GU Flashcards
What are meds that are anticholinergics/antimuscarinics? What’s their MOA?
oxybutynin (Ditropan) tolterodine (Detrol) darifenacin (Enablex) solifenacin (Vesicare) fesosterodine (Toviaz) Antagonize PSNS stimulation of muscarinic receptors in bladder (increases bladder capacity & initial urge to void)
How is oxybutynin different?
Oxybutynin has both antimuscarinic, local anesthetic to bladder & antispasmodic
What are side effects of anticholinergics/antimuscarinics?
SE: ANTICHOLINERGIC EFFECTS dry mouth, vision changes (blurred vision), cognitive impairment, urinary retention
Tachycardia
Edema
Dizziness
Abd pain
diarrhea
What caution must you take with Detrol?
those with glaucoma & prolong QT
What is the MOA for mirabegron?
Decrease frequency of B3 receptors, produce smooth muscle relaxation & increase size of bladder
What drug/drug interactions are with Mirabegron?
Interactions w codeine, tamoxifen (reduce levels) ketoconazole
What are the guidelines for OAB management?
1st line: ER anticholinergic, mirabegrom 2nd line: different anticholinergic, botulinum A toxin. Duloxetine 3rd: surgical intervention Same for peds, women & geriatrics
What is the difference between upper and lower UTI?
lower UTI- bladder, urethra upper- renal (complicated)
What is the MOA for alpha-adrenergic antagonists? What med is under this class?
reduces urethral stricture, more beneficial in BPH - tamsulosin
What are some side effects for tamsulosin?
postural hypotension precipitate stress incontinence
What are some urinary tract analgesics?
methenamine (Urised) phenazopyridine (Pyridium, Uristat) flavoxate (Urispas)
What is the order of treatment for uncomplicated cystitis?
What is the order of treatment for uncomplicated pyelonephritis?
What antibitics would you give to a pregnant women w UTI?
Amoxicillin is effective in approximately two thirds of UTIs in pregnant women and is safe for the fetus. Also safe are cephalexin and nitrofurantoin (only during the first and second trimesters). Sulfonamides are safe except in the last trimester. In pregnancy, the urine is cultured 1 week after treatment and every 4 to 6 weeks during the pregnancy. (Arcangelo, 20161108, p. 525)
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What antibiotics would you use for children w UTI?
First-line antimicrobial agents include the β-lactams amoxicillin–clavulanate (25–45 mg/kg/d divided every 12 hours), cephalexin (25–50 mg/kg/d, divided every 6–12 hours), and cefpodoxime (10 mg/kg/d divided every 12 hours) as well as TMP–SMX (8–10 mg/kg/d divided every 12 hours). Two-day to 4-day courses have been shown to be as effective as 7 to 14 days. (Arcangelo, 20161108, p. 525)
