Urinary Tract Pharmacology

Question 1

What does angiotensin 2 act preferentially on and what is its role?

Answer 1

ATII acts preferentially on glomerular efferent arteriole.
Maintains Glomerular FIltration Rate (GFR) and transcapillary pressure in the glomerulus

Question 2

List three things that will happen if we blovk the effect of angiotensin 2

Answer 2

Prevents efferent vasoconstriction (effectively vasodilation)
Reduces transcapillary pressure in the glomerulus
Reduces degree of proteinuria

Question 3

What are the two points that we can influences the renin-angiotencin pathway?

Answer 3

Angiotensin converting enzyme inhibitors (ACE-i)
Angiontensin receptor blockers (ARB)

Question 4

List three indications of ACE-inhibitors

Answer 4

Reduce glomerular pressure and proteinuria
Reduce afterload and preload in heart failure
Mild reduction in blood pressure (systemic hypertension)

Question 5

When are ACE-inhibitors contraindicated?

Answer 5

Hypovolaemia, hypotensive states, hyponatraemia and acute kidney injury

Question 6

What are two indications of angiotensin receptor blockers?

Answer 6

Recution of proteinuria associated with chronic kidney disease (CKD)
Avoids ACE escape

Question 7

Which arm of the ANS controls detrusor muscle emptying?

Answer 7

Parasympathetic

Question 8

List three uses of parasympathomimetics

Answer 8

Promotre function of acetylcholine
Used in bladder atony
Cholinergic side-effects

Question 9

Which animals are most likely to display urinary sphincter mechanism incompetance?

Answer 9

Spayed bitches

Question 10

Which arm of the ANS keeps the internal urethral sphincter closed?

Answer 10

Sympathetic

Question 11

List three drugs that are used to treat sphicter mechanism incompetence

Answer 11

Alpha-adrenergic agonists
Oestrogens
Testosterone in the male dog

Question 12

Which dogs and cats show urethral spasm?

Answer 12

Seen in cats with feline lower urinary tract disease (FLUTD) and dogs with reflex dyssynergia.

Question 13

List three drugs that are used to treat smooth muscle urethral spasm

Answer 13

Prazosin
Phenoxybenzamine
ACP

Question 14

List two drugs that are used to treat skeletal muscle urethral spasm and briefly describe how they work

Answer 14

Dantrolene - uncouples excitation contraction process
Diazepam - enhances GABA activity

Question 15

List four adjunctive treatments for urethral spasm.

Answer 15

Analgesia
Glycosaminoglycan supplements
Stress relief
Water intake