Pharmacology of Urinary Tract Medications
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Questions and Answers

What is the primary mechanism of action of tamsulosin?

  • Inhibits the enzyme 5-alpha reductase
  • Blocks adrenergic receptors in the prostate (correct)
  • Increases sodium reabsorption in the kidneys
  • Promotes vasoconstriction of the systemic circulation
  • Which of the following side effects is associated with finasteride?

  • Gynecomastia (correct)
  • Increased urinary flow
  • Pulmonary edema
  • Orthostatic hypotension
  • What potential risk is associated with the prolonged use of medication beyond 2 days?

  • Dizziness
  • Nasal decongestion
  • Hepatic toxicity (correct)
  • Renal toxicity (correct)
  • Which condition may be treated using a loop diuretic like furosemide?

    <p>Pulmonary edema related to heart failure</p> Signup and view all the answers

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

    <p>Nasal congestion</p> Signup and view all the answers

    What is the therapeutic use of a urinary tract stimulant?

    <p>Promotion of urination and emptying of the bladder</p> Signup and view all the answers

    Which mechanism of action is associated with cholinergic stimulation in the urinary system?

    <p>Enhancement of detrusor muscle tone</p> Signup and view all the answers

    What adverse effects are associated with urinary tract stimulants?

    <p>Cholinergic symptoms like flushing, sweating, and urinary urgency</p> Signup and view all the answers

    What is the main therapeutic use of anticholinergic agents in the urinary system?

    <p>Control of overactive bladder symptoms</p> Signup and view all the answers

    What is a common adverse effect associated with anticholinergic urinary medications?

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

    Which symptom is indicative of the SLUDGE syndrome related to cholinergic symptoms?

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

    How do beta-3 adrenergic agents function in the urinary system?

    <p>Act as selective beta-3 adrenergic agonists</p> Signup and view all the answers

    What potential adverse effect must be monitored when using oxybutynin for overactive bladder?

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

    What is a primary effect of spironolactone?

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

    Which adverse effect is associated with spironolactone?

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

    Mannitol is mainly used for which purpose?

    <p>Decrease intracranial pressure</p> Signup and view all the answers

    What is a common side effect of osmotic diuretics like mannitol?

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

    What is the mechanism of action for carbonic anhydrase inhibitors?

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

    Which condition is NOT typically treated with potassium-sparing diuretics like spironolactone?

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

    What is a potential metabolic consequence of carbonic anhydrase inhibitors?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What is a common side effect of carbonic anhydrase inhibitors like acetazolamide?

    <p>Paresthesias of extremities</p> Signup and view all the answers

    What is the primary mechanism of action of Mirabegron?

    <p>Increases bladder capacity</p> Signup and view all the answers

    Which adverse effect is not commonly associated with Mirabegron?

    <p>Reddish-orange coloring of urine</p> Signup and view all the answers

    What is the primary action of Pentosan polysulfate sodium?

    <p>Buffers urine to reduce irritation</p> Signup and view all the answers

    Which of the following is a common side effect of antibiotics used for UTI treatment?

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

    What is a potential side effect of Phenazopyridine?

    <p>Reddish-orange urine</p> Signup and view all the answers

    How does Fosfomycin function in treating UTIs?

    <p>Kills or reduces pathogens</p> Signup and view all the answers

    What is a significant adverse effect of sulfamethoxazole-trimethoprim?

    <p>Blood dyscrasias</p> Signup and view all the answers

    What condition is treated using an antibiotic that also may cause dysuria?

    <p>Urinary tract infection</p> Signup and view all the answers

    What condition can be caused by thiazide diuretics due to their effect on reabsorption?

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

    Which electrolyte imbalance is typically associated with the use of thiazide diuretics?

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

    What is a potential side effect of thiazide diuretics related to sodium and water balance?

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

    What adverse effect can occur from thiazide diuretics, manifesting as dizziness or weakness?

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

    Which statement about thiazide diuretics is incorrect?

    <p>They block reabsorption of potassium.</p> Signup and view all the answers

    Which condition is NOT a side effect of thiazide diuretics?

    <p>Increased urination</p> Signup and view all the answers

    What metabolic condition is commonly associated with the use of thiazide diuretics?

    <p>Metabolic alkalosis</p> Signup and view all the answers

    What is the primary action of thiazide diuretics in the kidney?

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

    Study Notes

    Urinary Tract Stimulant

    • Bethanechol (Urecholine) is a cholinergic drug used to treat urinary retention.
    • It relaxes the trigone muscle and opens the urethral sphincter, enhancing detrusor muscle tone and promoting bladder emptying.
    • Side effects include cholinergic symptoms such as flushing, sweating, urinary urgency, nausea, and vomiting.
    • Severe cholinergic symptoms (SLUDGE) can occur: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis

    Urinary Tract Antispasmodic

    • Oxybutynin (Ditropan) is an anticholinergic drug used to control overactive bladder symptoms like frequency, urgency, and nocturia.
    • It inhibits cholinergic receptors in the bladder, relaxing the detrusor muscles.
    • Side effects are related to the blocking of the parasympathetic nervous system, including dizziness, drowsiness, dry mouth, urinary retention, constipation, nausea, blurred vision, and tachycardia.

    Beta-3 Adrenergic Agonist

    • Mirabegron (Myrbetriq) is a beta-3 adrenergic agonist used for overactive bladder.
    • It increases bladder capacity by relaxing the detrusor smooth muscle during the storage phase of the bladder fill-void cycle.
    • Side effects can include dizziness, headache, angioedema, increased blood pressure, tachycardia, constipation, diarrhea, nausea, urinary tract infections, and nasopharyngitis.

    Bladder Protectant

    • Pentosan polysulfate sodium (Elmiron) 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.
    • Used for treating interstitial cystitis.
    • Side effects can include bleeding that may progress to hemorrhage, headache, alopecia, and gastrointestinal disturbances.

    Antibiotics

    • Fosfomycin (Myonurol), sulfamethoxazole-trimethoprim (Bactrim), nitrofurantoin (Macrodantin), and ciprofloxacin (Cipro) are antibiotics used for treating urinary tract infections.
    • They kill or reduce the amount of pathogens responsible for UTIs.
    • Common side effects include nausea, vomiting, diarrhea, anorexia, bladder irritation, and dysuria.
    • Less frequent side effects can include blood dyscrasias, pruritus, urticaria, headache, dizziness, nervousness, and confusion.

    Analgesic

    • Phenazopyridine (Pyridium) is an analgesic used to treat symptoms of UTIs like burning, pain, frequency, and urgency.
    • It provides a local anesthetic to the urinary tract mucosa.
    • Side effects include gastrointestinal upset, headache, rash, a reddish-orange coloring of urine, staining of contact lenses, and potential for renal and hepatic toxicity.

    Peripherally-Acting Alpha Adrenergic Blockers

    • Tamsulosin (Flomax) is a peripherally-acting alpha-adrenergic blocker used for urinary flow symptoms associated with benign prostatic hyperplasia (BPH).
    • It blocks adrenergic receptors in the prostate, relaxing prostate smooth muscles and improving urine flow.
    • Side effects include dizziness, headache (due to hypotensive and orthostatic hypotension), retrograde or diminished ejaculation, and rhinitis.

    5-Alpha Reductase Inhibitors

    • Finasteride (Proscar) is a 5-alpha reductase inhibitor used for BPH and baldness.
    • It inhibits the enzyme 5-alpha reductase that converts testosterone to the form responsible for prostate enlargement.
    • Side effects include gynecomastia, prostate cancer, decreased libido, decreased volume of ejaculate, erectile dysfunction, infertility, angioedema, and breast cancer.

    Loop Diuretics

    • Furosemide (Lasix) is a loop diuretic used for pulmonary edema, edema related to heart failure, renal or liver disease, and hypertension.
    • 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.
    • Side effects can include dehydration, electrolyte imbalance (hypokalemia, hyponatremia, hypotension), ototoxicity, hyperglycemia, rash, hypomagnesemia, hypovolemia, metabolic alkalosis, aplastic anemia, agranulocytosis, erythema multiforme, and Stevens-Johnson Syndrome.

    Thiazide Diuretics

    • Hydrochlorothiazide (Hydrodiuril, HCTZ) is a thiazide diuretic used for hypertension, pulmonary edema, edema related to heart failure, renal disease, and treatment of kidney stones.
    • It blocks reabsorption of sodium and chloride in the early distal convoluted tubule, preventing reabsorption of water.
    • Side effects include dehydration, hypokalemia, hyponatremia, hypotension, Stevens-Johnson Syndrome, hyperglycemia, hypomagnesemia, hypophosphatemia, hypercholesterolemia, hypovolemia, and hyperuricemia.

    Potassium-Sparing Diuretics

    • Spironolactone (Aldactone) is a potassium-sparing diuretic used for heart failure, hypertension, and not for renal failure (used in combination with other diuretics).
    • It blocks the action of aldosterone, resulting in potassium retention and sodium and water excretion.
    • Side effects can include hyperkalemia, amenorrhea, gynecomastia, impotence, Stevens-Johnson Syndrome, toxic epidermal necrolysis, dizziness, clumsiness, headache, arrhythmias, and erectile dysfunction.

    Osmotic Diuretics

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

    Carbonic Anhydrase Inhibitors

    • Acetazolamide and Dichlorphenamide are carbonic anhydrase inhibitors used as adjuncts to other diuretics and for glaucoma.
    • They block the effects of carbonic anhydrase, slowing the movement of hydrogen ions.
    • Side effects relate to disturbances in acid-base and electrolyte balances, including metabolic acidosis, hypokalemia, paresthesias of extremities, confusion, and drowsiness.

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    Urinary & Renal Medications PDF

    Description

    This quiz explores pharmacological agents used for urinary tract disorders, including cholinergic stimulants like Bethanechol, antispasmodics like Oxybutynin, and beta-3 adrenergic agonists like Mirabegron. Test your knowledge on their mechanisms of action, side effects, and clinical applications.

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