Brainscape's Knowledge GenomeTM

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


See full index

Renal 2 Test 1 > Renal 2 Pharmacology > Flashcards

Renal 2 Pharmacology Flashcards

1
Q

Male Disorder A1 adrenergic antagonist drugs

A 
Doxazosin
Terazosin
Alfuzosin-BPH only
Tamsulosin-BPH only 
Silodosin-BPH only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Male Disorder 5a-reductase inhibitor drugs

A

Finasteride

Dutasteride

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

Erectile Dysfunction Drugs

A 
-phosphodiesterase-5 (PDE5) inhibitors
Sildenafil
Vardenafil
Tadalafil
-can also tx ysubg PGE1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Benign Prostatic Hyperlasia (BPH)–what is it? Treatment?

A
  • enlargement obstructs bladder outlet

- Tx using alpha 1 adrenergic antogonists, steroid 5alpha reductase inhibitors, PDE5 inhibitor

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

Lower Urinary Tract Symptoms (LUTS)

A
  • interrupted stream
  • hesitation
  • frequency
  • dribbling
  • fullness
  • urgency
  • weak stream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Drugs for symptomatic relief of LUTS

A
  • antagonists of a1 receptors
  • Terazosin, Doxasozin, Tamsulosin, Silodosin, Alfuzosin
  • Drug class to relax muscle tone
  • dynamic remedy
  • rapid relief of symptoms ~days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

a1 adrenoreceptors in blood vessels

A

a1B more than a1A

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

A1 receptors in prostate

A
  • smooth muscle contraction

- a1A

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

a1 receptors in detrusor

A

instability

a1D>a1A

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

A1 receptors in spinal cord

A
  • control of urinary function

- a1D

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

Stimulation of genitourinary a1-receptors

A

mediate bladder outlet obstruction

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

Detrusor instability caused by =

A

a1D receptors + NE

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

Muscle contraction caused by=

A

a1A receptors + NE

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

a1 antagonists

A
  • compete with NE

- this mechanism reduces spasm, promotes muscle relaxation and improves urine flow

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

Non-specific a1 antagonists

A
  • Terazosin
  • Doxazosin
  • Alfuzosin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

a1 antagonists specific for a1A and/= A1D

A
  • Tamsulosin

- Silodosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Terazosin and Doxazosin

A
  • no uroselectivity
  • adverse effects: postural hypotension, titrate 1st dose; fatigue
  • Drug interaction with PDE-5 inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Alfuzosin

A
  • uroselective (functional) (doesn’t discriminate between subtypes but tends to accumulate in prostate!)
  • a1 antagonist
  • adverse effects: QT prolongation
  • drug interaction with CYP450
  • take immediately after meal every day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tamsulosin and Silodosin

A
  • uroselective for a1A and a1D (a1 antagonist)
  • adverse effects: reduced ejaculation; intraoperative floppy iris syndrome (IFIS)
  • drug interaction with CYP450
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Avoid alfuzosin in

A

hepatic impairment

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

Steroid 5a reductase inhibitors (SARI, 5ARI)

A
  • Finasteride
  • Dutasteride
  • drug class that prevents enlargement and shrinks prostate
  • structural remedy (slow BPH progression)
  • delayed action–>shrinkage and symptoms relief ~3-6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why is the prostate enlarging?

A

-aging puls dihydrotestosterone

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

Enable prostate epithelium survival and growth

A
  • androgenic steroids, testosterone and dihydrotestosterone (DHT)
  • DUT potency ~10x >testosterone
  • T converted to DHT via SAR (steroid alpha reductase) types I and II
  • hypertrophic prostate has ecess SARII
24
Q

Steroid 5a-reductase (SAR) types I and II convert

A

serum testosterone to DHT in cells

25
Q

Hypertrophic prostate has excess

A

SAR-II

26
Q

DHT ‘starvation’ may cause

A

epithelial atrophy, shrinkage, gradual relief of LUTS

27
Q

DHT starvation can be caused by

A

inhibiting SAR II

28
Q

Direct Effects of SAR II Inhibition (Finasteride or Dutasteride)

A
  • testosterone accumulation

- DHT depletion

29
Q

Indirect Effects of SAR II Inhibition

A
  • AR receptor less occupied

- no gene transcription

30
Q

Finasteride Selectivity

A

-specific inhibitor of SAR II

31
Q

Dutasteride selectivity

A

-dual inhibitor of SAR I and II

32
Q

Both finasteride and dutasteride

A

take about 3 months for a measurable effect

  • have similar efficacy
  • improved LUTS, reduced prostate volume and serum PSA
  • reduced need for surgery
  • no dosage adjustment needed for age or renal insufficiency
  • no established clinically significant drug interaction (CYP3A metabolism)
  • caution with liver abnormalities
33
Q

Adverse Effects of Finasteride and Dutasteride

A

-Erectile dysfunction, gynecomastia, depressed libido, ejaculation disturbances

34
Q

Tadalafil

A
  • phosphodiesterase-5 inhibitor

- approved for use BPH

35
Q

Erectile (endothelial) Dysfunction associated conditions

A

-Hypertension, CAD, depression, alcohol abuse, drug abuse, endocrine disorders, diabetes, hypogonadism, trauma to pelvis or spine, hperlipidemia, LUTS, PVD, vascular surgery, smoking, anemia

36
Q

Corporus cavernosum

A
  • relaxed smooth muscle–>blood in sinusoids–>rigid organ

- neuronal input (NANC) and endothelial lining modulate smooth muscle tone

37
Q

Corpus spongiosum

A

-NOT prominent in erectile dysfunction

38
Q

Nitric Oxide and cGMP

A

-No interacts directly with guanylate cyclase which activates cGMP which causes smooth muscle relaxation (vasodilation) and erection

39
Q

Phosphodiesterase-5

A

-metabolizes cGMP back into GMP

40
Q

PDE-5 inhibitors

A

-enhance cGMP signaling by blocking metabolism of cGMP -Sildenafil, Vardenafil, Tadalafil

41
Q

PDE-5 Inhibitor onset

A

~15 minutes (take 1 hour before)

42
Q

PDE-5 Inhibitor span of efficacy

A
  • sildenafil: 3-4 hours; t1/2 4 hrs
  • vardenafil: 4-5 hours; t1/2 4 hours
  • tadalafil: ~36 hours ; t1/2 18 hours
43
Q

PDE-5 inhibitors clearance by

A

hepatic CYP3A4

44
Q

PDE5 expressed in

A

corpus cavernosum

45
Q

PDE6 expressed in

A

retina

  • Sildenafil, vardenafil)
  • adverse effect is blue vision disturbance
  • take about 10fold to cause this affect
46
Q

PDE1 expressed in

A

vasculature, heart, brain

  • would take about 80 fold to cause affect
  • little clinical significance
47
Q

PDE11

A
  • heart pituitary testes

- 800 fold to cause affect

48
Q

PDE3

A

heart

-negligible effect

49
Q

PDE-5 related inhibitor side effects

A
  • headache
  • dyspepsia
  • nasal congestion
  • sidlenafil, vardenafil, tadalafil
50
Q

Tadalafil other side effects

A

-back pain, myalgia, limb pain

51
Q

PDE-5 inhibitors contraindications

A
  • do not use with organic nitrates!
  • use of PDE-5 inhibitors concurrently with nitrates (e.g. glyceryl trinitrate) may induce extreme hypotension
  • drops of 25 mm Hg have been reported, with syncope
52
Q

Vardenafil and nonspecific a-receptor antagonists

A
  • patients should be hemodynamically stable prior to initiating therapy
  • initiate vardenafil at the lowest recommended dose
53
Q

Tadalafil and nonspecific a-receptor antagonists

A

-when tadalafil is used for treatment of BPH, concurrent alpha1-blockers are not recommended.

54
Q

Sildenafil and nonspecific a-receptor antagonists

A

-alpha-blockers should be initiated at the lowest recommended dose in patients currently receiving sildenafil

55
Q

Intracavernosal injection of vasoactive drugs

A
  • effective for treating eternal dysfunction
  • papaverine, phentolamine, prostaglandin E1
  • relaxed smooth muscle–>blood in sinusoids–>rigid organ
56
Q

PGE1

A

-interacts with GPCR which activates Adenylate cyclase and activates cAMP–> smooth muscle relaxation

Renal 2 Test 1 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions