Pharm Quiz 2 Drugs PDF

Ears// chapter 13 ATI Amoxicillin// prototype for penicillin - Given to pt for Acute otitis media - Make sure they are not allergic to penicillin or cephalosporins as well - Adverse effects: nausea, vomiting, lethargy, diarrhea, glossitis, stomatitis, bone...

Ears// chapter 13 ATI Amoxicillin// prototype for penicillin - Given to pt for Acute otitis media - Make sure they are not allergic to penicillin or cephalosporins as well - Adverse effects: nausea, vomiting, lethargy, diarrhea, glossitis, stomatitis, bone marrow suppression, rash, fever, superinfections Amoxicillin- clavulanate - Wth recurring - AB resistant otitis media?? Otitis externa “Swimmer's ear” treatment Ciprodex - (local analgesic?) most common, has steroids to decrease inflammation and AB too Oral treatment of swimmer's ear// used to treat outer ear infection Ciprofloxacin - Given to adults for treatment of Otitis externa (swimmer’s ear) - Aka dexamethasone (ciprodex)// treatment of infections that cause otitis media in pediatric patients with tympanostomy tubes and acute otitis externa - GIVEN PERFORATED EARDRUM Cephalexin, Fluoroquinolones - ORAL F CAN CAUSE TENDON RUPTURE IN YOUNGER PT’S, THEY SHOULD NOT BE GIVEN TO PT YOUNGER THAN 18!! Necrotizing Otitis Externa treatment Ciprofloxacin - Given orally, teach pt they may be on 2 medications bc one is for infection, other is for inflammation - GIVEN FOR PERFORATED EARDRUM Fluoroquinolone antibiotics plus steroid medication Ciprofloxacin plus hydrocortisone otic drops - Topical medications to treat otitis externa// th ciprofloxacin and anti-inflammatory effect of hydrocortisone should decrease pain, edema, and erythema - CNS effect: dizziness, lightheadedness, tremors, restlessness, convulsions - PT education: question family about allergies to fluoroquinolone antibiotics or steroids (dexamethasone or cortisone) - Other medications: acetic acid 2% solution otic drops(helps with reduction of pain), ciprofloxacin plus dexamethasone otic drops, ofloxacin otic drops Ear wax emulsifier Debrox//carbamide peroxide - Helps dissolve ear wax - Lay pt on unaffected side, then flush ear with warm water then tilt head over to see Eyes// Chapter 13 ATI Timolol//Beta-adrenergic blockers - First line for glaucoma - Decrease IOP by decreasing the amount of aqueous humor produced - Used primarily for OAG (topical) - Occasionally used to treat acute closed-angle glaucoma on an emergency bases - Can cause stinging discomfort in eye after drop is instilled - Teach pt that this is benign - Pt should report occasional conjunctivitis, blurred vision, photophobia, dry eyes - Adverse effects - Local: unusually minimal - Systemic: heart and lungs if absorbed in sufficient amount (bradycardia, bronchospasm) hypotension, HEART BLOCK CARDIAC DYSRHYTHMIA - Cardioselective agents: betaxolol, levobetaxolol) recommended for asthma patients - Contraindications - Worry about COPD, Respiratory → can cause systemic effects// or don’t give to someone with asthma or COPD - Warning: pregnancy (safety not established) - Lactation: use lowest effective dose if benefit outweighs risk - DON'T USE beta2(all except cardioselective) ON SOMEONE WITH CHRONIC RESPIRATORY DISEASE (can constrict airway and cause bronchospasms) - Beta1 blockers can be used with caution in pt with chronic respiratory disease - Don't use on pt with sinus bradycardia, or AV heart block, and use caution with clients who have heart failure - If diabetic, monitor blood glucose - Beta blockers and calcium channel blockers can increase CV and respiratory effects Brimonidine// Alpha 2- Adrenergic agonists (other: apraclonidine) - Can be combined with timolol - Brimonidine(long term) decreases production while increasing outflow of aqueous humor to lower IOP - Used for first-line medication for long-term topical treatment of POAG - Apraclonidine// short term therapy for POAG only and also used preoperatively for laser eye surgeries - Does not cross BBB, does NOT PROMOTE HYPOTENSION (Apraclonidine? ) - Common side effects: stinging that will go away, make sure they DON’T RUB EYE - Eye drops first, wait 5 minutes, then ointment - Complications - Stinging discomfort, pruritus - Localized stinging discomfort and pruritus of conjunctiva - Sensation that a foreign body is in eye// TELL THEM NOT TO SCRATCH EYE  - Report: Dilated pupils, blurred vision, headache, dry mouth - Reddened sclera - Caused by blood-vessel engorgement - Be aware of possibly of effect → teach pt that - Brimonidine crosses BBB// can cause hypotension, drowsiness - Client education: use caution with driving and other tasks, and inform the provider if dizziness and/or weakness occur - Contraindications: - Pregnancy (safety not established), use lowest dose with lactation - Advise clients who wear soft contacts to administer brimonidine with lenses removed, wait at least 15 min after adm. To prevent absorption of medication into lens. - Antihypertensive medication can intensity hypotension caused by brimonidine Latanoprost// Prostaglandin analogs - Latanoprost reduces IOP by increasing aqueous humor outflow through relaxation of ciliary muscle - Topical first line medication for clients who have POAG and ocular hypertension - Complications: bilging of ocular blood vessel// inform pt about possibility of this effect - Increased pigmentation: permanent increased brown pigmentation of the iris, usually occurring in individuals with a brown tint to the iris (can also cause pigmentation of lids, lashes)// tint does not go away - Client education: DO NOT RUB EYES - As effective as beta blockers, fewer side effects - Blurred vision report to provider!! Migraine is a rare adverse effect, report to the provider! - Contraindications: pregnancy safety not established, use lowest dose for lactation Pilocarpine// Direct- acting cholinergic agonist - Purpose: SECOND LINE treatment for POAG; lowers IOP indirectly through ciliary contraction - Also used to treat closed-angle glaucoma// emergency treatment for it - Warnings: might not be safe for pregnancy, lowest dose when lactating - Adverse effects: retinal detachment, parasympathetic effects (bradycardia, increase in saliva, sweating, flushing, pupil constriction) - Decreased visual acuity, MIOSOS, blurred vision, hypotension, bronchospasm Dorzolamide// Carbonic anhydrase inhibitor (CAIs) - Reduces IOP by decreasing production of aqueous humor - Generally well tolerated: ocular stinging, bitter taste, allergic reaction in 10-15% of patients// BITTER TASTE IN MOUTH - Acetazolamide and methazolamide// systemic CAIs - TAKE ACETAZOLAMIDE IN MORNING BC OF ITS DIURETIC EFFECT - Also available in combination with timolol - Second-line treatment for POAG, which decreases aqueous humor production - timolol/dorzolamide combination produces increased effect of both medications  - Warnings: pregnancy avoid use ESPECIALLY FIRST TRIMESTER, avoid use during lactation - Adverse effects: localized allergic reactions in up to 15%, blurred vision, dryness, photophobia, can absorb into soft contacts, ocular stinging, conjunctivitis, and lid reaction, BITTER TASTE Mannitol// Osmotic agent - Osmotic agents decrease intraocular pressure by making the plasma hypertonic, thus drawing fluid from the anterior chamber of the eye - Therapeutic use: these agents treat the rapid progression of closed-angle glaucoma to prevent blindness - Adverse effects: headache, nausea, vomiting, edema, fluid electrolyte imbalance - Warning: safety not established for lactation nor pregnancy Acetazolamide// Carbonic anhydrase inhibitor (systemic) - Other: methazolamide - Reduces production of aqueous humor by causing diuresis through renal effects - Quickly lower IOP in clients for whom other medications have been ineffective - Acetazolamide, an antimicrobial sulfonamide, can be used as an emergency medication prior to surgery for acute-angle closure glaucoma and as a second-line medication for treatment of POAG - Acetazolamide can also be used to treat acute altitude sickness, seizures, and heart failure (as a diuretic) - Complications: can cause anaphylaxis if allergic - Rare serious blood disorders (bone marrow depression) → educate cline to recognize and immediately report effects - GI effects → educate pt to report GI and weight loss to provider - Prepare pt to obtain regular labs, weigh daily, monitor for postural hypotension, increase fluid intake to 2 to 3/L day, unless contraindicated - General flu-like symptoms,(headache, fever, body aches malaise), CNS, glucose disturbance (in clients who have diabetes mellitus)// if diabetic, closely monitor blood glucose - Nephrolithiasis: report manifestations of stones to the provider (flank pain) - Warnings: pregnancy// avoid use during the first trimester - Acetazolamide can decrease blood levels of lithium Combigan 0.2% brimonidine and 0.5% timolol - Treatment: 1 drop applied to affected eye twice daily (about every 12 hours) - Benefits and adverse effects are about equal to those seen when the two drugs are applied separately Echothiophate (phospholine iodine) // Cholinesterase Inhibitors - Long duration of action - Inhibits the breakdown of ACh, promotes accumulation of ACh at muscarinic receptors - Effect of eye: miosis, focusing on the lens for near vision, reduction of IOP - No longer a first-line drug  - Adverse effects - Myopia: absorption into the system can cause parasympathetic responses - Catacters Cycloplegics: paralyze ciliary muscles → if ur looking at eyes, you don’t want pt to blink Mydriatics: dilate the pupil ex. Atropine sulfate// can be drop or ointment - Adjunct to measurement of refraction, intraocular examination, intraocular surgery, treatment of anterior uveitis - Adverse effects: blurred vision and photophobia (difficulty with light), precipitation of angle-closure glaucoma, systemic effects - INCREASES HEART RATE → so tachycardia, and arrhythmia history is contraindication Phenylephrine// Adrenergic agonist - adjunctive therapy in middle-ear infections; ophthalmically to dilate pupils; and as a decongestant to provide temporary relief of eye irritation. - Adverse effects: Fear, anxiety, restlessness, headache, nausea, decreased urine formation, pallor, hypertension. Tetrahydrozoline// Decongestant - Symptomatic relief of nasal and nasopharyngeal mucosal congestion due to the common cold, hay fever, or other respiratory allergies. - Sympathomimetic effects, partly due to release of norepinephrine from nerve terminals; vasoconstriction leads to decreased edema and inflammation of the nasal membranes. - Disorientation, confusion, light-headedness, nausea, vomiting, fever, dyspnea, and rebound congestion. Glucocorticoids: given to reduce inflammation, corticosteroids used sometimes ex. Dexamethasone, ointment or solution as well Fluorescein//Dyes: dyes eyes, used when trying to see if a foreign body is in the eye, may be orange vision, but goes away after a while Diuretics// chapter. 51 Hydrochlorothiazide// Thiazide and thiazide-like diuretics - First line for hypertension// pt will be started on this first if they have hypertension, when diet DOES NOT WORK - Block chloride pump, keeps chloride and sodium in the tubule to be excreted in the urine - Prevent reabsorption of both in the vascular system - Pharmacokinetics: oral medication, well absorbed from GI tract, metabolized in liver; excreted in urine, cross the placenta and enter human milk - Contraindications: - allergy to thiazides or SULFONAMIDES, Hypovolemia//dehydration - Severe renal disease (these are the big ones), diarrhea, vomiting, tell the provider! - Caution: SLE, glucose tolerance abnormalities gout, liver disease, hyperparathyroidism, bipolar disorder, pregnancy and lactation - BIPOLAR CAUTIONS BECAUSE THEIR MEDICATIONS CAN BE ALTERED BY FLUID - Adverse effects: GI upset, fluid and electrolyte imbalance, hypotension (orthostatic hypotension)// safety, getting up slowly, HYPOKALEMIA, decreased calcium excretion - Prolonged use: blood glucose levels may increase - Someone hyperglycemic, can cause increased levels - Someone who is diabetic may use another drug - Drug-drug: OTHER ANTIHYPERTENSIVE MEDICATIONS - Prototype summary: Inhibits reabsorption of sodium and chloride in distal renal tubules, increasing the excretion of sodium, chloride, and water by the kidneys. - Adverse effects: Dizziness, vertigo, orthostatic hypotension, hypokalemia and other electrolyte alterations, nausea, anorexia, vomiting, dry mouth, diarrhea, dehydration, polyuria, nocturia, muscle cramps, or spasms. Furosemide (Lasix)// Loop diuretics - Work in the Loop of Henle - Patient education: weight themselves regularly, labs drawn regularly, assess for hypokalemia, orthostatic hypotension// CAN BE GIVEN ORALLY OR IV - Therapeutic actions: block the chloride pump in the ASCENDING LOOP OF HENLE, decreases reabsorption of sodium and chloride - Indications - Drug of choice when rapid and extensive diuresis is needed, acute HF, acute pulmonary edema, edema associated with HF or with renal or liver disease, hypertension - Pt who has acute onset of fluid volume overload, heart failure, hypertension, pulmonary edema - Given IV if needed quickly, can be given IM as well - Pharmacokinetics: metabolized and excreted vary by specific drug// always look at liver kidneys  - Contraindications: allergy, electrolyte depletion (specifically potassium), anuria, hepatic encephalopathy (because it is going to be metabolized in liver), pregnancy - Cautions: SLE, glucose tolerance abnormalities or diabetes mellitus, gout - Adverse effects: imbalance in electrolyte and fluid, HYPOKALEMIA, ALKALOSIS, HYPOKALEMIA, hyperuricemia (lead to kidney stones/gout)OTOTOXICITY - Can also effect antidiabetic medications, can also cause orthohypo - Long term: hyperglycemia//increase in blood glucose - Anyone who is diabetic needs to monitor closely if on this for a long time - Drug-drug: ANTICOAGULANT, ibuprofen, salicylates, NSAIDs, aminoglycosides - Prototype: Treatment of edema associated with HF, acute pulmonary edema, hypertension. - Actions: Inhibits the reabsorption of sodium and chloride from the distal renal tubules and the loop of Henle, leading to a sodium-rich diuresis - Adverse effect: Dizziness, vertigo, paresthesia, orthostatic hypotension, rash, urticaria, nausea, anorexia, vomiting, hyperglycemia, hyperuricemia, urinary bladder spasm, ototoxicity, dehydration, electrolyte alterations. Acetazolamide// Carbonic Anhydrase Inhibitors - Relatively mild, given oral or IV - Given for pt with glaucoma, usually open angle glaucoma// acute closure - Bc it blocks carbonic anhydrase, causing increased pressure in eye - Sometimes pt with heart failure - Pharmacokinetics: rapidly absorbed and widely distributed, excreted in urine - Contraindications: allergy, non congestive angle-closure glaucoma, pregnancy - Caution: renal or hepatic disease, adrenocortical insufficiency, COPD, respiratory acidosis (can cause further onset of this issue), COPD - Adverse effects: related to disturbances in acid base and electrolyte balances, metabolic acidosis, HYPOKALEMIA, paresthesias of extremities, confusion, drowsiness - Renal calculi bc of increase in uric acid - Can cause liver impairment// so don’t give it to someone with past liver impairment, tinnitus (ringing in ears), HYPONATREMIA (low sodium in blood) - Drug-drug: salicylates, medications that could cause metabolic acidosis, medications that lower potassium - Prototype: Adjunctive treatment of open-angle glaucoma, secondary glaucoma; preoperative use in acute angle-closure glaucoma when delay of surgery is indicated; edema caused by heart failure; and drug-induced edema; prevention or treatment of symptoms of acute mountain sickness. - Actions: Inhibits carbonic anhydrase, which decreases aqueous humor formation in the eye, intraocular pressure, and hydrogen secretion by the renal tubules. - Adverse effects:Weakness, fatigue, rash, anorexia, nausea, urinary frequency, renal calculi, bone marrow suppression, weight loss, metabolic acidosis, hypersensitivity reactions, liver impairment, hypokalemia, hyponatremia, paresthesia, tinnitus. Spironolactone// Potassium Sparing Diuretics - Not as powerful as loop diuretics, retain potassium instead of wasting it - Therapeutic actions: loss of sodium while retaining potassium - Spironolactone and eplerenone; aldosterone agonists - Amiloride and triamterene: block potassium secretion - Pull back potassium, but not quite as strong as other diuretics - Used in patients who are at risk for hypokalemia, or pt taking a lot of another diuretic, but they need more potassium - Indications: pt at risk for hypokalemia, adjunctive treatment of edema, some: improve survival for patients with HF - Spironolactone: drug of choice for hyperaldosteronism - Pharmacokinetics: metabolized in liver, excreted in kidneys, cross placenta and enter human milk - Contraindications: allergy, HYPERKALEMIA, severe renal/liver disease, Anuria (not putting out urine) → can cause worsening issues - Cautions: pregnancy - Adverse effects: HYPERKALEMIA, dizziness, lightheadedness, GYNECOMASTIA, HIRSUTISM (excessive growth of course, dark, hair), deepening of voice, irregular menses - Spironolactone: various hormonal changes// sometimes used in pt WHO HAVE HORMONAL INDUCED ACNE (has to do with hormonal release) - Drug-drug: salicylates, other antihypertensives, other medications that block RAAS - PT teaching: salt substitutes ex. Ms. Dash, pt with hypertension may stay away from salt, ARE HIGH IN POTASSIUM - Prototype: Competitively blocks the effects of aldosterone in the renal tubule, causing loss of sodium and water and retention of potassium. - Dizziness, headache, drowsiness, rash, cramping, diarrhea, hyperkalemia, hirsutism, gynecomastia, deepening of the voice, irregular menses. Mannitol (Osmitroll)// Osmotic diuretics - Pull water into renal tubule without sodium loss - Therapeutic actions: sugar that is not well absorbed by tubules, pulls large amounts of fluid into the urine due to osmotic pull - Indications: acute situations, when necessary to decrease IOP, - diuretic of choice with increased cranial pressure (increased fluid in brain and intraocular pressure)//helps with cerebral edema and IOP - Acute renal failure due to shock - Drug overdose or trauma - Adverse effects: Dizziness, headache, hypotension, rash, nausea, anorexia, dry mouth, thirst, diuresis, fluid and electrolyte imbalances, hypersensitivity reactions, injection site reactions. - Pharmacokinetics: freely filtered at the renal glomerulus, poorly reabsorbed by renal tubule, resistant to metabolism, not known of causes fetal harm, effects during lactation not well understood - Contraindications: renal disease and anuria, pulmonary congestion, intracranial bleeding, dehydration, HF - Caution: pregnancy - Adverse effects: fluid shift may cause HF and pulmonary edema, hypotension, dehydration, CNS toxicity - Nausea, vomiting, light-headedness, electrolyte imbalances, infusion site reactions, headache, can drop bp, headaches - NOT USED FOR HEART FAILURE, WE WOULD USE LOOP - Primarily used for cranial pressure! & IOP in eyes - Pt is most likely sedated with this is given, however, can be given prophylactically - Prototype: Elevates the osmolarity of the glomerular filtrate, leading to a loss of water, sodium, and chloride; creates an osmotic gradient in the eye, reducing IOP; creates an osmotic effect that decreases swelling after transurethral surgery. - Dizziness, headache, hypotension, rash, nausea, anorexia, dry mouth, thirst, diuresis, fluid and electrolyte imbalances, hypersensitivity reactions, injection site reactions. Drugs impacting urinary system// Chapter 52 Fosfomycin//Urinary tract antiinfectives - Therapeutic actions: some act specifically within the UT to destroy bacteria, direct antibiotic effect or acidification of urine, trimethoprim works systematically, Nitrofurantoin and fosfomycin are used to treat susceptible gram-positive and gram-negative pathogens - Indications: treatment of UTIs, other indications vary by specific drug - Pharmacokinetics: vary with each drug - Contraindications: allergy - Cautions: renal dysfunction, pregnancy and lactation - Adverse effects: nausea, vomiting, diarrhea, anorexia, bladder irritation, dysuria, - Infrequent: blood dyscrasias, pruritus, urticaria, headache, dizziness, nervousness, confusion - Worry about itchy reaction - Drug-drug: vary with each agent; consult a nursing drug guide - Used more specifically for uncomplicated UTIs, can cause secondary fungal vaginitis, headache, dizziness, and nausea - 3 year old child is diagnosed with UTI nurse expects bactrim to be ordered → indicated for use in children 2 months of age and older - Prototype: Treatment of acute uncomplicated UTIs caused by susceptible strains of bacteria.Treatment of acute uncomplicated UTIs caused by susceptible strains of bacteria. - Adverse: Headache, dizziness, nausea, diarrhea, vaginitis. Oxybutynin (Ditropan)// Urinary tract Antispasmodic - Can cause drowsiness, dizziness, blurred vision, urinary retention, WATCH OUT FOR ANGIOEDEMA - Therapeutic actions: most block parasympathetic activity, thus suppressing overactivity, leads to relaxation of detrusor and other UT muscles - Other specific agents work differently - Indications: bladder spasm, treatment of overactive bladder, other indications vary by drug - USED TO HELP REDUCE SPASMS AND PAIN THAT CAN OCCUR IN THESE PT - Pharmacokinetics: rapidly absorbed, slow onset of action, metabolized in lover, excreted in urine, crosses placenta and milk - Contraindications: allergy, pyloric or duodenal obstruction, obstructive UT problems - Glaucoma, myasthenia gravis, acute hemorrhage - Cautions: renal and hepatic dysfunction, pregnancy and lactation - Mirabegron: hypertension  - Adverse effects: related to blocking parasympathetic system - USED IN PT WHO HAS NEUROLOGICAL BLADDER, OTHER ISSUES WITH NEUROGENIC BLADDER, BLADDER SPASM - Prototype summary: Relief of symptoms of bladder instability associated with uninhibited neurogenic and reflex neurogenic bladder; treatment of signs and symptoms of overactive bladder; treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida). - Acts directly to relax smooth muscle in the bladder; inhibits the effects of acetylcholine at muscarinic receptors - Adverse effects: Drowsiness, dizziness, blurred vision, tachycardia, dry mouth, nausea, urinary hesitancy, decreased sweating, angioedema. Phenazopyridine// Urinary tract Analgesic - Pain involving the UT - Can be uncomfortable, lead to urinary retention and increased risk of infection - DYE USED TO RELIEVE URINARY TRACT PAIN - Therapeutic actions: exerts direct, topical analgesic effect on UT mucosa - Indications: relieves symptoms related to UT irritation from infection, trauma, or surgery - CAN CAUSE ORANGE COLOR OF URINE, STAINING OF CONTACT LENSES - Renal and hepatic toxicity, USE OF DRUG FOR LONGER THAN 2 DAYS NOT RECOMMENDED - Adverse effects: GI upset, headache (and look above for more) - Drug-drug: not known, may interfere with urinalysis using spectrometry or color reactions - Prototype: Symptomatic relief of pain, urgency, burning, frequency, and discomfort related to lower urinary tract irritation caused by infection, trauma, surgery, or various procedures.Has a direct, topical analgesic effect on the urinary tract mucosa; exact mechanism of action is not known. - Adverse: Headache; rash; yellowish tinge to skin, sclera, and urine; reddish-orange coloring of the urine; staining of contact lenses; GI disturbances. Pentosan polysulfate sodium (Elmiron)// Bladder protectant - Protects it from irritation related to solute in urine - used for someone with cystitis, or chronic bladder issues - Therapeutic action: heparin like compound that has anticoagulant and fibrinolytic effects - Adheres to the bladder wall mucosal membrane and acts as a bugger to control cell permeability - Prevent irritating solutes in the urine from reaching the bladder wall cells - Indications: decrease pain and discomfort of interstitial cystitis - Pharmaco: little of the drug is absorbed, distributed GI, liver, spleen, skin, bone marrow MAKE SURE THEY HAVE NO SPLEEN ISSUES - Contraindications: any condition that involves increased risk of bleeding, history of heparin- induced thrombocytopenia  - Cautions: hepatic or splenic dysfunction, pregnancy and lactation - Adverse effects: bleeding that may progress to hemorrhage, headache, ALOPECIA, GI, disturbances - Drug-drug: anticoag., aspirin, NSAID, → just known what it is, and what it is used for - CAN BE INTERACTIONS WITH BLEEDINGS - Prototype: Relief of bladder pain associated with interstitial cystitis. - Actions: Adheres to the bladder wall mucosal membrane and acts as a buffer to control cell permeability, preventing irritating solutes in the urine from reaching the bladder wall cells. - Bleeding, headache, alopecia, and GI disturbances Doxazosin// drugs for BPH → block alpha-adrenergic receptors - Enlargement of gland surrounding the urethra// discomfort, struggling initiating a stream of urine → feelings of bloating, increased incidence of cystitis - Contraindication: allergy - Caution: hepatic or renal dysfunction// heart failure, known coronary disease - Always assess if pt is taking alternative medications, any herbs - Block alpha adrenergic receptors, relax bladder and UT - Worry about sexual dysfunction, difficulty getting erection, sns effects, - Pt needs to report palpitations and tachycardia if they have any cardiac issues - Drug-drug: other antihypertensives, nitrates, erectile dysfunction drugs - Prototype: Treatment of BPH, - Blocks postsynaptic alpha1-adrenergic receptors, which results in a dilation of arterioles and veins and a relaxation of sympathetic effects on the bladder and urinary tract. - Headache, fatigue, dizziness, postural dizziness, lethargy, vertigo, tachycardia, palpitations, nausea, dyspepsia, diarrhea, sexual dysfunction, rash. Finasteride// drugs for BPH → inhibit testosterone production - Discomfort, difficulty in initiating a stream of urine, feelings of bloating, increased incidence of cystitis - Indication: treatment of BPH - Contraindication: allergy - Caution: hepatic or renal dysfunction - Teaching: always assess to see if they are taking alternative medications, any herbs - INHIBIT TESTOSTERONE PRODUCTION - Adverse effects → impotence: can’t have erection - Decreased libido - BREAST ENLARGEMENT/TENDERNESS GYNECOMASTIA (have open discussion with pt about this) - Contraindication: SAW PALMETTO DRUG DRUG - Prototype: Headache, fatigue, dizziness, postural dizziness, lethargy, vertigo, tachycardia, palpitations, nausea, dyspepsia, diarrhea, sexual dysfunction, rash. - Action: Inhibits the intracellular enzyme that converts testosterone to a potent androgen that the prostate depends on for its development and maintenance. - adverse effects: Impotence, decreased libido, abdominal upset, breast enlargement/tenderness, gynecomastia.