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PHARM > GU > Flashcards

GU Flashcards

1
Q

Are anticholinergics muscarinic agonists or antagonists?

A

antagonists

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2
Q

Example of muscarinic antagonist for reversal of Bethanechol toxicity?

A

Atropine

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3
Q

MOA of Atropine?

A

Will help the heart speed up by blocking the cholinergic receptors.

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4
Q

Prototype for muscarinic agonist for urinary retention?

A

Bethanechol (Urecholine)

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5
Q

Therapeutic use of Bethanechol?

A

urinary retention

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6
Q

MOA of Bethanechol?

A

Stimulates the release of Ach which activates the PNS

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7
Q

What are the adverse effects of Bethanechol?

A

Hypotension, bradycardia, increased tone and motility of GI, exacerbation of asthma, dysrhythmias in patients with hyperthyroidism.

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8
Q

Sx of Bethanechol toxicity?

A

profuse salivation, lacrimation, visual disturbances, bronchospasms, diarrhea, bradycardia, hypotension, cardiovascular collapse.

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9
Q

What is the tx for Bethanechol toxicity?

A

Atropine and supportive therapy

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10
Q

How do we evaluate the effectiveness of Bethanechol?

A

monitor I/Os

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11
Q

Contraindications for Bethanechol?

A

PUD, urinary or GI obstruction, coronary insufficiency, hypotension, asthma, and hyperthyroidism

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12
Q

How is Bethanechol taken in regards to meals?

A

PO 1 hour AC or 2 hrs PC to reduce gastric upset

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13
Q

What are the 4 major symptoms of an overactive bladder?

A

urgency, frequency, nocturia, and urge incontinence.

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14
Q

Prototype for anticholinergic drug for overactive bladder?

A

Oxybutynin (Ditropan XL, Oxytrol)

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15
Q

Therapeutic use for Oxybutynin?

A

overactive bladder

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16
Q

Adverse effects of of Oxybutynin?

A

anticholinergic effects: Xerostomia (dry mouth), blurred vision, photophobia, constipation, hyperthermia

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17
Q

Symptoms of Oxybutynin overdose?

A

dry mouth, blurred vision, photophobia, hyperthermia, hallucinations, and delirium; the skin becomes hot, dry, and flushed.

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18
Q

What is the reversal agent for Oxybutynin toxicity?

A

Physostigmine

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19
Q

Available routes for Oxybutynin?

A

transdermal patch and topical gel

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20
Q

Oxybutynin is contraindicated in who?

A

patients with glaucoma, intestinal atony, urinary tract obstruction, and tachycardia.

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21
Q

Name 2 examples of PDE5 inhibitors?

A

Viagra and Cialis

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22
Q

What is PED5 enzyme?

A

it converts available cGMP into GMP and the erection subsides

23
Q

Therapeutic uses for Sildenafil (Viagra)?

A

erectile dysfunction and pulmonary arterial HTN

24
Q

Is Sildenafil taken in regards to meals?

A

No, but high fat meals can slow down absorption

25
Q

When should Sildenafil be taken?

A

1 hr before sexual activity

26
Q

Interactions with Sildenafil?

A

nitrates, alpha blockers, and CYP40 inhibitors.

27
Q

Adverse effects of Sildenafil?

A

Hypotension, priapism, HA, dyspepsia, flushing, nasal congestion, diarrhea, rash, dizziness, mild transient visual disturbances, intensification of OSA.

28
Q

Rare side effects of Sildenafil?

A

Nonarteritic ischemic optic neuropathy (NION) and sudden hearing loss.

29
Q

Who should be cautious with Sildenafil?

A

men with recent MI, stroke, or life threatening dysrhythmia in the past 6 months; resting hypotension (<90/50); resting HTN (>170/110); heart failure; unstable angina

30
Q

Which PDE5 inhibitor lasts the longest (36 hours)?

A

Tadalafil (Cialis)

31
Q

Adverse effects of Taldalafil?

A

Headache, dyspepsia, back pain, myalgia, limb pain, flushing, nasal congestion. Can also be associated with NAION and sudden hearing loss.

32
Q

Meds to avoid while taking Taldalfil?

A

nitrates and alpha blockers except Tamsulosin (Flomax)

33
Q

Food interactions with Sildenafil?

A

grapefruit juice

34
Q

Two types of obstructions that cause BPH?

A

mechanical and dynamic obstruction

35
Q

What is a mechanical obstruction?

A

when there is an overgrowth of epithelial cells

36
Q

What is a dynamic obstruction?

A

When there is an overgrowth of smooth muscle cells. The prostate is not enlarged, but still same problem.

37
Q

Which drug can decrease epithelial overgrowth in BPH?

A

Finesteride (Proscar)

38
Q

Therapeutic use for Finasteride?

A

BPH for individuals with very large prostates

39
Q

Adverse effects of Finasteride?

A

Decreases ejaculation volume and libido, gynecomastia.

40
Q

Black box warning for Finasteride?

A

teratogenic to male fetus

41
Q

Effects of Finasteride when taken in smaller doses?

A

propecia-promotes hair growth

42
Q

When will Finasteride produce improved urination?

A

3-6 months

43
Q

How does Finasteride affect PSA levels?

A

may decrease them

44
Q

Interactions with Finasteride?

A

anticholinergics and testosterone

45
Q

Which alpha 1 adrenergic antagonist is approved for tx of BPH?

A

Tamsulosin (Flomax)

46
Q

Therapeutic use for Tamsulosin?

A

BPH with small prostates/dynamic obstruction

47
Q

Off-label use for Flomax?

A

urinary hesitancy or retention in women

48
Q

MOA of Flomax?

A

Relaxes urethra neck and prostate; selective for alpha1a receptors (will not affect BP)

49
Q

Adverse effects of Tamsulosin?

A

Abnormal ejaculation (ejaculation failure, reduced volume, retrograde ejaculation)

50
Q

Interactions with Tamsulosin?

A

anticholinergics and testosterone

51
Q

Does Flomax lower PSA levels?

A

No

52
Q

When should Flomax be taken?

A

30 min after same meal QD

53
Q

How is effectiveness of Tamsulosin evaluated?

A

noting decreased urinary frequency, hesitancy, urgency, dribbling, nocturia

PHARM (35 decks)

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