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Pharmacology > Urology Drugs > Flashcards

Urology Drugs Flashcards

1
Q

Name a 5a reductase inhibitor

A

Finasteride

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2
Q

What is use of finasteride

A

Second-line agent in BPH

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3
Q

How do 5a reductase inhibitors work

A

Inhibits 5a reductase preventing conversion of testosterone to dihydrotestosterone = reducing size of prostate gland

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4
Q

Why are a-blockers preferred to finasteride

A

As 5a reductase inhibitors take several month to reduce size of prostate

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5
Q

What are 4 side effects due to androgen action of finasteride

A
  • ED
  • Decrease libido
  • Abnormal hair growth
  • Gynaecomastia
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6
Q

When is finasteride advantageous

A

Male baldness

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7
Q

What serious side effect of finasteride has been reported

A

Breast cancer in males

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8
Q

What is an absolute CI of finasteride and why

A

Pregnancy - will cause abnormality in genitalia of male infants

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9
Q

How is pregnant women’s exposure to finasteride avoided

A

Do not have unprotected sex with male taking finasteride

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10
Q

name 3 alpha-blockers

A
  • Tamsulosin
  • Doxazosin
  • Alfuzosin
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11
Q

what a-receptor are alpha blockers selective for

A

a1-adrenoceptors

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12
Q

where are a1-receptors found

A

smooth muscle of blood vessels and urinary system

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13
Q

what side-effects are associated with a-blockers

A
  • Postural Hypotension
  • Dizziness
  • Syncope
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14
Q

when are side effects of a-blockers worse

A

First-dose

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15
Q

what drug should be omitted when the first dose of a-blockers is given

A

B-blockers:

  • as a-blockers cause vasodilation (postural hypotension)
  • b-blockers would inhibit reflex tachycardia that forms part of compensatory response
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16
Q

when is the best time to take doxazosin and why

A

bedtime - due to postural hypotension effects

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17
Q

if a man has HTN and BPH what may you consider

A

introduce doxazosin (not tamsulosin as only licensed for BPH) earlier in HTN management

18
Q

what is the role of aldosterone

A

Increases ENaC channels in the distal tubule increasing sodium reabsorption

19
Q

what is the role of aldosterone antagonists

A

Aldosterone antagonists inhibit aldosterone causing sodium and water excretion and potassium retention

20
Q

what is a serious adverse effect of aldosterone antagonists

A

Hyperkalaemia

21
Q

how may hyperkalaemia present

A

Muscle weakness

Arrhythmias

22
Q

what effect do patient’s complain of with aldosterone antagonists

A

Gynaecomastia

23
Q

what can aldosterone antagonists do to the liver

A

Liver impairment - causing jaundice

24
Q

what is a serious dermatological side effect of aldosterone antagonists

A

Steven Johnson Syndrome

25
Q

what are 3 absolute contraindications of aldosterone antagonists

A
  • Addison’s
  • Hyperkalaemia
  • Severe renal impairment
26
Q

when should aldosterone antagonists be avoided

A

Pregnant and breast feeding

27
Q

when combined with what drug may aldosterone antagonists cause hyperkalaemia

A

ACEi

28
Q

what are two aldosterone antagonists

A

spirinolactone

eplerenone

29
Q

what should spirionlactone be taken with

A

Food

30
Q

what should be monitored on spirinolactone

A

U+E

31
Q

what are 3 anti-muscarinics used in GU system

A
  • Tolerodine
  • Oxybutynin
  • Solifenacin
32
Q

when are anti-muscarinics used

A

Urge incontinence

Following completion bladder training

33
Q

explain action anti-muscarinics in the bowel

A
  • Bladder muscle is under parasympathetic control

- Antagonising this causes bladder relaxation

34
Q

what muscarinic receptor is in the bladder

A

M3

35
Q

what are anti muscarinic side effects

A
  • Dry mouth
  • Constipation
  • Blurred vision
  • Tachycardia
36
Q

what is an absolute CI to anti-muscarinics

A

UTI

37
Q

what population are susceptible to drowsiness and confusion with anti-muscarinics

A

Dementia
Elderly

= Mirabegon prescribed as alternative for urge incontinence

38
Q

what ophthalmological condition should anti-muscarinics not be prescribed in

A

Angle-closure glaucoma

39
Q

what drug should anti-muscarinics be prescribed carefully with

A

TCAs

= Enhance anti-cholinergic effect

40
Q

what can help with dry-mouth side effect of anti-muscrainics

A

sugar-free chewing gum

sucking sweets

41
Q

what does dry mouth increase risk of

A

tooth decay

Pharmacology (12 decks)

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