GU Flashcards
Examples of alpha blockers
Tamsulosin
Doxazosin
Alfuzosin
2 indications of alpha blockers
First line to improve lower urinary tract symptoms in benign prostatic a enlargement
Add on treatment to resistance hypertension when others are insufficient
MOA of alpha blockers
Alpha 1 adrenoreceptors are found mainly in smooth muscle
Stimulation induces contraction and blockage induced relaxation
Hence inhibiting it causes vasodilation
Side effects of alpha blocker
Postural hypotension
Dizziness
Syncope
Contraindication if alpha blockers
Existing postural hypotension
Key interactions of alpha blockers
Caution with beta blocker and pde-5 inhibitor
Examples of antimuscarinic (gu)
Solifenacin
Oxybutynin
Tolterodine
Indication of antimuscarinics (gu)
To reduce urinary freq, urgency and urge incontinence in overactive bladder
MOA of of antimuscarinics (gu)
Antimuscarinic drugs, bind to muscarinic receptors, where they act as a competitive inhibitor of ACh
Blocking muscarinic receptor, promotes bladder relaxation, increasing bladder capacity antimuscarinics, working overactive, bladder through antagonism at the entry receptor, which is the main muscarinic receptor subtype in the bladder.
Side effects of of antimuscarinics (gu)
Dry mouth, tachycardia, constipation blurred vision, urinary retention, drowsiness
Contraindication of of antimuscarinics (gu)
UTI
Caution in elderly care, dementia patients are susceptible to angle-closure glaucoma and arrhythmias. anyone with risk of urinary retention.
Key interactions of antimuscarinics (gu)
Tricyclic antidepressant
Monitoring of antimuscarinics (gu)
Review within one month of starting treatment
Examples of PDE-5 inhibitor
Sildenafil tadalafil vardenafil
2 indication of PDE-5 inhibitor
Erectile dysfunction and primary pulmonary hypertension
MOA of PDE-5 inhibitor
Nitric oxide is responsible for maintenance of an erection .
Nitrix oxide activate soluble quanylyl cyclase, which produces the second messenger cyclic guanosinr monophosphate, cGMP, which activates protein kinase G which causes vasodilation in penal arteries
PDE 5 degrades cGMP to GMP terminating its affect , PDE5 inhibitor therefore increase cGMP concentration in the penis improving the likelihood of achieving an erection and prolongs its duration. PDE 5 is also expressed in pulmonary vascular causes, pulmonary arterial vasodilation by similar mechanism so also used to treat primary pulmonary hypertension.
Side effects of PDE-5 inhibitor
Headache, flushing, dizziness, nasal congestion, hypotension, arrhythmias, acute coronary syndrome, priapism
Contraindications of PDE-5 inhibitor
Avoid in recent/recent acute coronary syndrome or anyone with significant cardiovascular disease, use in caution in hepatic or renal impairment
Key interaction of PDE-5 inhibitor
Should not be prescribed with nitrates use with caution when using alpha blockers
Name 1 example of 5 alpha reductase inhibitor
Finasteride
2 indication of 5 alpha reductase inhibitor
Lower urinary tract symptoms due to benign prostatic enlargement
Androgenic alopecia
Side effects of 5 alpha reductase inhibitor
Impotence
Reduced libido
Gynaecomastia
Suicidal thoughts
Contraindication of 5 alpha reductase inhibitor
Women of childbearing potential ( even by touching the broken tablet )
Monitoring for 5 alpha reductase inhibitor
Follow up in 3-6 months and continue every 6-12months
