urinary tract drugs

Question 1

Anticholinergics

Answer 1

Muscarinic ACh antagonists
Inhibits bladder contraction
eg oxybutinin

Question 2

Side effects of anticholinergics

Answer 2

Dry mouth
Blurred vision
Palpitations
Drowsiness
Facial flushing

Question 3

Tricyclic antidepressants

Answer 3

Anticholinergic and direct muscle relaxant effects on bladder
Inhibits re-uptake of noradrenaline and serotonin, increasing their levels

Question 4

Examples of tricyclic antidepressants

Answer 4

Imipramine - used for children for nocturnal enuresis
Duloxetine - for severe stress urinary incontinence
Desmopressin - bed wetting
Mirabegron - selective beta 3 receptor agonist (for overactive bladder syndrome)

Question 5

Which hormones promotes retention

Answer 5

Noradrenaline & serotonin

Question 6

Drugs used in urinary retention

Answer 6

Alpha adrenergic blocking drugs

Parasympathomimetics - choline esters

Question 7

Action and examples of alpha adrenergic antagonists

Answer 7

relaxes smooth muscle at bladder neck

Alfuzosin, Doxazosin, …sin

Question 8

Side effects/cautions of alpha adrenergic antagonists

Answer 8

Can reduce blood pressure - hypotension
Drowsiness, depression
Headache
Dry mouth
GI distrubances

Question 9

Parasympathomimetics action and examples and uses

Answer 9

Agonist action at muscarinic Ach receptors - increases contraction of bladder detrusor muscle
Bethanecol
Limited role in relief of urinary retention

Question 10

Cautions/side effects of parasympathomimetics

Answer 10

Avoid in patients with cardiac disorders
Avoid in cases with GI ulceration, asthma, hypotension, epilepsy, Parkinsonism, pregnancy
Side effects: nausea, vomiting, intestinal colic, bradycardia, blurred vision, sweating

Question 11

Neostigmine and pyridostigmine

Answer 11

Inhibit breakdown of Ach - promote incontinence

Question 12

Finasteride, dutasteride

Answer 12

Inhibitors of androgen synthesis - relieve urinary retention caused by prostate hyperplasia