Treats symptoms of urinary pain/ kidney pain. Masks symptoms of potential UTI?
Alpha adrenergic receptor
Constrict prostate gland thereby reducing pressure on urethra
Lowers DHT (testosterone) that cause prostate growth.
Anticholinergics for incontinence?
Useful for increasing urethral resistance
- nitrofurantoin: Macrodantin
- trimethoprimsulfamethoxazole: Septra DS
- fluorquinolones: ▫Ciprofloxin
Bacteriostatic (low dose) / bactericidal(High dose)-depending on dose.
- Therapeutic class: Antibiotic
- Preg cat: B
- MOA: alters bacterial liposomal proteins. Inhibition of DNA and RNA synthesis, aerobic energy metabolism and cell wall synthesis. Take with food to avoid GI distress-avoid taking with antiacid, full glass of water.
- Indications: UTI and prophylaxis
- Contraindications: hepatic dysfunction, hypersensitivity, renal impairment, anuria, oliguria (creatine
- Adverse: GI upset, diarrhea, vomiting, dyspnea, Cx pain, fever and cough. Brown urine. Peripheral neuropathy(long term use)
- Therapeutic class: Antibiotic (sulfonamide)
- Preg cat: D
- MOA: usually given as DS- Double strength
- Indications: UTI, COPD, Otitis media, pneumocystitis
- Contraindications: history of sulfonamide or trimethoprim induced immune thombocytopenia, severe renal insufficiency.
- Adverse: rash, urticaria, nausea, vomiting
- Interactions: Dilantin can potentiate this antibiotic
also used for pneumonias
- Therapeutic class: Antibacterial
- Preg Cat: C
- MOA: IV/PO/Ophthalmic Widely used broad spectrum-Infuse over an hour.
- Indications: Enterobacter, E. Coli, Haemophilus, Klebsiella, Proteus, Staphylococcus, Shigella, Salmonella
- Contraindications: hypersensitivityAdverse: rash, diarrhea, nausea, vomiting, headache, irritability-High does can cause neurotoxicity.
- Interactions: concomitant tizanidine (muscle relaxant) (zanaflex) administration with
- Lab values: Peak and trough
bethanechol chloride (Urecholine)
Bladder stimulant (muscarinic cholinergic receptor agent)
- Therapeutic class: Parasympathomimetic
- Preg cat: C
- MOA: Increases the tone of the detrusor muscle-producing a stronger contraction of bladder strong enough to stimulate urination (micturition) urgent desire to urinate
- Indications: bladder function decreased due to neurogenic bladder, spinal cord injury, head injury, or other CNS lesion
- Contraindications: asthma, bradycardia, hypotension, CAD, epilepsy, GI inflammation, hypersensitivity, hyperthyroidism, parkinsonism, peptic ulcer
- Adverse: Flushing, abdominal cramps, diarrhea, urgent desire to urinate
oxybutynin (Ditropan)/ tolterodine tartrate (Detrol)
- Therapeutic class: urinary anti-spasmodics
- Preg cat: B
- MOA: Decreases urge of urination (overactive bladder)
- Indications: Bladder muscle dysfunction-overactive and a neurogenic bladder
- Contraindications: hypersensitivity, Gastric retention, ileus, risk for urinary retention
- Adverse: constipation, indigestion, nausea, xertomia most common. Anticholinergic side effects.
Anticholinergic side effects?
- Dry as a bone
- Blind as a bat
- Hot as a hare
- Red as a beet
- Mad as a hatter
- Full as a flask
5-alpha reductase inhibitor Dihydrotestosterone
- THerapeutic class: BPH agent/ anti-androgen
- Preg cat: X
- MOA: inhibits metabolism of testosterone
- Indications: BPH, prostate cancer, propecia-baldness-5 times lower than normal dose. May take up to 6 months
- Contraindications: Hypersensitivity, PREGO
- Adverse: Abnormal ejaculation, breast tenderness, reduced libido.
tamsulosin hydrochloride (Flomax)
Alpha adrenergic blocker
- Therapeutic class: Benign prostatic hypertrophy agent
- Preg Cat: B
- MOA: alpha-1a adrenoceptor antagonist, selectively blocks SNS of the receptor resulting in relaxation of the smooth muscle of prostate, prostatic urethra and bladder.
- Indications: BPH, spinal cord injury, neurogenic bladder, ureteric stone, radiation induced-urethritis.
- Contraindications: hypersensitivity to tamsulosin
- Adverse: Most alpha-adrenergic blockers will cause first-dose hypotension and syncope- patient needs to be especially careful at this time- however: tamsulosin (Flomax) doesn’t cause this problem as much.
- Interactions: Tadalafil (Cialis-ED or BPH), Alcohol.
- teachings: avoid activities that require alertness
Androgen Hormones: Testosterone
May be used for hypogonadism-growth delay initiate after 14.
Anabolic-androgenic steroids (AAS)
Excessive intake can cause increase in cholesterol levels, acne, high blood pressure, liver damage and changes in the left ventricle of the heart.
- Mood and cognitive changes
- muscle strength may decrease 12-60%
- loss of libido
Viagra (sildenafil) phosphodiesterase (PDE)-5 inhibitor.
avanafil-these will be on the HESI exam. DFU
- Therapeutic class: Antihypertensive, Peripheral vasodilator
- Moa: relaxes smooth muscle allowing for increased blood flow to penis.
- Indications: ED
- Contraindicated: heart problems, and Nitrates in any form-unsafe drop in blood pressure=death/code
- Therapeutic class: Urinary analgesic
- Preg Cat: B
- MOA: topical analgesia of mucosa of urinary tract.
- Indications: Dysuria/ UTI pain
- Contraindications: Hypersensitivity, Renal insufficiency
- Adverse: may cause nephrotoxicity and hepatoxicity and GI upset