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Pharm 6 > men's health > Flashcards

men's health Flashcards

1
Q

post-void residual normal and abnormal volumes

A

normal is less than 50-100

abnormal is over 200

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2
Q

normal and abnormal urine velocity

A

normal is 20-25 ml/sec

abnormal is less than 12-15 ml/sec

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3
Q

neurologic control of bladder

A

PSNS (ACh, M3) causes detrusor constriction and bladder emptying
SNS (adrenergic) facilitates urine storage (B2 and B3-R in detrusor -> relaxation; alpha-1 in internal sphincter -> contraction)
somatic control via pudendal nerve

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4
Q

behavioral modifications for tx of urinary incontinence

A

toilet assistance - regular scheduling, caregiver
bladder training - education, scheduled voiding, positive reinforcement
pelvic mm rehab (Kegel)
biofeedback

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5
Q

MOA of drugs for overactive bladder

A

stop spontaneous detrusor contractions - anti-ACh

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6
Q

differences in drugs for OAB

A

muscarinic receptor specificity, lipophilicty (CNS effects), metabolism, and dosage form

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7
Q

oxybutinin

A

anti-ACh for OAB
most ACh ADRs (dry mouth, etc.)
available short- and long-acting oral tabs, transdermal patches, topical gel

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8
Q

tolterodine

A

anti-ACh for OAB

more selective M3-blocker vs oxybutinin

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9
Q

trospium

A

anti-ACh for OAB

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10
Q

fesoteridine

A

anti-ACh for OAB

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11
Q

solifenacin

A

anti-ACh for OAB

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12
Q

darifenacin

A

anti-ACh for OAB

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13
Q

mirebegron

A

first oral B3 agonist for OAB

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14
Q

onabotulinumtoxinA

A

injected into detrusor during cystoscopy to block ACh release at NMJ for OAB
lasts 19-24 weeks

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15
Q

drugs that can cause or exacerbate urinary incontinence

A

urinary retention: anti-ACh, anti-depressants, anti-psychotics, B-agonists, CCB, opioids
polyuria, freq, urgency: EtOH, caffeine, diuretics
urethral relax: a-blockers
mm relaxer: sedatives, hypnotics

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16
Q

tissues of prostate

A

epithelial/ glandular: makes secretions, under androgen control
stroma: SM with a1-receptors

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17
Q

5-a-reductase

A

converts testosterone to DHT in prostate, beginning at puberty -> rapid growth and enlargement of prostate

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18
Q

normal and BPH ratio of stroma:epithelial tissue

A

normal 2:1, BPH 5:1

19
Q

drugs for BPH

A

non-selective a1-blockers, selective a1-blockers, 5a-reductase inhibitors, PDE5 inhibitors, herbal products

20
Q

doxazosin

A

non-selective a1-blocker for BPH

21
Q

terazosin

A

non-selective a1-blocker for BPH

22
Q

alfuzosin

A

non-selective a1-blocker for BPH

23
Q

tamsulosin

A

selective a1-blocker for BPH

*may cause “floppy iris syndrome” - don’t give before cataract surgery

24
Q

silodosin

A

selective a1-blocker for BPH

25
Q

finasteride

A

5a-reductase inhibitor for BPH

*caution in pregnancy: anti-androgenic effects

26
Q

dutasteride

A

5a-reductase inhibitor for BPH

*caution in pregnancy: anti-androgenic effects

27
Q

tadalafil

A

PDE5 inhibitor for BPH

*interacts with a1-blocker -> hypotension

28
Q

saw palmetto

A

herbal product used for BPH

29
Q

acute prostatitis: pathogens and tx

A

similar pathogens as those that cause UTIs, identify with urine culture
4 wk therapy of TMP-SMX or FQs if allergy or if G- bacteria (not sensitive to TMP-SMX)

30
Q

PDE5 MOA

A

prevents breakdown cGMP, which decreases cellular Ca in arterial SM in penis -> SM relaxation = inflow of blood into intercavernosal trabeculae = erection

31
Q

sildenafil

A

PDE5 inhibitor for ED

32
Q

ADR sildenafil

A

common: HA, facial flushing, nasal congestion, dyspepsia
severe: priapism, hearing loss, vision disturbance (blue), sudden vision loss

33
Q

sildenafil drug interactions

A

CI with nitrates like NTG, isosorbide -> too much cGMP = hypotension
caution with CYP 3A4 inhibitors = increased drug level and ADRs

34
Q

tadalafil

A

PDE5 inhibitor for ED

35
Q

ADR tadalafil

A

common: flushing, HA, congestion, dyspepsia
unique: back pain or muscle aches (PDE11 inhibition in sk mm)
vision disturbances rare compared to other PDE5 inhibitors

36
Q

meds that can cause ED

A

BBs, central anti-HTN (clonidine, methyldopa), digoxin, spironolactone, thiazides, most antidepressants, typical antipsychotics, anticonvulsants, lithium, 5a-reductase inhibitors, EtOH, cimetidine, opioids, corticosteroids

37
Q

FDA-approved drugs for low testosterone

A

NONE for low T without associated medical condition

38
Q

primary hypogonadism

A

late-onset, “andropause”
slow loss of T is natural in aging
s/s: loss of libido, impotence, loss mm mass and strength, fatigue, depression, inability to concentrate

39
Q

secondary hypogonadism

A

causes include obesity, metabolic syndrome, DM, some meds

40
Q

who should be treated with testosterone replacement therapy

A

should only be men with clinical symptoms and low T levels (less than 200; normal 270-1070)

41
Q

oral testosterone product use

A

rarely used d/t hepatic effects

42
Q

forms of artificial testosterone

A

oral (rarely used), depot injection, TD patch, TD gel, TD solution, subQ pellets, buccal tablet

43
Q

adverse effects of T replacement therapy

A

increased prostate and breast ca, inc prostate growth, polycythemia, infertility, hepatic toxicity, CV toxicity, thrombophlebitis, lower HDL

Pharm 6 (5 decks)

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