named

A

Mirabegron (Myrbetriq)

51
Q

Adverse effects of beta 3 adrenorecptor agonist

A

Hypotension

52
Q

First line treatment for Chlamydia

A
  1. Azthromycin 1 gram PO 2. Doxycycline 100 MG BID for 7 days
53
Q

HPV treatment first line

A

Prevention with the vaccine 9-26 year olds no greater than 45

54
Q

HPV second line treatment patient applied

A
  1. Podofilox 0.5% solution or gel for 3 days then 4 days of no therapy 2. Imiquimod 5% cream 3 times a week for up to 16 weeks
55
Q

HPV second line treatment provider applied

A
  1. Podophyllin resin 10-25% in compound tincture of benzoin weekly as needed 2. Trichloroacetic acid or bichloraetic acid 80-90% weekly as needed
56
Q

Syphilis Primary Infection

A

An ulcer chancre at the infection site that erupts approximately 3 weeks after exposure

57
Q

Syphilis Secondary Infection

A

Low grade fever, malaise, sore throat, harness, headache, anorexia, rash, lesions, alopecia, and adenopathy

58
Q

Syphilis Tertiary Infection

A

Cardiac, neurologic, ophthalmic, auditory or gummatous lesions

59
Q

What is the treatment for Early, primary, second or latent syphilis less than 1 year

A
  1. Adult: benzathine penicillin G 2.4 million U IM single dose 2. Child; 500,000 U/kg up to 2.4 million U IM single dose
60
Q

What is the treatment for latent syphilis disease > 1 year or unknown duration

A
  1. Adult: benzathine penicillin G 2.4 million U IM for 3 doses at 1 week intervals 2. Child; 500,000 U/kg up to 2.4 million U IM for 3 doses at 1 week intervals.

Advanced Pharmacology (5 decks)

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