Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Medications Used for BPH

A

Alpha-1 blockers
5-alpha-reductase inhibitors
Combo: Dutasterid-Tamulosin (Jalyn)
Tadalafil (Cialis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Examples of Alpha-1 Blockers

A 
Terazosin (Hytrin)
Doxazosin (Cardura)
Alfuzosin (Uroxatrol)
Tamsulosin (Flomax)
Silodosin (Rapaflo)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MOA of Alpha-1 Blockers

A

Relax smooth muscle in the bladder neck & the prostatic capsule & prostatic urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Reason for Alpha-1 Blockers

A

Short & long term symptom management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where are alpha-1 receptors located?

A

Base of the bladder

In the prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SE of Alpha-1 Blockers

A 
Dizziness
Orthostatic hypotension
Asthenia (muscle weakness)
Nasal congestion
Problems with ejaculation (especially with Tamsulosin (Flomax))
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Alpha-1 Blockers with More BP Effects

A

Terozosin (Hytrin)

Doxazosin (Cardura)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Alpha-1 Blockers with Less BP Effects

A

Tamsulosin (Flomax)
Alfuzosin (Uroxatrol)
Silodosin (Rapaflo_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of 5-alpha-reductase Inhibitors

A

Finasteride (Proscar)

Dutasteride (Avodart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Benefits of 5-Alpha-Reductase Inhibitors

A

Long term decrease in prostate size & decreased need for prostatic surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MOA of 5-Alpha-Reductase Inhibitors

A

Competitive inhibitor of both tissue & hepatic 5-alpha reductase
Inhibition of the conversion of testosterone to DHT & suppress serum DHT levels
Decreases prostatic size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Efficacy of 5-alpha-reductase Inhibitors

A

May be up to a year to notice reduction in symptoms
Reduce symptoms scores
Increase maximum urinary flow rate
Reduction in mean prostatic volume
Decreased need for surgery
Decreased development of acute urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Major SE of 5-Alpha-Reductase Inhibitors

A

Decreased libido
Ejaculatory or erectile problems
Decreases serum PSA by 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cialis for BPH

A

Blocks PDE5 in the prostate & bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Medications not to Use with Cialis

A

Nitrates

Alpha-1 Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Medications for Erectile Dysfunction

A 
Alprostadil
Tadalafil (Cialis)
Vardenafil (Levitra)
Sildenafil (Viagra)
Avanafil (Stendra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Drug Category for Alprostadil (Caverject, Muse)

A

Prostaglandin

Vasodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MOA of Alprostadil (Caverject, Muse)

A

Vasodilation on vascular & smooth muscles

Relaxes trabecular smooth muscle by dilation of cavernosal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Onset & Duration of Action of Alprostadil (Caverject, Muse)

A

Onset: 5-20 minutes
Duration:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Contraindications of Alprostadil (Caverject, Muse)

A

Conditions that predispose the patient to priapism
Anatomic or fibrotic conditions of the penis
For pellets: urethral stricture, perineal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SE of Alprostadil (Caverject, Muse)

A

Syncope
Priapism
May cause BP lowering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Phosphodiasterase Inhibitors

A

Tadalafil (Cialis)
Vardenafil (Levitra)
Sildenafil (Viagra)
Avanafil (Stendra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MOA of Phosphodiasterase Inhibitors

A

Release of nitric oxide (NO) during sexual stimulation
NO produces smooth muscle relaxation & inflow of blood
Enhances the effect of NO by inhibiting phosphodiesterase type 6 (PDE-5)
Do not directly cause penile erections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Contraindications of Phosphodiasterase Inhibitors

A

Men taking nitrates

Caution with alpha-1 blockers (severe hypotension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

SE of Phosphodiesterase Inhibitors

A 
Severe hypotension
Flushing
Headaches
Dyspepsia
Transient blue vision with sildenafil (Viagra)
Increase risk for non-arteritis ischemic optic neuropathy
Hearing loss
Priapism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Administration of Phosphodiesterase Inhibitors

A

Take 60 minutes prior to intercourse

Food/alcohol delay onset of action in sildenafil (Viagra) & vardenafil (Levitra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Duration of Action of Phosphodiesterase Inhibitors

A

Tadalafil (Cialis): up to 36 hours

All others: 8-12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Define Primary Hypogonadism

A

Testes fail to produce testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Define Secondary Hypogonadism

A

Pituitary or hypothalamus malfunctino

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

MOA of Testosterone Replacement

A

Bind to the androgen receptor
Act in tissues that express the enzyme 5-alpha reductase
Can act as estrogen after converting to estradiol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Indications for Testosterone Replacement

A 
Decreased libido
Decreased AM erections
Loss of body hair
Low bone density
Gynecomastia
Small testes
Decreased muscle mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Goal of Testosterone Replacement

A

Return testosterone level back to normal range

33
Q

Things to do Prior to Starting Testosterone Replacement

A

Screen for prostate cancer
Screen for erythrocytosis
Make sure sleep apnea is present

34
Q

SE of Testosterone Replacement

A 
Polycythemia
Worsening of BPH symptoms
Acne
Increase in PSA
Oral & prolonged IM doses associated with liver issues
Increased risk of prostate cancer
Decreased spermatogenesis
Fluid retention
Worsening of sleep apnea
Possible increased risk of CV events
35
Q

Contraindications of Testosterone Replacement Therapy

A 
CV events in the last 6 months
Known prostate cancer
Known breast cancer
Severe lower urinary tract symptoms
HCT >50%
Untreated severe sleep apnea
PSA >4 mcg/L
PSA >3 mcg/L with risk factors for prostate cancer
36
Q

Routes of Testosterone Replacement

A 
Oral (hepatic SE)
Buccal  tablet (BID)
Subcutaneous pellet (replace 3-6 months)
Nasal gel (TID)
Parenteral: long acting
Transdermal/topical: patch, gel
37
Q

Which Formulation to Use

A 
Transdermal gel (1st): well tolerated
Some prefer injections
38
Q

Monitoring During Testosterone Replacement

A

Serum testosterone
Serum LH: primary hypogonadism
Bone density
Hematocrit: 3-6 months after starting therapy, then yearly
PSA prior to initiating therapy: 3-6 months after starting therapy, then yearly
DRE: 3-6 months after starting therapy, then yearly

39
Q

Examples of Gels

A

AndroGel: metered pump or packets
Testim
Fortesta
Axiron

40
Q

Adroderm

A

Worn on arm or torso

Significant skin irritation

41
Q

IM Testosterone

A 
Testosterone enanthate (Delatestry)
Testosterone cypionate (Depo-Testosterone)
Gluteal injections
42
Q

Urinary Tract Analgesic

A

Phenazopyridine (Pyridium)

Pentosan (Elmiron)

43
Q

Benefit of Phenazopyridine (Pyridium)

A

Symptomatic relief of urinary burning, itching, frequency, & urgency associated with UTI or post urologic procedures

44
Q

Contraindication of Urinary Tract Analgesics

A

GFR

45
Q

Prescribing Considerations for Urinary Tract Analgesics

A

Use

46
Q

SE of Urinary Tract Analgesics

A

Orange urine
HeadacheDizziness
Stomach cramps

47
Q

Indications of Pentosan (Elmiron)

A

Interstitial cystitis

48
Q

Define Interstitial Cystitis

A

Inflammation of the wall of the blader

49
Q

MOA of Pentosan (Elmiron)

A

Adhere to the bladder wall mucosa where it may act as a buffer to protect the tissues from irritating substances in the urine
Low-molecular weight heparinoid

50
Q

SE of Pentosan (Elmiron)

A 
Headache
Dizziness
Alopecia
Rash
Rectal hemorrhage
Diarrhea
Nausea
Abdominal pain
Dyspepsia
LFT abnormalities
51
Q

Medications for Incontinence (Anti-muscarinic Agents)

A 
Oxybutynin (Ditropan) (Ditropan XL)
Tolterodine (Detrol) (Detrol LA)
Trospium (Sanctura) (Trospium XR)
Solifenacin (Vesicare)
Darifenacin hydrobromide (Enablex)
Fesoterodine (Toviaz)
52
Q

Treatment of urgency, urgency-predominant mixed or OAB symptoms

A

Do not use pharmacologic therapy in demented patients

53
Q

Contraindications for Anti-muscarinic Agents

A

Gastric retention
Angle closure glaucoma
Neurogenic bladder

54
Q

MOA of Anti-muscarinic Agents

A

Increase bladder capacity

Block basal release of acetylcholine during bladder filling resulting in decreased urgency

55
Q

Prescribing Anti-muscarinic Agents

A

Extended release agents have lower rates of SE
Start with lowest available dose
Evaluate for response in 4-6 weeks
May respond to one agent & not another

56
Q

SE of Anti-muscarinic Agents

A 
Dry mouth
Constipation
Blurred vision to near objects
Tachycardia
Drowsiness
Decreased cognitive function
Dizziness
57
Q

Considerations for Prescribing Anti-muscarinic Agents

A 
Hepatic metabolism at CYP450
Renal failure
Liver failiure
Cognitive impairment
Combinations to avoid
AE to avoid 
Generally prescribe ER or transdermal formulations
58
Q

Drug Combinations to Avoid with Anti-muscarinic Agents

A 
1st generation antihistamines
Muscle relaxants
Some anti-psychotics
TCAs
Ipratropium (Combivent)
Tiotropium (Spiriva)
Cholinesterase inhibitors (donepezil, rivastigmine, glantamine)
Triospium & ETOH within 2 hours
Mirabegron
Metoprolol & darifenacin
Grapefruit juice (darrifenacin, solifenacin, festerodine, tolerodine)
59
Q

Set Realistic Expectations Prior to Prescribing Anti-muscarinic Agents

A

Reduce number of incontinence episodes
30% of patients achieve complete bladder control
Failure of one medication, try another

60
Q

Common Antibiotics for UTI Treatment

A 
Ciprofloxacin
Trimethoprim/sulfamethoxazole (Bactrim/Septra)
Nitrofurantoin (Macrodantin)
Amoxicillin
Ampicillin
61
Q

Class of Ciprofloxacin

A

Fluoroquinolones

62
Q

MOA of Ciprofloxacin

A

inhibit DNA gyrase & topoisomerase IV necessary for replication of bacteria

63
Q

Pregnancy Category of Ciprofloxacin

A

Category C

64
Q

Black Box Warnings for Ciprofloxacin

A

Increased risk of tendinitis & tendon rupture

65
Q

Urologic Indications for Ciprofloxacin

A

Cystitis
UTI
Prostatitis

66
Q

Class of Trimethoprim/sulfamethoxazole (Bactrim/Septra)

A

Sulfa drugs

67
Q

MOA of Trimethoprim/sulfamethoxazole (Bactrim/Septra)

A

Folic acid synthesis inhibitors
Inhibits dihydropteroate synthetase
Inhibits dihydrofolate reductase

68
Q

Pregnancy Category of Trimethoprim/sulfamethoxazole (Bactrim/Septra)

A

Category C

69
Q

Nitrofurantoin (Macrodantin) in the Setting of CKD & Decreased CrCl

A

Can cause peripheral neuropathy

Don’t use with CrCl

70
Q

MOA of Nitrofurantoin (Macrodantin)

A

Disrupt bacterial cell wall synthesis through inhibition of bacterial enzymes

71
Q

Pregnancy Category of Nitrofurantoin (Macrodantin)

A

Category B

Contraindicated at term

72
Q

Urologic Indications of Nitrofurantoin (Macrodantin)

A

UTIs

73
Q

Class of Amoxicillin

A

Secondary generation penicillin

74
Q

MOA of Amoxicillin

A

Bactericidal to growing bacteria

Interferes with transpeptidation of cell wall synthesis

75
Q

Pregnancy Category of Amoxicillin

A

Category B

76
Q

Class of Ampicillin

A

Secondary generation penicillin

77
Q

MOA of Ampicillin

A

Bactericidal to growing bacteria

Interferes with transpeptidation of cell wall synthesis

78
Q

Pregnancy Category of Ampicillin

A

Category B

Urology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions