urinary system agents

Question 1

nephr/o, ren/o

Answer 1

kidneys

Question 2

pyel/o

Answer 2

renal pelvis

Question 3

ur/o, urin/o

Answer 3

urin

Question 4

ureter/o

Answer 4

ureters

Question 5

cyst/o

Answer 5

urinary bladder

Question 6

urethr/o

Answer 6

urethra

Question 7

prostat/o

Answer 7

prostate

Question 8

Phosphodiesterase Inhibitors (PDE-I)

Answer 8

1st line ED Agents

Question 9

Sildenafil, Vardenafil, Tadalafil MOA

Answer 9

Inhibit phosphodiesterase (PDE) 5 leading to increased levels of cyclic guanosine monophosphate (cGMP) and enhancing the effects of nitric oxide (NO) and smooth muscle relaxation in the corpus cavernosum of the penis
Also cause relaxation of smooth muscle of the pulmonary vasculature

Question 10

Sildenafil, Vardenafil, Tadalafil uses

Answer 10

Erectile dysfunction

Pulmonary arterial hypertension

Question 11

Sildenafil, Vardenafil, Tadalafil adverse effects

Answer 11

Headache, flushing, dizziness
Visual abnormalities
Priapism

Question 12

Sildenafil, Vardenafil, Tadalafil contrainindications

Answer 12

Concomitant use of nitrates

Question 13

Sildenafil, Vardenafil, Tadalafil interactions

Answer 13

Nitrates
Antihypertensives
CYP-450 3A4 Inhibitors

Question 14

Sildenafil, Vardenafil, Tadalafil counseling

Answer 14

Ineffective in the absence of sexual arousal
Do not engage in sexual activity if clinically inadvisable
No protection against STDs
Do not take if you are using a nitrate
Be aware of s/sx of low blood pressure
Seek medical attention if priapism occurs

Question 15

Benign Prostatic Hyperplasia (BPH )

Answer 15

Enlargement of the prostate gland
Occurs in all males with advancing age
Age 60: 50% of all men will have BPH
Age 85: 90% of all men will have BPH

Question 16

Terazosin, Doxazosin, Alfuzosin, Tamsulosin

Answer 16

α- Adrenergic blockers, alpha blockers

Question 17

Terazosin, Doxazosin, Alfuzosin, Tamsulosin adverse effects

Answer 17

Dizziness, hypotension, orthostatic hypotension, weakness, somnolence, impotence, decreased libido

Question 18

Terazosin, Doxazosin, Alfuzosin, Tamsulosin interactions

Answer 18

Antihypertensive agents

Question 19

Terazosin, Doxazosin, Alfuzosin, Tamsulosin patient counseling

Answer 19

Be aware of s/sx of low blood pressure

Results of therapy may take several days to weeks

Question 20

Terazosin, Doxazosin, Alfuzosin, Tamsulosin MOA

Answer 20

Antagonists of α₁-adrenergic receptors
Relaxes prostatic smooth muscle
± peripheral vasculature

Question 21

Finasteride, Dutasteride MOA

Answer 21

Interfere with testosterone’s stimulatory effect on prostate gland size
Block conversion of T to DHT
Slow disease progression & decrease risk of complications

Question 22

Finasteride, Dutasteride class

Answer 22

α-Reductase Inhibitors

Question 23

Finasteride, Dutasteride uses

Answer 23

Moderate to severe BPH disease with enlarged prostate glands
Both agents offer once daily dosing
Delayed onset of clinical effect
Takes about 6 months to see full effects
Adequate clinical trial 6-12 months
Male pattern Baldness

Question 24

Finasteride, Dutasteride adverse effects

Answer 24

Breast tenderness and swelling, neoplasm of male breast, decreased libido, ejaculation disturbances, erectile dysfunction, testicular pain
Associated with more sexual dysfunction
2nd line agent in treating younger males

Question 25

Finasteride, Dutasteride contraindications

Answer 25

Pregnancy, female gender, children

Question 26

Finasteride, Dutasteride pregnancy

Answer 26

Exposure of male fetus to finasteride may result in offspring with ambiguous genitalia (pseudo-hermaphroditic)
Pregnant women should avoid contact
Pharmacists (women) should use rubber gloves

Question 27

Finasteride, Dutasteride counseling

Answer 27

Women of childbearing age should not touch or handle broken tablets
Results of therapy may take several months

Question 28

Urinary Incontinence (UI)

Answer 28

Urinary Incontinence (UI): The involuntary leakage of urine
Chronic UI is one of the most common reasons for elderly institutionalization in the US

Question 29

Tolterodine, Oxybutynin

Answer 29

Anticholinergic agents

Question 30

Tolterodine, Oxybutynin MOA

Answer 30

Antagonize muscarinic cholinergic receptors
Relaxation of detrusor muscle
Reduction in frequency and intensity of bladder contractions

Question 31

Tolterodine, Oxybutynin indications

Answer 31

UI/Overactive bladder

Question 32

Tolterodine, Oxybutynin adverse effects

Answer 32

Anticholinergic – dry mouth, constipation, xerophthalmia, blurred vision, mydriasis, tachycardia, sedation, dizziness, hallucinations, delirium

Question 33

Tolterodine, Oxybutynin contraindications

Answer 33

Uncontrolled narrow-angle glaucoma
Urinary retention
Gastric retention/conditions with severely decreased GI motility

Question 34

Tolterodine, Oxybutynin interactions

Answer 34

Anticholinergic agents

Tolterodine – CYP3A4 and 2D6 inhibitors and inducers

Question 35

Tolterodine, Oxybutynin counseling

Answer 35

Drink water and/or eat sugarless candy to lessen dry mouth effects
Exercise caution with driving due to possibility of sedation
Extended release – Do not crush or chew
Oxybutinin gel – Apply to clean, dry, intact skin on abdomen, thighs, or upper arms/shoulders. Rotate site; do not apply to the same site on consecutive days. Wash hands after use. Cover treated area with clothing after gel has dried to prevent transfer of medication to others. Do not bathe, shower, or swim until 1 hour after gel is applied.
Oxybutinin transdermal – Apply to clean, dry skin on abdomen, hip, or buttocks. Select a new site for each new system, avoiding reapplication to the same site within 7 days.