Urinary Retention Flashcards
What is meant by urinary retention
Inability to voluntarily urinate
What may cause urinary retention
Urethral blockage
Medication: antimuscarinic drugs, sympathomimetics, tricyclic antidepressants
What are the 2 different types of urinary retention
Acute: medical emergency - abrupt development over s short period of hours
Chronic: gradual over months- inability to completely empty bladder
What is meant by benign prostatic hyperplasia
A type of chronic urinary retention
Most common cause in men- enlarged prostate - blocks the urethra
Symptoms includes: urinary retention, urgency, frequency and nocturia
Name some sympathomimetic drugs
Dopamine
Epinephrine
Norepinephrine
Dobutamine
Etc
What is the drug treatment for acute urinary retention
Immediate Catheriterisation due to the pain
Provide alpha blocker for 2+ days before removing catheter
Name alpha blocker drugs
Alfuzosin
Doxasozin
Tamsulosin
Terazosin
What is the drug treatment for chronic urinary retention
Catheters used long term
- may cause recurrent UTIs, urethra trauma, pain and stone formation
If got UTI give antibiotic for 7 days
What is the drug treatment for benign prostatic hyperplasia
Alpha-blocker (relaxes smooth muscle)
Patients with an enlarged prostate, raised prostate antigens or at a high risk of progression use: 5-alpha reductase inhibitor (finisteride or dutasteride)
Finasteride can cause hair growth in men
What condition should you avoid alpha blockers if a ageing has a history of what
Avoid if the patient has a history of:
Micturition syncope (fainting)
Postural hypotension
What are the side effects of alpha blockers
Dizziness, postural hypotension
First dose may cause collapse due to hypotension effect
-taken before bed
-Lie down if dizzy, fatigue or sweating develop until they feel better
What are 5 alpha- reductase inhibitors
Drugs are: Finisteride or dutasteride
Can cause breast disorder
Sexual dysfunction
Can increase risk of suicidal risk and suicide ideation
What cautions should be taken when using 5 alpha- reductase inhibitors
Male breast cancer reported- report lumps, pain or nipple discharge
Excreted in semen- use condom if partner is pregnant or likely to become pregnant. Toxic to the reproductive system
Women of childbearing potential should avoid handling crushed or broken tablets
Finisteride: reports of depression and rare cases of suicidal thoughts
- stop finisteride immediately and inform a HCP
In the elderly and people who have had cataract surgery what should you be cautious of
Increases risk of floppy iris syndrome
