Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Human Pharm, MTE > Genitourinary Module > Flashcards

Genitourinary Module Flashcards

1
Q

Name the main antimuscarinics used to treat urinary incontinence

A

Oxybutynin, propantheline, darifenacin, solifenacin, tolterodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the MOA of urinary antimuscarinics?

A

Non-selective muscarinic receptor antagonists

Reduce bladder muscle contractility and increase bladder capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the indication/s for urinary antimuscarinics?

A

Urinary urge incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name some ADRs for urinary antimuscarinics

A

Drowsiness & seizures (H1 block)

hallucinations and agitation (wrong dosage)

Blurry vision, dry mouth, constipation (M-receptor block)

Palpitation and cardiac arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which urinary antimuscarinics are more selective? (Uroselectivity)

A

Darifenacin, solifenacin, tolterodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which antimuscarinics has the highest incidence of dry mouth?

A

Oxybutynin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which urinary antimuscarinics will increase QT interval and constipation?

A

Solifenacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

True or False

Oxybutynin has an increased likelihood of CNS effects?

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the four concepts of uroselectivity?

A

Receptor-selective, tissue selective, clinically uroselective, functionally selective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain the following type of uroselectivity:

Receptor-selectivity

A

Difference in potency for one receptor compared to another

(E.g. selectivity for alpha 1A subtype that regulate smooth muscle contraction compared to vascular smooth muscle contraction alpha 1B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Explain the following type of uroselectivity:

Tissue selective

A

Primarily distributed in the target tissues of the urinary tracts versus other tissues and organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the following type of uroselectivity:

Clinically uroselective

A

The drug is able to produce the desired pharmacological effect with few side effects

(E.g. improves urinary flow rate and BPH symptoms with few ADR such as dizzy, orthostatic hypotension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain the following type of uroselectivity:

Functional selectivity

A

The drug is able to act on the physical function of the organ, changing its function from normal

(E.g. preferentially dec urethral pressure versus arterial BP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name the urinary selective alpha blockers

A

Alfuzosin, prazosin, silodosin, tamsulosin, terazosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MOA of urinary alpha-1 selective blockers?

A

Blocks alpha 1 receptor > decreasing circulating Ca2+ > relax smooth muscle (SM) in bladder neck and prostate > dec resistance to urine outflow

E.g. MOA of alpha-agonist = Noreadrenaline
Binding noreadrenaline to alpha1 receptor > mobilization of intracellular Ca2+ stores > smooth muscle contraction (SM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which alpha 1 blockers show equal selectivity to all receptor subtypes?

A

Terazosin, doxazosin, alfuzosin

Makes them non-selective =)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which urinary alpha 1 blockers show receptor selectivity?

A

Tamsulosin (Alpha1a = alpha1 d > Alpha1 B)

Silodosin (Alpha1a > alpha1 d > Alpha1 B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the indication for genitourinary selective alpha-1 blockers?

A

Symptomatic relief of benign prostatic hyperplasia (BPH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name some ADRs of Prazosin

(just know some/be able to explain some)

A

Depression, nervousness

Headache, drowsiness = blood vessel changes due to alpha1-Ab inhibition

Palpitations, tachycardia = physiological reflex reaction to alpha 1Ab block

Orthostatic hypotension = alpha 1Ab block > decrease PVR > decrease BP

Priapism, impotence, gynaecomastia

Nasal congestion, nosebleeds = alpha1 antagonism > vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name some Tamsulosin ADRs

A

Constipation, Diarrhoea

Blurry vision, floppy iris syndrome

Postural hypotension

Priapism, abnormal ejaculation (retrograde ejaculation)

21
Q

What is the MOA of 5-alpha-reducatse inhibitors

A

block 5-alpha reductase > prevent conversion of testosterone to dihydrotestosterone (DHT, stimulate prostatic growth) > reduce prostate size and improve urinary output

22
Q

Name the two relevant 5-alpha-reducatse inhibitors

A

Dutasteride, finasteride

23
Q

What are the indications for genitourinary 5-alpha-reducatse inhibitors (Dutasteride, finasteride)

A

Benign prostatic hyperplasia (BPH)
Male pattern baldness

24
Q

Name some notable side effects for genitourinary 5-alpha-reducatse inhibitors

A

Impotence, ejaculation disorders, decreased libido

breast tenderness/enlargement = less testosterone

25
Which is more potent, dutasteride or finasteride?
Dutasteride
26
What are the genitourinary indications for desmopressin?
nocturnal enuresis
27
What drug class is desmopressin?
Vasopressin analogue
28
What are the notable ADR of desmopressin?
Headache, nausea, vomiting Weight gain (water gain) Seizures = due to decrease Na+ concentration in blood hyponatraemia = due to decrease Na+ concentration in blood
29
What is the mechanism of action for desmopressin?
Agonist of V2 receptor in the renal collecting duct > increasing water re-absorption and decreasing urine output
30
What is the class of imipramine?
Tricyclic antidepressant
31
What is the indication for imipramine?
nocturnal enuresis
32
What is the MOA of Imipramine?
inhibit reuptake of noradrenaline and serotonin into presynaptic terminals Unrelated to therapeutic effects, they also block: - histaminergic receptor - cholinergic receptor - alpha-1 adrenergic receptor - serotonergic receptor
33
Name the notable ADRs for Imipramine
Anticholinergic effects: blurred vision, dry mouth, constipation, difficulty urinating Drowsiness, sedation = H1 block
34
Name the three notable phosphodiesterase 5 inhibitors used to treat sexual dysfunction
Sildenafil, Tadalafil, Vardenafil
35
Name the drugs used to treat sexual dysfunction and their class
Phosphodiesterase 5 inhibitors = sildenafil, tadalafil, vardenafil Alprostadil = prostaglandin E1 agonist (analogue) ---> vasodilation, can cause necrosis and damage Dapoxetine = SSRI Papaverine = cholinergic agonist --> work in absence of sexual arousal
36
True or False Sildenafil, Tadalafil, and Vadenafil can work in the absence of sexual stimulation
FALSE They are phosphodiesterase inhibitors used to treat sexual dysfunction but all require sexual stimulation to work.
37
What are the indications for Sildenafil, Tadalafil, and Vardenafil (phosphodiesterase inhibitors)
Erectile dysfunction Pulmonary arteriolar hypertension
38
Sildenafil, Tadalafil, and Vardenafil contraindications and precautions
Migraines = vasodilation will aggravate them History of non-arteritic anterior ischaemic optic neuropathy (NAION) - 2-fold inc risk of developing - sildenafil is most likely to cause Cardiovascular - Use of nitrates --> mass vasodilation and mass drop in BP --> death - Unstable angina = dilation of blood vessels will worsen heart's ability to get nutrients
39
Name some ADRs for Phosphodiesterase inhibitors (Sildenafil, Tadalafil, and Vardenafil)
Transient amnesia, headache, hearing loss, vision loss, migraine, flushing, seizure Priapism Nasal congestion/rhinitis, diarrhoea, dyspepsia
40
How can medicines affect urinary incontinence?
Increase urine production, act directly lower urinary tract, impairing cognitive function, causing constipation
41
What is the primary drug target of Dutasteride?
5-alpha-reductase inhibitors sub types I and II
42
What is the primary drug target of Finasteride?
5-alpha-reductase inhibitors sub type II
43
How do alpha-1 adrenergic agents cause urinary incontinence?
Alpha-1 Agonists = contract the neck of bladder causing overflow incontinence (e.g. pseudoephedrine, phenylephedrine) Alpha-1 antagonists = relax bladder neck/sphincter causing stress incontinence (e.g. prazosin, tamsulosin, terazosin, etc.)
44
How do cholinergic agents cause urinary incontinence?
Anticholinergic agents (cholinergic antagonist) = reduce detrusor activity causing overflow incontinence (e.g. Oxybutynin, propantheline, etc) Cholinergic agonist = increase detrusor activity causing urge incontinence (e.g. bethanechol) Cholinesterase inhibitors = increase detrusor activity causing urge incontinence (e.g. donepezil, rivastigmine, etc.)
45
How do antihypertensive agents cause urinary incontinence?
ACE inhibitors = stress incontinence due to sphincter weakness Diuretics = cause polyuria and constipation causing urge incontinence (e.g. frusemide, hydrochlorothiazide, indapamide) Calcium channel blockers = cause constipation and reduce detrusor activity causing overflow incontinence (e.g. dilitiazem, verapamil)
46
How do psychotropic agents cause urinary incontinence?
Antipsychotics = cause sedation and confusion due to H1-R block and anticholinergic actions causing overflow, functional, and stress incontinence (e.g. clozapine, olanzapine, risperidone, amisulpride, etc.) Antidepressants = increase detrusor activity and cause sedation/impaired mobility causing urge and functional incontinence (e.g. SSRI, moclibemide, venlafaxine) Antidepressants (TCA’s, mirtazepine, reboxetine) = anticholinergic effects and sedation/impaired mobility causing overflow and functional incontinence Benzodiazepines = cause sedation and impaired mobility resulting in functional incontinence Lithium = cause polydipsis, nocturia, and frequency causing functional incontinence
47
How do opioids cause urinary incontinence?
Through inhibition of voiding reflex and reduction of detrusor muscle activity Causes overflow and functional incontinence
48
How do systemic hormone replacement therepy agents cause urinary incontinence?
Cause ineffective urethral closure Causing stress and urge incontinence

Human Pharm, MTE (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions