Pharmacological manipulation of micturition Flashcards

1
Q

Label a diagram of the bladder showing the location of receptors

A
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2
Q

State the action of each of the receptors in the bladder wall

A
  • M3, a1 - stimulatory, causes contraction
  • B2, M2 - inhibitory, causes relaxation
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3
Q

To which component of the ANS do the receptors belong?

A
  • Parasympathetic - M3, M2
  • Sympathetic - a1, B2
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4
Q

During storage of urine which receptors are dominant?

A

Sympathetic a1 and B2

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5
Q

What are the 2 classes of drug?

A

Agonist and antagonist - both subdivided into specific and non-specific

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6
Q

What are the names given to direct acting drugs?

A
  1. Agonists - sypmathomimetics, parasympathomimetics
  2. Antagonists - sympatholytics, parasympatholytics
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7
Q

What is the action of sympathomimetics?

A

Displace NA

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8
Q

What is the action of parasympathomimetics?

A

Acetyl choline esterase inhibitors (ACHE), displace ACh

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9
Q

What are the causes of detrusor hypercontractility?

A

Bladder infection, neurogenic disorders

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10
Q

What is the aim of the drugs given to treat detrusor hypercontractility? Give examples of drugs used

A
  • decrease detrusor activity, need muscarinic antagonist
  • e.g. Oxybutalin, Propantheline, Flavoxate, Atropine
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11
Q

What are the problems associated with muscarinic antagonists?

A
  • Side effects reflect systemic distribution
  • decreased saliva, GI stasis, tachycardia, excitement, sedation, increases IOP, mydriasis
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12
Q

What are the causes of detrusor atony?

A

Uriniary retention, neurgenic disorders, overdistension

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13
Q

What is the aim of the drugs given to treat detrusor atony? Give examples of drugs

A
  • Increase detrusor activity with cholinergic agonists/ non-specific muscarinic agonists
  • e.g. Bethanechol
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14
Q

What are the side effects associated with Bethanechol?

A

GI stimulation, hypersalivation, defecation

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15
Q

What are the causes of urethral sphincter incompetence?

A

Speying bitches, steroids

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16
Q

What is the aim of drugs used to treat urethral sphincter incompetence? Give examples of drugs

A
  • Increase sphincter tone, a1 agonist
  • e.g. phenylpropanolamine, ephedrine
17
Q

What are the side effects associated with drugs used to treat urethral sphincter incompetence?

A

Hypertension, restlessness, increased IOP

18
Q

What are the causes of urethral spasticity?

A

Infections, inflammatory neurological disorders, urethral obstruction, Bethanacol treatment

19
Q

What is the aim of drugs used to treat urethral spasticity? Give examples of drugs

A
  • Decrease sphincter tone, a1 adrenergic antagonist
  • e.g.phenoxybenzamine
20
Q

What are the side effects associated with phenoxybenzamine?

A

Hypotension, reflex tachycardia, increased IOP, GI upset