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Pharmacy > Genito-Urinary > Flashcards

Genito-Urinary Flashcards

1
Q

what are the different types of incontinence?

A

urgency - sudden, immediate need to pass urine
stress - leakage on exertion, coughing, sneezing
mixed - urgency and stress (treat as predominant type)

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2
Q

how do you treat urge incontinence?

A

1st bladder training for 6 weeks
2nd antimuscarinic (oxybutynin/ tolterodine)
3rd mirabegron

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3
Q

what are the contraindications to antimuscarinics?

A

glaucoma
GI obstruction

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4
Q

name the antimuscarinics?

A

oxybutynin, solifenacin, tolterodine, trospium

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5
Q

what are side effects to the anti-muscarinics?

A

constipation, dry mouth, flushing, dizziness, drowsiness, tachycardia

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6
Q

how do you manage nocturnal enuresis in children?

A

1st enuresis alarm
2nd desmopressin (>5)

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7
Q

what is the major side effect of desmopressin?

A

hyponatraemic convuslions

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8
Q

what are the counselling points for desmopressin for nocturnal enuresis?

A

avoid fluid overload (restrict fluid overload 1 hour before food and until 8 hours after desmopressin)
stop desmopressin in V&D

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9
Q

what medications can be used for urinary retention?

A

alpha blockers
5 alpha reductase inhibitors

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10
Q

what are the side effects of alpha blockers?

A

postural hypotension, dizziness, intra-operative floppy iris syndrome

*take first dose before bed

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11
Q

what are the side effects of finasteride (5 alpha reductase inhibitor)?

A

male breast cancer

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12
Q

what is the MHRA alert for finasteride?

A

depression and suicidal thoughts

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13
Q

what is the advice regarding finasteride and its teratogenic effect?

A

women of CB age should not handle crushed/ broken tablets
men should use a condom if partner of CB age

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14
Q

what treatment options are available for erectile dysfunction?

A

phosphodiesterase type-5 inhibitors
prostaglandin analogue (alprostadil)

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15
Q

what effect dose food have on the phosphodiesterase type-5 inhibitors?

A

delayed effect

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16
Q

how long before sex should sildenafil be taken?

A

1 hour

17
Q

how long before sex should tadalafil and avanafil be taken?

A

30 minutes

tadalafil is long acting, can be used once daily

18
Q

how long before sex should vardenafil be taken?

A

25-50 minutes

19
Q

what are the side effects of phosphodiesterase type-5 inhibitors?

A

flushing
dizziness
nasal congestion
migraine
priapism (erection > 4 hours) - medical emergency

20
Q

what medications are used in abortions?

A

gemeprost
mifepristone
misoprostol

21
Q

what medications are used to induce labour?

A

dinoprostone
misoprostol
oxytocin

22
Q

what medications are used to prevent and treat bleeding in labour, abortion and miscarriage?

A

carbetocin
carboprost
ergometrine
misoprostol
oxytocin

23
Q

what medication is used to treat an ectopic pregnancy?

A

methotrexate

24
Q

what medications are used to treat premature labour?

A

salbutamol/ terbutaline
atosiban
indometacin
nifedipine

25
Q

what non-hormonal contraceptive treatments are there?

A

barrier (condom - oil based products can damage latex)
IUD (copper coil)

26
Q

what drugs are available in a POP?

A

levonorgestrel, northisterone, desogestrel

27
Q

will additional contraception be required when starting the POP?

A

no additional precaution if started in first 5 days of cycle

2 days precaution if started at other point

28
Q

if a dose of the POP is missed, within how many hours is it safe to take the missed dose without needing further contraception?

A

within 3 hours

12 hours if desogestrel

  • if longer use condom for 2 days
29
Q

what is the upper age limit for CHC?

A

50

30
Q

what is the pill free period with CHC?

A

21 days
7 days pill free

31
Q

will additional contraception be required when starting the CHC?

A

if started on day 6 of cycle or later, additional contraception for 7 days

32
Q

if 1 pill of CHC has been missed, what should be done?

A

take ASAP, no further action

33
Q

if 2 or more pills of CHC have been missed, what should be done?

A

take one pill ASAP + condom for 7 days
omit pill free interval
EHC - if missed in first 7 days of cycle and sex occurs

34
Q

what is first line for emergency contraception?

A

IUD, up to 5 days after UPSI

35
Q

what drug options are available for EHC?

A

levonorgestrel (72 hours)
ulipristal (120 hours) - 1 week delay of breastfeeding, can use more than once in each cycle, use barrier for 14 days if on CHC and 9 days if on POP, await 5 days before starting regular contraception

Pharmacy (20 decks)

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