Respiratory & Urologic Flashcards
Drugs used to treat respiratory & urologic disease
Which alpha-1 antagonists are used to treat BPH?
Hint: ending -osin
Tamsulosin
Doxasozin
Prazosin
Terazosin
Name the (2) 5-alpha reductive inhibitors that treat BPH Hint: ending -asteride
Finasteride (Proscar & Propecia (for alopecia))
& dutasteride (Avodart)
What is the name & type of drug for overactive bladder?
Tolterodine; anticholinergic
What is the MOA of tolterodine? (for overactive bladder)
Blocks ACh from binding to bladder’s M3 receptors, inhibiting contraction
Name the drugs for gout
Allopurinol & probenecid
The 5 categories of drugs for asthma & COPD
bronchodilators, steroids, leukotriene antagonists, mucolytic, and expectorant
name the 3 types of bronchodilators
B2 (adrenergic) agonists, anticholinergic drugs aka muscarinic/cholinergic antagonists, and methylxanthine
MOA of B2 (adrenergic) agonists
stimulate B2 receptors on lungs, which causes bronchodilation
Names & MOA of cholinergic/muscarinic antagonists
Ipratropium, tiotropium;
inhibit M3 receptors on lungs; long-acting
MOA of methylxanthine (caffeine-like structure)
inhibits phosphodiesterase in bronchiole smooth muscle–>increase cAMP in bronchial smooth muscle
Also: rarely used due to narrow therapeutic index
Which (2) inhaled B2 agonists are fast & short acting?
albuterol, levalbuterol
Which inhaled B2 agonist is fast and long acting?
formoterol, always used with an inhaled steroid
which inhaled B2 agonist has a long duration + onset of action, (not used in acute attack)
salmeterol, always used with an inhaled steroid
name the (4) inhaled B2 agonists
albuterol, levalbuterol, salmeterol (slow), formoterol
which B2 agonists are always used with an inhaled steroid?
formoterol & salmeterol, which are both long acting
Ocular side effects of inhaled B2 agonists
increase IOP, (by B2 stimulation of NPCE of ciliary body–>aq. humor production)
reduced accommodation and blur (due to B2 stimulation on ciliary muscle)
systemic side effects of inhaled B2 agonists
tremors (due to skeletal muscle effects)
headache, anxiety, due to effects in brain
which (2) inhaled B2 agonists are fast & short acting?
albuterol & levalbuterol
adverse effects of methylxanthines
headache, insomnia, increase BP & HR, seizures, , dehydration, anxious shakiness; low therapeutic index
MOA of inhaled steroids
inhibit phospholipase A2, which blocks production of inflammatory cells, long-term
Name of (3) inhaled steroids
budesonide, fluticasone, beclomethasone
adverse effects of inhaled steroids
posterior subcapsular cataract, increased IOP & risk of prolonged bleeding, and oral thrush
MOA of leukotriene receptor antagonists
inhibit binding of leukotrienes to lung receptors, relieving inflammation to open up airways; taken orally
side effects of leukotriene receptor antagonists (zafirlukast & montelukast)
headache, churg-strauss syndrome (rare vasculitis)
MOA & side effect of acetylcysteine (mucolytic agent)
breaks disulfide bonds in mucus proteins to make it thinner & easier to clear out
Smells like sulfur (rotten eggs)
What exactly is BPH?
benign prostate hyperplasia
Enlarged prostate keeps urethra from passing urine
Dihydrotestosterone (DHT)?
potent form of testosterone involved in prostate tissue growth & male pattern hair loss (alopecia)
(2) categories of drugs to treat BPH
alpha-1 antagonists (-osin)
5-alpha reductase inhibitors (-asteride)
MOA of alpha-1 antagonists to treat BPH
relax smooth muscle in bladder & prostate, reducing obstruction & allowing stronger urine flow & complete bladder emptying
Side effects of alpha-1 blockers
floppy iris syndrome (due to a1 inhibition at iris radial (dilator) muscle)
also vasodilation, blood pressure falls
MOA of 5-alpha reductase inhibitors for BPH treatment
block conversion of testosterone to DHT, eventually reducing prostate size
side effects of 5-alpha reductase inhibitors (-asteride)
gynecomastia: growth of breast gland tissue in males due to estrogen/testosterone imbalanca
Drug category for erectile dysfunction
PDE-5 inhibitors
MOA of PDE-5 inhibitors
prolong cGMP in corpus collosum to prolong muscle relaxation & vasodilation
What do PDE-5 inhibitors treat?
impotence, pulmonary arterial hypertension, & altitude sickness, so also for women
Name of (3) PDE-5 inhibitors
sildenafil (Viagra)
vardenafil (Levitra)
tadalafil (Cialis)
SYSTEMIC side effects of PDE-5 inhibitors
orthostatic hypotension, fainting, headache, flushing, priapism (erection >4hrs)
OCULAR side effects of PDE-5 inhibitors
Photophobia, non-arteric ischemic optic neuropathy, Blurry vision/central haze, changes in light perception (flashing lights) Cyanopsia: blue tint to vision Conjunctiva hyperemia (red eye)
Name, type, & MOA of drug for overactive bladder
tolterodine, a cholinergic antagonist, blocks ACh–M3 receptor binding on bladder to prevent contraction
(5) side effects of tolterodine (anti-cholinergics)
Mydriasis (M3 inhibition at iris sphincter)
Increase IOP (if narrow angles, less aq. outflow)
Reduced accommodation (M2. M3 on ciliary muscle)
Dry mouth & eyes (M2,M3 inhibition at lacrimal gland)
Allopurinol’s MOA
prevents urate/uric acid synthesis
Probenecid’s MOA
increases renal excretion of uric acid
side effects of allopurinol
rash/hives, if any
side effects of probenecid
none known
