GU

Question 1

Examples of alpha blockers

Answer 1

Tamsulosin
Doxazosin
Alfuzosin

Question 2

2 indications of alpha blockers

Answer 2

First line to improve lower urinary tract symptoms in benign prostatic a enlargement
Add on treatment to resistance hypertension when others are insufficient

Question 3

MOA of alpha blockers

Answer 3

Alpha 1 adrenoreceptors are found mainly in smooth muscle
Stimulation induces contraction and blockage induced relaxation
Hence inhibiting it causes vasodilation

Question 4

Side effects of alpha blocker

Answer 4

Postural hypotension
Dizziness
Syncope

Question 5

Contraindication if alpha blockers

Answer 5

Existing postural hypotension

Question 6

Key interactions of alpha blockers

Answer 6

Caution with beta blocker and pde-5 inhibitor

Question 7

Examples of antimuscarinic (gu)

Answer 7

Solifenacin
Oxybutynin
Tolterodine

Question 8

Indication of antimuscarinics (gu)

Answer 8

To reduce urinary freq, urgency and urge incontinence in overactive bladder

Question 9

MOA of of antimuscarinics (gu)

Answer 9

Antimuscarinic drugs, bind to muscarinic receptors, where they act as a competitive inhibitor of ACh
Blocking muscarinic receptor, promotes bladder relaxation, increasing bladder capacity antimuscarinics, working overactive, bladder through antagonism at the entry receptor, which is the main muscarinic receptor subtype in the bladder.

Question 10

Side effects of of antimuscarinics (gu)

Answer 10

Dry mouth, tachycardia, constipation blurred vision, urinary retention, drowsiness

Question 11

Contraindication of of antimuscarinics (gu)

Answer 11

UTI
Caution in elderly care, dementia patients are susceptible to angle-closure glaucoma and arrhythmias. anyone with risk of urinary retention.

Question 12

Key interactions of antimuscarinics (gu)

Answer 12

Tricyclic antidepressant

Question 13

Monitoring of antimuscarinics (gu)

Answer 13

Review within one month of starting treatment

Question 14

Examples of PDE-5 inhibitor

Answer 14

Sildenafil tadalafil vardenafil

Question 15

2 indication of PDE-5 inhibitor

Answer 15

Erectile dysfunction and primary pulmonary hypertension

Question 16

MOA of PDE-5 inhibitor

Answer 16

Nitric oxide is responsible for maintenance of an erection .
Nitrix oxide activate soluble quanylyl cyclase, which produces the second messenger cyclic guanosinr monophosphate, cGMP, which activates protein kinase G which causes vasodilation in penal arteries
PDE 5 degrades cGMP to GMP terminating its affect , PDE5 inhibitor therefore increase cGMP concentration in the penis improving the likelihood of achieving an erection and prolongs its duration. PDE 5 is also expressed in pulmonary vascular causes, pulmonary arterial vasodilation by similar mechanism so also used to treat primary pulmonary hypertension.

Question 17

Side effects of PDE-5 inhibitor

Answer 17

Headache, flushing, dizziness, nasal congestion, hypotension, arrhythmias, acute coronary syndrome, priapism

Question 18

Contraindications of PDE-5 inhibitor

Answer 18

Avoid in recent/recent acute coronary syndrome or anyone with significant cardiovascular disease, use in caution in hepatic or renal impairment

Question 19

Key interaction of PDE-5 inhibitor

Answer 19

Should not be prescribed with nitrates use with caution when using alpha blockers

Question 20

Name 1 example of 5 alpha reductase inhibitor

Answer 20

Finasteride

Question 21

2 indication of 5 alpha reductase inhibitor

Answer 21

Lower urinary tract symptoms due to benign prostatic enlargement
Androgenic alopecia

Question 22

Side effects of 5 alpha reductase inhibitor

Answer 22

Impotence
Reduced libido
Gynaecomastia
Suicidal thoughts

Question 23

Contraindication of 5 alpha reductase inhibitor

Answer 23

Women of childbearing potential ( even by touching the broken tablet )

Question 24

Monitoring for 5 alpha reductase inhibitor

Answer 24

Follow up in 3-6 months and continue every 6-12months