DRUGS!

Question 1

mechanism of action of sulfonamides

Answer 1

inhibits folate synthesis

Question 2

mechanism of action of quinolones

Answer 2

DNA replication inhibitor

Question 3

mechanism of action of penicillins

Answer 3

cell wall inhibitors

Question 4

mechanism of action of cephalosporins

Answer 4

cell wall inhibitors

Question 5

mechanism of action of nitrofurantoin

Answer 5

inhibits enzymes, damages DNA

Question 6

indication for alprostadil

Answer 6

erectile dysfunction

Question 7

indication for sildenafil

Answer 7

erectile dysfunction

Question 8

indication for tadalafil

Answer 8

erectile dysfunction

Question 9

indication for leuprolide

Answer 9

prostate cancer

Question 10

indication for flutamide

Answer 10

prostate cancer

Question 11

indication for finasteride

Answer 11

BPH

Question 12

indication for prazosin, terazosin, tamsulosin, alfuzosin

Answer 12

symptomatic BPH

Question 13

mechanism of action of finasteride

Answer 13

5-a reductase inhibitor - prevents conversion of testosterone to dihydrotestosterone

Question 14

mechanism of action of prazosin, terazosin, tamsulosin, alfuzosin

Answer 14

a1-antagonists/blockers - relax smooth muscle of the bladder neck and prostate to improve urine flow

Question 15

indication for tolterodine tartrate, oxybutynin, trospium chloride

Answer 15

overactive urinary bladder disease aka URGE INCONTINENCE

Question 16

mechanism of action of tolterodine tartrate, oxybutynin, trospium chloride

Answer 16

block muscarinic receptors in the bladder which lowers intravesicular pressure, which increases bladder capacity and reduces frequency of bladder contractions

Question 17

side effects of tolterodine tartrate, oxybutynin, trospium chloride

Answer 17

dry mouth, constipation, blurred vision

Question 18

mechanism of action of leuprolide

Answer 18

GnRH analogs - occupy GnRH receptors in the pituitary, leading to desensitization and subsequent inhibition of release of FSH and LH - so androgen synthesis is reduced

Question 19

mechanism of action of flutamide

Answer 19

Synthetic, nonsteroidal antiandrogens - compete with natural androgens for binding to androgen receptor, thus preventing translocation of androgens into nucleus
–causes increased SERUM testosterone levels

Question 20

side effects/adverse reactions of flutamide

Answer 20

gynecomastia, GI distress, liver failure

Question 21

side effects of leuprolide

Answer 21

impotence
hot flashes
bone pain
gynecomastia

Question 22

side effects/adverse reactions of a1-antagonists (blockers)

Answer 22

dizziness, orthostatic hypotension, tachycardia, sexual dysfunction. “floppy iris syndrome”

Question 23

side effects/adverse reactions of sildenafil, tadalafil

Answer 23

HA, flushing, dyspepsia, nasal congestion, color blindness (sildenafil only)

Question 24

side effects/adverse reactions of alprostadil

Answer 24

hypotension, dizziness, syncope, priapism, penile/urethral/testicular pain

Question 25

indications for nitrofurantoin

Answer 25

UTI w/ E. coli, gram-positive cocci, prostatitis

Question 26

side effects/adverse reactions of nitrofurantoin

Answer 26

GI disturbances, acute pneumonitis, neurologic problems....chronic use of nitrofurantoin may result in interstitial pulmonary fibrosis

Question 27

side effects/adverse reactions of TMP-SMX

Answer 27

Skin rash Nausea Hematologic (anemia, leukopenia, thrombocytopenia)

Question 28

side effects/adverse reactions of fluoroquinolones

Answer 28

PHOTOTOXICITY, increased risk of TENDINITIS/TENDON RUPTURE, GI disturbances, HA, dizziness, QT PROLONGATION

Question 29

side effects/adverse reactions of penicillins

Answer 29

hypersensitivity; diarrhea; nephritis, neurotoxicity, decreased coagulation

Question 30

Which anticholinergic medication is available in a patch formulation to help decrease the dry mouth side effect, and is thus more tolerated?

Answer 30

Oxybutynin

Question 31

Beside the “can’t shit, spit, see, or pee” side effects of anticholinergics, what else do we worry about with the elderly?

Answer 31

Clouds their sensorium | can lead to QT prolongation

Question 32

In the treatment of prostate cancer, flutamide is always given in combination with:

Answer 32

Leuprolide

Question 33

Side effects of finasteride?

Answer 33

decrease ejaculate and libido, ED | gynecomastia

Question 34

How long does it take for the prostate size to be reduced with the treatment of finasteride?

Answer 34

6-12 months

Question 35

Which alpha-blocker has the most selective to the prostate and less BP lowering effects?

Answer 35

Tamsulosin

Question 36

Due to its tendency to retain sodium, which alpha blocker is usually administered with a diuretic?

Answer 36

Prazosin

Question 37

Outpatient treatment of pyelonephritis?

Answer 37

Quinolone

Question 38

What’s the criteria for recurrent UTI prophylaxis? And what do you use?

Answer 38

> 3 episodes/ year | TMP/SMX, nitrofurantoin, cephalexin - single dosing at bedtime or at time of sexual intercourse

Question 39

Which drugs are used for a 3 day regimen for UTI treatment?

Answer 39

cephalexin, ciprofloxacin

Question 40

Which drugs are used for 7 days to treat a UTI?

Answer 40

Nitrofurantoin

Question 41

Which drug is only a single dose treatment for a UTI?

Answer 41

TMP/SMX - worry about resistant strains

Question 42

Indications for Ciprofloxacin?

Answer 42

UTIs (complicated and non complicated), prostatitis, pyelonephritis

Question 43

What are contraindications of nitrofurantoin?

Answer 43

anuria oliguria renal function with creatinine clearance 38 weeks pregnancy