UTI, BPH, UI Flashcards
Name the 2 classes of drugs that are used to treat urinary incontinence
1) Beta-3 adrenergic agonist
(Mirabegron)
2) Anticholinergics
(Oxybutynin, Tolterodine, Solifenacin)
Describe the MOA of Beta-3 Adrenergic agonist
(Mirabegron)
Used to treat urge incontinence, this medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold.
It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.
Describe the MOA for anticholinergics
(Oxybutynin, Tolterodine, Solifenacin)
MOA: Calm an overactive bladder and may be helpful and may be helpful for urge incontinence
Name the 2 classes of drugs used to treat Benign Prostatic Hyperplasia (BPH)
- Which part of the urinary tract are they targeting?
Static region
(1) 5-alpha reductase inhibitors (~steride)
- Duta(steride),
- Fina(steride),
Dynamic region
(2) Alpha 1 blockers (~osin)
- Praz(osin)
- Tamsul(osin)
- Alfuz(osin)
How does 5-alpha reductase inhibitors work?
(Works on the static part)
Reduces the size of the prostate gland by blocking hormones that spur the growth of prostate gland. Need to wait three to six months for symptom relief with 5-alpha reductase inhibitors.
How does alpha 1 blockers work?
(Works on the dynamic part)
In men who have urge incontinence or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder.
Should be taken in the evening as it can cause dizziness and hypotension.
List the non-pharmacological interventions for BPH
- Bladder diary
- Timed voiding
- Double voiding
- Pelvic floor exercises
What are the considerations before starting pharmacological interventions for BPH?
1) If the prostate is too big, surgical interventions might be needed (i.e. TURP)
Check: Procedure might induce water absorption for patients with existing fluid overload.
2) Patient education: medications to resolve the dynamic part of BPH, alpha-1 blocker can cause dizziness and hypotension, should be taken in the evening.
List the 5 classes of antibiotics used in the treatment for UTI
(1) Beta-lactam antibiotic with oxapenamsA
aminopenicillins
(2) 2nd generation Fluoroquinolones
(3) Sulfonamides
(4) Novel class
(5) DNA synthesis inhibitor
List 5 types of antibiotics used in the treatment for UTI
(1) Amoxycillin/clavulanate (IV, PO)
(2) Ciprofloxacin (PO)
(3) Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim; PO)
(4) Fosfomycin (PO)
(5) Nitrofurantoin (PO)
List 5 types of antibiotics used in the treatment for UTI
List the MOA, Class, Rationale and A.E.
for (1) Amoxycillin/clavulanate (IV,PO)
Drug: Amoxycillin/clavulanate (IV, PO)
Class: Beta-lactam antibiotic with oxapenamsA
aminopenicillins
MOA: Inhibits bacterial cell wall synthesis (inhibit transpeptidationC)
Rationale:
Extended spectrum
A.E:
Well-tolerated;
Rash and diarrhoea most common adverse effect
1-4% patient allergic reaction: severe hypersensitivity are but potentially fatal such as SJSB;
Thrombophlebitis (inflammation at injection site)
List 5 types of antibiotics used in the treatment for UTI
List the MOA, Class, Rationale and A.E.
for (2) Ciprofloxacin (PO)
Drug: Ciprofloxacin (PO)
Class: 2nd generation Fluoroquinolones
MOA: DNA synthesis inhibition
Rationale:
Broad spectrum;
Pharmacokinetics:
Fluoroquinolones belong to a special class of antibiotics that is concentration-dependent killing. (read this article if interested)
However no longer a first choice drug as increasing resistance rates
A.E: Nausea, diarrhoea, vomiting, headache, restlessness, pain and inflammation at injection site
Anaphylaxis, tendon rupture, superinfection, photosensitivity, pseudomembranous colitis, seizure, peripheral neuropathy, hepatotoxicity.
*thus, not suitable for elderly with tendonitis or athletes with ruptured tendon
List 5 types of antibiotics used in the treatment for UTI
List the MOA, Class, Rationale and A.E.
for (3) Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim; PO)
Drug: Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim; PO)
Class: Sulfonamides Inhibit folate synthesis(note: D)
MOA: TMP and SMZ synergistically inhibit folate synthesis (2 step);
However no longer a first choice urinary septic drug as increasing resistance rates
A.E: Nausea, vomiting, anorexia, rash, photosensitivity, crystalluria, anaphylaxis, blood dyscrasias, fulminant hepatic necrosis, hyperkalaemia, Steven-Johnson syndrome (SJS)
List 5 types of antibiotics used in the treatment for UTI
List the MOA, Class, Rationale and A.E.
for (4) Fosfomycin (PO)
Recall: This drug is a consideration for a p/t who can’t take which type of antibiotics?
Drug: Fosfomycin (PO)
Class: Novel class
MOA: Inhibits bacterial cell wall synthesis (inhibit transglycosylationC)
MOA: Specific for urinary systems; safe for pregnant women; serve important roles as secondary medications especially in patients with infections resistant to TMP-SMZ or fluoroquinolones
A.E: Nausea, diarrhoea, backpain, headache, anaphylaxis, superinfection
List the MOA, Class, Rationale and A.E.
for (5) Nitrofurantoin (PO)
Drug: Nitrofurantoin (PO)
Class: DNA synthesis inhibitor
MOA: Disrupts nucleic acid synthesis via oxidative stress (works very much like metrodinazole)
Rationale: Specific coverage for UTI infections
A.E: Nausea, vomiting, anorexia, dark brown urine, anaphylaxis, superinfections, hepatic necrosis, interstitial pneumonitis, Steven-Johnson syndromeB
