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Clinical Pharmacology > Micturition Drugs > Flashcards

Micturition Drugs Flashcards

1
Q

what are the two stages of micturition?

A

passive storage
active voiding of urine

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2
Q

what are the common clinical signs of incontinence?

A

urine dribbling
loss of voluntary control

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3
Q

what are the common clinical signs of abnormal micturition?

A

disruption of the urine stream
stranguria
dysuria

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4
Q

what is the most frequently diagnosed micturition disorder?

A

urethral sphincter mechanism incompetence

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5
Q

what can estrogens be used for?

A

hormone responsive incontinence

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6
Q

how do estrogens work with urinary incontinence?

A

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

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7
Q

what can testosterone be used for?

A

hormone responsive incontinence

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8
Q

what is the mechanism of action of testosterone?

A

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

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9
Q

what is phenylpropanolamine?

A

alpha adrenergic agonist

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10
Q

what are the indications for phenylpropanolamine?

A

urethral sphincter mechanism incompetence: hormone responsive and stress

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11
Q

what are the contraindications for phenylpropanolamine?

A

glaucoma
diabetes mellitus
hypertension

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12
Q

what is the mechanism of action of tricyclic antidepressant agents?

A

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

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13
Q

what are some causes of detrusor hyperspasticity?

A

inflamed or irritated bladder
spinal cord disease
idiopathic

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14
Q

what are some indications for propantheline bromide?

A

detrusor hyperspasticity
urge incontinence

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15
Q

what are some indications for flavoxate hydrochloride?

A

detrusor hyperspasticity
urge incontinence

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16
Q

what is an indication of oxybutinin?

A

detrusor hyperspasticity

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17
Q

what is the mechanism of action of oxybutinin?

A

anticholinergic
direct acting smooth muscle relaxant

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18
Q

how does bethanechol chloride work?

A

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

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19
Q

what is an indication for bethanechol chloride?

A

detrusor atony

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20
Q

when should you not use bethanechol chloride?

A

with urethral obstruction

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21
Q

what are prazosin and tamsulosin?

A

alpha-adrenergic blockers

22
Q

what is diazepam?

A

skeletal muscle relaxant

23
Q

what is dantrolene?

A

skeletal muscle relaxant

24
Q

what is baclofen?

A

skeletal muscle relaxant

25
Q

which nerves innervate the bladder?

A

hypogastric nerve
pelvic nerve

26
Q

which nerve innervates the external urethral sphincter?

A

pudendal nerve

27
Q

which parasympathetic nerves have to do with urination?

A

pelvic nerve
pudendal nerve

28
Q

what does the hypogastric nerve innervate in the urinary system?

A

bladder
internal urethral sphincter

29
Q

what are some voiding disorders?

A

functional outflow obstruction
mechanical outflow obstruction
atonic bladder

30
Q

what are some storage disorders?

A

urethral sphincter mechanism incompetence
ectopic ureters
detrusor instability

31
Q

which drugs are used to treat female hormone responsive incontinence?

A

diethylstilbestrol- old
estriol (incurin)

32
Q

what are the side effects of estrogens?

A

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

33
Q

what drugs are used to treat male hormone responsive incontinence?

A

testosterone crypionate
testosterone propianate
methyltestosterone

34
Q

what are the side effects of testosterone?

A

none noted

35
Q

what is the mechanism of action of phenylpropanolamine?

A

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)

36
Q

what are the side effects of phenylpropanolamine?

A

occasional nausea
inappetance
hypertension
increased intraocular pressure

37
Q

what are some tricyclic antidepressant agents?

A

imipramine
clomipramine

38
Q

what are the side effects of propantheline bromide?

A

vomiting
dry mouth
sedation
constipation
increased intraocular pressure

39
Q

what is the mechanism of action of flavoxate hydrochloride?

A

anticholinergic
direct acting smooth muscle relaxant

40
Q

what are the side effects of flavoxate hydrochloride?

A

vomiting
increased intraocular pressure
tachycardia

41
Q

what are the side effects of oxybutinin?

A

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

42
Q

what is detrusor atony like?

A

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

43
Q

what are the side effects of bethanechol?

A

vomiting
diarrhea
salivation
anorexia
do not use with urethral obstruction

44
Q

what are the side effects of phenoxybenzamine?

A

hypotension
miosis
reflex tachycardia
inhibits contraction nicitating membrane

45
Q

what is used for urethral spasticity?

A

alpha adrenergic blocking agent

46
Q

what are prazosin, tamsulosin, and terazosin?

A

alpha adrenergic blockers

47
Q

what do prazosin and tamsulosin cause?

A

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

48
Q

what is diazepam used for?

A

functional urethral obstruction due to increased external urethral sphincter tone

49
Q

what are the side effects of baclofen?

A

weakness
vomiting
inappetance

50
Q

what does baclofen do?

A

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

Clinical Pharmacology (19 decks)

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