Pharmacology of Urinary Drugs
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Questions and Answers

What is the primary therapeutic use of urinary tract stimulants?

  • Relaxation of detrusor muscles
  • Prevention of urinary incontinence
  • Treatment for urinary retention (correct)
  • Control of nocturia

    • Which of the following mechanisms of action is associated with urinary tract stimulants?

  • Stimulation of cholinergic receptors (correct)
  • Stimulation of beta-3 adrenergic receptors
  • Inhibition of cholinergic receptors
  • Relaxation of urethral sphincter

    • What is a common adverse effect of the drug bethanechol?

  • Urinary urgency (correct)
  • Dizziness
  • Dry mouth
  • Constipation

    • What is the role of oxybutynin in the management of urinary conditions?

    <p>Inhibits cholinergic receptors</p> Signup and view all the answers

    Which adverse effects are associated with cholinergic symptoms?

    <p>Flushing and sweating</p> Signup and view all the answers

    Which substance is known to cause SLUDGE symptoms?

    <p>Bethanechol</p> Signup and view all the answers

    What adverse effects might be expected from the use of anticholinergic medications like oxybutynin?

    <p>Anaphylaxis and tachycardia</p> Signup and view all the answers

    Which statement accurately describes the action of beta-3 adrenergic agonists in urinary treatment?

    <p>They decrease detrusor muscle activity</p> Signup and view all the answers

    What is the primary action of spironolactone?

    <p>Blocks the action of aldosterone</p> Signup and view all the answers

    Which condition is primarily treated with osmotic diuretics like mannitol?

    <p>Prevention of kidney failure in severe hypotensive situations</p> Signup and view all the answers

    What is a common side effect of spironolactone?

    <p>Erectile dysfunction</p> Signup and view all the answers

    What is the mechanism of action of carbonic anhydrase inhibitors?

    <p>Block the effects of carbonic anhydrase</p> Signup and view all the answers

    Which of the following is a potential complication of mannitol administration?

    <p>Transient volume expansion</p> Signup and view all the answers

    What electrolyte imbalance is most commonly associated with the use of carbonic anhydrase inhibitors?

    <p>Hypokalemia</p> Signup and view all the answers

    What is a contraindication for the use of spironolactone?

    <p>Renal failure</p> Signup and view all the answers

    In which situation would osmotically active agents be avoided?

    <p>Renal failure</p> Signup and view all the answers

    What is the primary mechanism of action of tamsulosin?

    <p>Blocks adrenergic receptors in the prostate</p> Signup and view all the answers

    Which side effect is commonly associated with the use of finasteride?

    <p>Erectile dysfunction</p> Signup and view all the answers

    What condition is NOT recommended to be treated with furosemide?

    <p>Benign Prostatic Hyperplasia</p> Signup and view all the answers

    What is a potential risk of using tamsulosin for longer than 2 days?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    Which of the following best describes the action of 5-alpha-reductase inhibitors?

    <p>Reduce the size of the prostate</p> Signup and view all the answers

    What is the primary mechanism by which Mirabegron increases bladder capacity?

    <p>Relaxing detrusor smooth muscle</p> Signup and view all the answers

    Which side effect is NOT commonly associated with Pentosan Polysulfate Sodium?

    <p>Increased blood pressure</p> Signup and view all the answers

    What is the main action of antibiotics used as treatment for UTIs?

    <p>Reduce the number of pathogens present</p> Signup and view all the answers

    What unique characteristic does Phenazopyridine offer for UTI symptom management?

    <p>Provides local anesthetic effects</p> Signup and view all the answers

    Which of the following is a common side effect of Fosfomycin?

    <p>Dizziness</p> Signup and view all the answers

    What is the role of antibiotics in the treatment of UTIs?

    <p>Killing or reducing pathogens</p> Signup and view all the answers

    Which medication is specifically indicated for treating symptoms of interstitial cystitis?

    <p>Pentosan Polysulfate Sodium</p> Signup and view all the answers

    Which antibiotic is known to cause infrequent side effects such as urticaria and nervousness?

    <p>Sulfamethoxazole-trimethoprim</p> Signup and view all the answers

    What is a common side effect of thiazide diuretics?

    <p>Hypokalemia</p> Signup and view all the answers

    Which condition is treated effectively by thiazide diuretics?

    <p>Renal stones</p> Signup and view all the answers

    Which electrolyte disturbance is commonly associated with thiazide diuretics?

    <p>Hypomagnesemia</p> Signup and view all the answers

    What mechanism do thiazide diuretics utilize to reduce blood pressure?

    <p>Blocking the chloride pump</p> Signup and view all the answers

    What is a potential serious adverse effect associated with thiazide diuretics?

    <p>Aplastic anemia</p> Signup and view all the answers

    Which of the following side effects is NOT commonly associated with thiazide diuretics?

    <p>Hypertension</p> Signup and view all the answers

    What condition can thiazide diuretics help prevent by blocking Na & Cl reabsorption?

    <p>Fluid retention</p> Signup and view all the answers

    Which of the following symptoms may indicate hypotension due to thiazide treatment?

    <p>Dizziness</p> Signup and view all the answers

    Study Notes

    Urinary Tract Stimulant

    • Bethanechol (Urecholine) is a drug that stimulates cholinergic receptors of the GU tract.
    • It causes relaxation of the trigone muscle and opening of the urethral sphincter which enhances detrusor muscle tone.
    • This ultimately promotes urination and helps empty the bladder more completely.
    • Possible adverse effects include flushing, sweating, urinary urgency, nausea/vomiting, hypotension, SLUDGE (Salivation, Lacrimation (excessive tear production), Urination, Defecation, GI upset, Emesis).

    Urinary Tract Antispasmodic

    • Oxybutynin (Ditropan) is a urinary tract antispasmodic.
    • It inhibits cholinergic receptors in the bladder, causing relaxation of detrusor muscles.
    • This helps to improve urinary symptoms related to an overactive bladder such as frequency, urgency, and nocturia.
    • Possible adverse effects include dizziness, drowsiness, and anticholinergic symptoms such as dry mouth, urinary retention, constipation, nausea, blurred vision, tachycardia, anaphylaxis, angioedema, photosensitivity, and hyperthermia.

    Beta-3 adrenergic agonist

    • Mirabegron (Myrbetriq) is a beta-3 adrenergic agonist.
    • It relaxes the detrusor smooth muscle during the storage phase of bladder fill void cycle, increasing bladder capacity.
    • Possible adverse effects can include dizziness, headache, angioedema, increased blood pressure, constipation, diarrhea, nausea, urinary tract infections (UTIs), and nasopharyngitis.

    Bladder Protectant

    • Pentosan polysulfate sodium (Elmiron) is a bladder protectant.
    • It adheres to the bladder wall mucosal membrane and acts as a buffer to control cell permeability.
    • It prevents irritating solutes in the urine from reaching the bladder wall cells.
    • Possible adverse effects include bleeding that may progress to hemorrhage, headache, alopecia, and GI disturbances.

    Antibiotics

    • Multiple antibiotics are used for the treatment of UTIs:
      • Fosfomycin (Myonurol)
      • Sulfamethoxazole-trimethoprim (Bactrim)
      • Nitrofurantoin (Macrodantin)
      • Ciprofloxacin (Cipro)
    • These antibiotics kill or reduce the amount of pathogens typical to UTIs.
    • Adverse effects can include nausea, vomiting, diarrhea, anorexia, and dysuria. Less common side effects include blood dyscrasias, pruritus, urticaria, headache, dizziness, nervousness, and confusion.

    Analgesic

    • Phenazopyridine (Pyridium) is an analgesic used to treat symptoms of UTIs.
    • It provides local anesthetic to the urinary tract mucosa.
    • Possible adverse effects include GI upset, headache, rash, reddish-orange coloring of the urine, staining of contact lenses, and renal and hepatic toxicity.
    • It is not recommended to use this drug for longer than 2 days.

    Peripherally-acting Alpha Adrenergic Blockers

    • Tamsulosin (Flomax) is a peripherally-acting alpha adrenergic blocker.
    • It blocks adrenergic receptors in the prostate causing relaxation of prostate smooth muscles and improved urine flow.
    • It can sometimes cause dizziness, headache, retrograde/diminished ejaculation, and rhinitis (nasal congestion).

    5-Alpha-reductase Inhibitors/Androgen Inhibitors

    • Finasteride (Proscar) is a 5-alpha-reductase inhibitor, used to treat BPH and baldness.
    • It inhibits the enzyme 5-alpha reductase, which converts testosterone to the form in which it enlarges the prostate.
    • Possible adverse effects include gynecomastia (enlarged male breast), prostate cancer, decreased libido, decreased volume of ejaculate, erectile dysfunction/infertility, angioedema, and breast cancer.

    Loop Diuretics

    • Furosemide (Lasix) is a loop diuretic.
    • It binds to the chloride transport channel in the Loop of Henle, causing sodium, chloride, and potassium loss in urine and preventing reabsorption of water.
    • Possible adverse effects include dehydration, electrolyte imbalances (hypokalemia, hyponatremia, hypotension), ototoxicity, hyperglycemia, rash, hypomagnesemia, hypovolemia, metabolic alkalosis, aplastic anemia, agranulocytosis, erythema multiform, and SJS (toxic epidermal necrolysis).

    Thiazide Diuretics

    • Hydrochlorothiazide (Hydrodiuril, HCTZ) is a thiazide diuretic.
    • It blocks sodium and chloride reabsorption in the early distal convoluted tubule, preventing water reabsorption.
    • Possible adverse effects include dehydration, hypokalemia, hyponatremia, hypotension, SJS, hypergylcemia, hypomagnesemia, hypophosphatemia, hypercholesterolemia, hypovolemia, and hyperuricemia (high level of uric acid in the blood).

    Potassium-sparing Diuretics

    • Spironolactone (Aldactone) is a potassium-sparing diuretic.
    • It blocks the action of aldosterone, resulting in potassium retention and sodium and water excretion.
    • Possible adverse effects include hyperkalemia, amenorrhea, gynecomastia, impotence, SJS, dizziness, clumsiness, headache, arrhythmias, and erectile dysfunction/impotence. It is typically not used for RF.

    Osmotic Diuretics

    • Mannitol (Osmitrol) is an osmotic diuretic.
    • It raises serum osmolality drawing fluid back into the vascular space and promoting renal excretion.
    • It is mainly used to prevent kidney failure in severe hypotensive situations (shock).
    • It is also used to decrease intracranial pressure (ICP) or intraocular pressure (IOP).
    • Possible adverse effects include heart failure, pulmonary edema, renal failure, dehydration, electrolyte imbalances (Na, K+), hypokalemia, phlebitis at the IV site, and transient volume expansion.

    Carbonic Anhydrase Inhibitors

    • Acetazolamide and Dichlorphenamide are carbonic anhydrase inhibitors.
    • They block the effects of carbonic anhydrase, slowing down the movement of hydrogen ions.
    • Possible adverse effects include metabolic acidosis, hypokalemia, paresthesias of extremities, confusion, and drowsiness.

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    Urinary & Renal Medications PDF

    Description

    Explore the mechanisms and effects of urinary tract stimulants and antispasmodics such as Bethanechol and Oxybutynin. This quiz covers their pharmacological actions, indications, and potential adverse effects. Test your knowledge on how these drugs impact urinary function!

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