Micturition Drugs

Question 1

what are the two stages of micturition?

Answer 1

passive storage
active voiding of urine

Question 2

what are the common clinical signs of incontinence?

Answer 2

urine dribbling
loss of voluntary control

Question 3

what are the common clinical signs of abnormal micturition?

Answer 3

disruption of the urine stream
stranguria
dysuria

Question 4

what is the most frequently diagnosed micturition disorder?

Answer 4

urethral sphincter mechanism incompetence

Question 5

what can estrogens be used for?

Answer 5

hormone responsive incontinence

Question 6

how do estrogens work with urinary incontinence?

Answer 6

increases resting urethral muscle tone of female urethra
binds to cytosol binding protein receptor: stimulates DNA, RNA, protein synthesis

Question 7

what can testosterone be used for?

Answer 7

hormone responsive incontinence

Question 8

what is the mechanism of action of testosterone?

Answer 8

activates testosterone and estrogen receptors
conversion to estradiol and activation of certain estrogen receptors

Question 9

what is phenylpropanolamine?

Answer 9

alpha adrenergic agonist

Question 10

what are the indications for phenylpropanolamine?

Answer 10

urethral sphincter mechanism incompetence: hormone responsive and stress

Question 11

what are the contraindications for phenylpropanolamine?

Answer 11

glaucoma
diabetes mellitus
hypertension

Question 12

what is the mechanism of action of tricyclic antidepressant agents?

Answer 12

inhibition of norepinephrine re-uptake at synaptic level and results in increased urethral tone

Question 13

what are some causes of detrusor hyperspasticity?

Answer 13

inflamed or irritated bladder
spinal cord disease
idiopathic

Question 14

what are some indications for propantheline bromide?

Answer 14

detrusor hyperspasticity
urge incontinence

Question 15

what are some indications for flavoxate hydrochloride?

Answer 15

detrusor hyperspasticity
urge incontinence

Question 16

what is an indication of oxybutinin?

Answer 16

detrusor hyperspasticity

Question 17

what is the mechanism of action of oxybutinin?

Answer 17

anticholinergic
direct acting smooth muscle relaxant

Question 18

how does bethanechol chloride work?

Answer 18

parasympathetic and muscarinic drug
directly stimulates parasympathetic cholinergic receptors
stimulates ganglia to a lesser extent

Question 19

what is an indication for bethanechol chloride?

Answer 19

detrusor atony

Question 20

when should you not use bethanechol chloride?

Answer 20

with urethral obstruction

Question 21

what are prazosin and tamsulosin?

Answer 21

alpha-adrenergic blockers

Question 22

what is diazepam?

Answer 22

skeletal muscle relaxant

Question 23

what is dantrolene?

Answer 23

skeletal muscle relaxant

Question 24

what is baclofen?

Answer 24

skeletal muscle relaxant

Question 25

which nerves innervate the bladder?

Answer 25

hypogastric nerve pelvic nerve

Question 26

which nerve innervates the external urethral sphincter?

Answer 26

pudendal nerve

Question 27

which parasympathetic nerves have to do with urination?

Answer 27

pelvic nerve pudendal nerve

Question 28

what does the hypogastric nerve innervate in the urinary system?

Answer 28

bladder internal urethral sphincter

Question 29

what are some voiding disorders?

Answer 29

functional outflow obstruction mechanical outflow obstruction atonic bladder

Question 30

what are some storage disorders?

Answer 30

urethral sphincter mechanism incompetence ectopic ureters detrusor instability

Question 31

which drugs are used to treat female hormone responsive incontinence?

Answer 31

diethylstilbestrol- old estriol (incurin)

Question 32

what are the side effects of estrogens?

Answer 32

induce signs of estrus bone marrow toxicity (hypoplasia, aplasia)

Question 33

what drugs are used to treat male hormone responsive incontinence?

Answer 33

testosterone crypionate testosterone propianate methyltestosterone

Question 34

what are the side effects of testosterone?

Answer 34

none noted

Question 35

what is the mechanism of action of phenylpropanolamine?

Answer 35

stimulates both alpha and beta adrenergic receptors may act directly with alpha1 (proximal urethra) and beta2 (bladder) may have indirect effect: norepinephrine relaxes detrusor muscle (beta) and increases tone of urethral sphincter (alpha)

Question 36

what are the side effects of phenylpropanolamine?

Answer 36

occasional nausea inappetance hypertension increased intraocular pressure

Question 37

what are some tricyclic antidepressant agents?

Answer 37

imipramine clomipramine

Question 38

what are the side effects of propantheline bromide?

Answer 38

vomiting dry mouth sedation constipation increased intraocular pressure

Question 39

what is the mechanism of action of flavoxate hydrochloride?

Answer 39

anticholinergic direct acting smooth muscle relaxant

Question 40

what are the side effects of flavoxate hydrochloride?

Answer 40

vomiting increased intraocular pressure tachycardia

Question 41

what are the side effects of oxybutinin?

Answer 41

diarrhea sedation aggravation of hyperthyroidism aggravation of cardiac disease aggravation of prostatic disease

Question 42

what is detrusor atony like?

Answer 42

dribbling urine large distended bladder, easily expressed decreased or absent perineal reflex

Question 43

what are the side effects of bethanechol?

Answer 43

vomiting diarrhea salivation anorexia do not use with urethral obstruction

Question 44

what are the side effects of phenoxybenzamine?

Answer 44

hypotension miosis reflex tachycardia inhibits contraction nicitating membrane

Question 45

what is used for urethral spasticity?

Answer 45

alpha adrenergic blocking agent

Question 46

what are prazosin, tamsulosin, and terazosin?

Answer 46

alpha adrenergic blockers

Question 47

what do prazosin and tamsulosin cause?

Answer 47

alpha adrenergic block centrally mediated decrease in somatic input to external urethral sphincter

Question 48

what is diazepam used for?

Answer 48

functional urethral obstruction due to increased external urethral sphincter tone

Question 49

what are the side effects of baclofen?

Answer 49

weakness vomiting inappetance

Question 50

what does baclofen do?

Answer 50

decreases muscle tone by a depressive effect on the CNS inhibits medullary interneurons and spinal reflexes decreases spasticity by reducing activity of gamma efferent neurons