mens health

Question 1

parasympathetic control of the bladder (action, receptor)

Answer 1

detrusor muscle contraction, M3/Gq

Question 2

sympathetic control of the bladder (action, receptor)

Answer 2

detrusor muscle relaxation, B3 receptors

Question 3

sympathetic control of the urethra

Answer 3

urethral contraction, a1 receptors

Question 4

somatic control of urination

Answer 4

pudendal nerve

Question 5

drugs that cause urinary retention (6)

Answer 5

anticholinergics, antipsychotics, antidepressants, B-agonists, CCBs, opiates

Question 6

drugs that cause increased urinary frequency (3)

Answer 6

alcohol, caffeine, diuretics

Question 7

what is OAB?

Answer 7

detrusor contraction that occurs prior to the bladder being full

Question 8

3 classes of meds used for OAB

Answer 8

M3 antagonists
B3 agonists
paralytics

Question 9

what is the use limiting effect of M3 antagonists?

Answer 9

other anticholinergic effects

Question 10

which M3 antagonist has the most anti-cholinergic effects?

Answer 10

oxybutinin

Question 11

which medication is B3 agonist?

Answer 11

mirabegron

Question 12

which medication is used as a paralytic?

Answer 12

botox

Question 13

hormone that mediates prostate growth

Answer 13

DHT

Question 14

3 general classes of medications for BPH

Answer 14

a1 antagonists
5a reducstase inhibitors
PDE5 antagonists

Question 15

what are the 2 types of a1 antagonists?

Answer 15

non-selective

selective (tamsulosin)

Question 16

when are non-selective a1 antagonists preferred?

Answer 16

patient has co-exisiting, uncontrolled HTN

Question 17

what are the 2 main SE of nonselective a1 antagonists?

Answer 17

orthostatic hypotension and refelx tachycardia

Question 18

serious hypotension can occur if nonselective a1 antagonists are combined with-

Answer 18

PDE5 inhibitors

Question 19

MOA of selective a1 antagonists, advantage?

Answer 19

specific for a1A/D receptors in the urethra only, will not cause orthostatic hypotension or reflex tachycardia

Question 20

unique ADR of tamsulosin

Answer 20

intra-operative floppy iris syndrome

Question 21

MOA of finasteride

Answer 21

5a reductase inhibitor (decreases DHT)

Question 22

alt use for 5a reductase inhibitors

Answer 22

male pattern baldness

Question 23

1st line therapy for acute prostatitis/2nd line

Answer 23

1- TMP-SMX

2- ciprofloxacin

Question 24

MOA of PDE5 inhibitors

Answer 24

inhibit PDE5 = increased cGMP = vasodilation = erection

Question 25

common SE of PDE5 inhibitors (4)

Answer 25

headache, flushing, nasal congestion, dyspepsia

Question 26

severe SE of PDE5 inhibitors

Answer 26

priapism, hearing loss, vision loss, blue-green vision impairment

Question 27

which meds are CI with PDE5 inhibitors?

Answer 27

nitrates

Question 28

which PDE5 inhibitor has less visual SE? what is it's unique SE?

Answer 28

tadalafil; muscle aches

Question 29

when secondary hypogonadism should be considered? (8)

Answer 29

sellar mass, use of opiates/glucocorticoids, HIV, ESRD, COPD, DM2, infertility, osteoporosis

Question 30

testosterone replacement should be reserved for levels below

Answer 30

200