Week 8 Flashcards

1
Q

Type of incontinence where muscles of the bladder are weakened with force to include cough, sneezing, heavy lifting, or prolapsed pelvic organs.

A

Stress

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2
Q

Type of incontinence with strong sudden urge to urinate and patient is unable to control urine resulting in involuntary release sooner than expected.

A

Urge

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3
Q

What nerve maintains external sphincter and pelvic muscle tone?

A

Pudenal

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4
Q

What nerve stimulates bladder contraction?

A

Pelvic nerve

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5
Q

What nerve stimulates internal sphincter closure and detrusor relaxation?

A

Hypogastric

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6
Q

Overactive bladder characteristic:

A

Nocturnal at a minimum of 2 times per night

Urinary urgency and frequency of at least 8 times in a 24-hour period

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7
Q

First line therapy in overactive bladder overview:

A

Anticholinergics/ antimuscarinics

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8
Q

MOA of anticholinergics:

A

Cause an increase bladder capacity and initial urge to void.

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9
Q

Side effects of anticholinergics:

A

Dry mouth, urinary retention, constipation, vision changes, cognitive impairment

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10
Q

Anticholinergic medications:

A
Oxybutin (ditropan) 
Tolterodine (Detrol)
Darifenacin ( enablex)
Solifenacin (vesicare)
Fesosterodine (toviaz)
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11
Q

What other medications can be used with overactive bladder?

A

TCAs, SNRIs, Alpha adrenergic antagonists

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12
Q

What is used in enuresis in children?

A

TCAs

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13
Q

Example of a TCA:

A

Imipramine (tofranil)

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14
Q

What is the MOA of SNRIs for overactive bladder?

A

Enhances urinary sphincter tone, improves bladder control and urinary storage.

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15
Q

Factors that worsen the condition of overactive bladder?

A
Stroke
Spinal cord injury 
Diabetes 
Sleep apnea
Depression
Estrogen deficiency 
UTI
Urinary obstruction
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16
Q

Complicated UTIs:

A

Men under 16, pregnancy, post menopause

17
Q

First line therapy in pyelonephritis:

A

Fluoroquinolones 10-14 days treatment

18
Q

First line therapy in uncomplicated UTI:

A

Bactrim 3 day course not with sulfa allergy

Trimethoprim with sulfa allergies 100 mg BID for 3 days

19
Q

First line therapy for UTI in pregnancy:

A

Macrobid 100mg BID for 5-7 days

20
Q

What is considered recurrent UTIs?

A

More than 2 UTIs in 6 months

21
Q

What system controls the initiation of the male erection?

A

Parasympathetic nervous system

22
Q

First line treatment for erectile dysfunction?

A

PDE-5 inhibitors

23
Q

MOA of PDE-5 inhibitors?

A

Inhibits the breakdown of responses involved in obtaining and sustaining an erection

24
Q

Examples of PDE-5 inhibitors:

A

Cialis 5-20mg/d
Viagra 25-100 mg/d
Levitra 5-20 mg/d

25
Q

What cannot be used with PDE-5 inhibitors?

A

Nitrates - due to hypotension effects

26
Q

Side effects of PDE-5 inhibitors?

A

Priapism, ha, flushing, nasal congestion, dyspepsia

27
Q

First line medications for BPH:

A

Alpha adrenergic blockers or 5 alpha reductase inhibitor

28
Q

What is the MOA of a 5 alpha reductase inhibitor?

A

Inhibits conversion of testosterone to DHT, decreasing the size of the prostate.

29
Q

5 alpha reductase inhibitor examples:

A

Proscar (finasteride)

Avodart (dutasteride)

30
Q

MOA of alpha adrenergic inhibitor:

A

Relaxed smooth muscle of the prostate and bladder, considered functional antihypertensives due to its action

31
Q

Examples of alpha adrenergic inhibitor:

A

Hytrin (terazosin)
Cardura (doxazosin)
Flomax (tamulosin)

32
Q

Third line treatment of BPH:

A

Combo therapy of 5 alpha reductase inhibitor and alpha blocker

33
Q

When to take hytrin?

A

Take at night to avoid postural hypotension

34
Q

Higher doses of flomax may cause:

A

Erectile dysfunction

35
Q

Proscar and avodart May take up to ___ months to see improvement of symptoms.

A

6 months

36
Q

Nonpharmacological therapies for BPH:

A
Weight loss
Low-fat diet
Avoid fluid intake 1-2 hours before bed
Avoid caffeine, diuretics, alcohol, which can excite the bladder
High-fiber diet 
Increase water intake
37
Q

Supplements for BPH:

A

Saw palmetto
Pygeum
Zinc