Exam 18 - Drugs for the Urinary System

Diuretic drugs promote fluid loss by increasing urine production.

Thiazides are diuretics commonly used as the first line treatment for high blood pressure.

Loop diuretics are potent drugs that increase urine output by blocking active transport in the loop of Henle.

Potassium-sparing diuretics increase urine output without causing potassium loss.

Osmotic diuretics increase plasma osmotic pressure, leading to fluid redistribution and diuresis.

Thiazides are known to lower blood potassium due to their action in the nephron.

Loop diuretics can also cause potassium depletion due to their effect on chloride, sodium, and potassium transport.

Potassium-sparing diuretics, as their name suggests, preserve potassium levels during diuresis.

Chlorothiazide (Diuril) and hydrochlorothiazide are examples of thiazide diuretics.

Bumetanide (Bumex) and furosemide (Lasix) are examples of loop diuretics.

A type of diuretic that works by inhibiting the enzyme carbonic anhydrase in the kidneys, which leads to increased urine production.

An example of an osmotic diuretic, commonly used to manage cerebral edema and increase urine output.

A side effect of diuretics that involves an increased urge and frequency of urination.

A side effect of diuretics that involves a dry mouth due to decreased saliva production.

A common side effect of diuretics that is often experienced due to the increased water elimination from the body.

A side effect of diuretics that involves a feeling of lightheadedness, often caused by a sudden drop in blood pressure.

A potential adverse effect of diuretics that can cause a significant decrease in fluid volume in the body.

A potential adverse effect of diuretics that involves abnormally low levels of sodium in the blood.

A potentially life-threatening adverse effect of diuretics that can occur when potassium levels in the blood are too low.

A potential adverse effect of diuretics that can occur when potassium levels in the blood are too high, leading to a serious heart rhythm problem.

Selective alpha1 blockers relax smooth muscle in the prostate, bladder neck, and urethra by binding to alpha1-adrenergic receptors. This improves urine flow by reducing pressure on the urethra.

Silodosin (Rapaflo), tamsulosin (Flomax), and terazosin are selective alpha1 blockers used to treat symptoms of benign prostatic hyperplasia (BPH).

Bladder anesthetics like phenazopyridine provide local anesthetic relief to the urinary tract, reducing burning, pain, and frequency when used in conjunction with antibiotics for UTIs.

Phenazopyridine (Pyridium) is the only drug in this class that specifically soothes urinary tract discomfort by acting as a local anesthetic.

Urinary antispasmodics relax the detrusor muscle in the bladder wall, allowing the bladder to hold more urine and reduce the urge to urinate frequently.

Oxybutynin (Ditropan), tolterodine (Detrol), solifenacin (Vesicare), and darifenacin (Enablex) are all examples of urinary antispasmodics often used to treat overactive bladder.

Dihydrotestosterone (DHT) inhibitors block the conversion of testosterone to DHT, reducing prostate size and improving urine flow in patients with BPH.

Common side effects of DHT inhibitors include a decreased interest in sexual activity, breast enlargement, and nipple drainage.

Quinolones, especially fluoroquinolones, are effective against both gram-negative and gram-positive bacteria. They are often used to treat UTIs, gonorrhea, and gonococcal urethritis.

Nitrofurantoin (Macrodantin, Macrobid) is specifically effective against certain gram-positive and gram-negative bacteria in the urinary tract, often used to treat UTIs.

Methenamine mandelate is a medication used to prevent recurrent urinary tract infections (UTIs) in patients who have already had an infection and are at risk of developing another one.

Methenamine mandelate is typically prescribed after antibiotics have successfully cleared an existing UTI.

Methenamine mandelate works by maintaining an acidic urine environment, making it difficult for bacteria to thrive and cause infection.

Although rare, side effects of methenamine mandelate can include nausea, vomiting, skin rash, and hives.

It is crucial to check for potential drug interactions with other medications the patient is taking before starting methenamine mandelate.

Even if symptoms improve quickly, it is essential for the patient to complete the full course of methenamine mandelate as prescribed.

Hydration is crucial for patients taking methenamine mandelate. Aim for a daily urinary output of 2000 mL unless contraindicated.

An acid-ash diet can help maintain a urine pH of 5.5, enhancing the efficacy of methenamine mandelate.

In case of skin irritations, applying cornstarch or taking a bath with bicarbonate of soda or dilute vinegar can provide relief.

If any signs of continuing infection persist, it is imperative to report them to the healthcare provider.