Urology Pharm Flashcards
BPH Medications
Alpha-1 Blockers
5 alpha-reductase inhibitors
Combo: Dutasteride-Tamulosin (Jalyn)
Tadalafil (Cialis)
Alpha-1 Blockers
Terazosin (Hytrin)
Doxazosin (Cardura)
Alfuzosin (Uroxatrol)
Tamsulosin (Flomax)
Silodosin (Rapaflo)
Alpha-1 Blockers MOA, SE, Efficacy
MOA: relax smooth muscle in bladder neck and prostatic capsule & urethra
SE: dizziness, orthostatic HOTN - severe if + phosphodiesterase
Flomax causes problems w/ ejaculation - none or decreased volume
Most effective for short & long term symptoms management
5 Alpha-reductase Inhibitors
Finasteride (Proscar)
Dutasteride (Avodart)
5 Alpha-Reductase Inhibitors MOA, SE
MOA: competitive inhibitor tissue & hepatic 5-alpha reductase
- takes a year to work, may decrease need for prostate CA surgery
The larger the prostate, the more effective the drug
SE: Decreased libido, ED/ejaculatory problems - may resolve after 1 year; reduces PSA by 50%
Combo 5 alpha-reductase inhibitor + alpha-1 blocker
Dutasteride-Tamulosin (Jalyn)
Tadalafil (Cialis)
Blocks PDEs in prostate and bladder
Takes 2-4 weeks for symptom improvement
CI with nitrates or alpha-1 blockers
Erectile Dysfunction
Prostaglandin Injectable
Phosphodiesterase Inhibitors
Prostaglandin Injectable
Alprostadil (Caverjetm, Muse - tablets)
MOA vasodilation directly on vascular and smooth muscle dilation relaxes trabecular smooth muscle allowing entrapment of blood
Onset 5-20 minutes, duration <1 hour
CI: Priapism predisposition, anatomic/fibrotic condition, stricture/perineal pain w/ pellets
SE: Syncope, priapism, low BP
Phosphodiesterase Inhibitors
Tadalafil (Cialis)
Vardenafil (Levitra)
Sildenafil (Viagra)
Avanafil (Stendra)
Phosphodiesterase Inhibitors
- afil
MOA: enhances nitric oxide effect inhibiting cGMP degradation in corpus cavernosum - increases smooth muscle relaxation and blood influx
Still need sexual stimulation
SE: severe HOTN, flushing, HA, dyspepsia, visual effects (Viagra)
Shortest and Longest Acting Phosphodiesterase Inhibitors
Avanafil (Stendra) - 15-30 minute onset, lasts up to 6 hours
Tadalafil (Cialis) - 60-120 minute onset, lasts up to 36 hour
Incontinence Drugs
Muscarinic Antagonists/Antispasmodics
Oxybutynin (Ditropan, Oxytrol transdermal)
Tolterodine (Detrol)
Trospium (Sanctura)
Solifenacin (Vesicare)
Darifenacin hydrobromide (Enablex)
Fesoterodine (Toviaz)
Muscarinic antagonists/Antispasmodics
Don’t use in demented patients, w/ gastric retention, or in angle-closure glaucoma
MOA: increased bladder capacity, block basal Ach release during bladder filling -> less urgency
Extended release have less side effects
Start w/ lowest dose, evaluate in 4-6 weeks
Goal: Decrease # incontinent episodes; only 30% get complete bladder control
Common Antibiotics for UTI
Ciprofloxacin
Trimethoprim/Sulfamethoxazole (Bactrim/Septra)
Nitrofurantoin (Macrodantin)
Amoxicillin/Ampicillin
