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Chap. - 15
PharmacologyHSC1149
| Question | Answer |
|---|---|
| most commonly used drug, influencing function of urinary tract, increasing urine excretion | diuretics |
| thiazides, loop, potassium-sparing, & osmotic agents are | four classes of diuretics |
| type of diuretic used is determined by | condition being treated |
| diuretics used to lower intraocular pressure | carbonic anhydrase inhibitors |
| most commonly used type of diuretic; increases excretion of water, sodium, chloride, & potassium | thiazides |
| thiazides are used in the treatment of __ from causes such as heart failure & cirrhosis | edema |
| thiazides are used in treatment of __ __, either alone or in combination w/drugs from other classes; functions to reduce peripheral vascular resistance as well as by decreasing fluid retention | uncomplicated hypertension |
| thiazides are used as __ for calculus formation in patient w/hypercalciuria | prophylaxis |
| thiazides are used to treat __ __ from renal dysfunction | electrolyte imbalance |
| diuretic of choice to treat electrolyte imbalance from renal dysfunction | metolazone |
| stone | calculus |
| excess calcium in the urine | hypercalciuria |
| side effect to thiazides that may lead to cardiac arrhythmias | hypokalemia |
| hypokalemia is __ deficiency | potassium |
| side effect to thiazides that may lead to alkalosis | hypochloremia |
| hypochloremia is __ deficiency | chloride |
| thiazide side effects include __ hypotension, vertigo, & headache | postural |
| side effect of thiazides can include __ & increased uric acid | hyperglycemia |
| contraindications/caution: thiazides may cause hyperglycemia & glycosuria for patient who have | diabetes |
| contraindications/caution: thiazides may cause increased uric acid level in patient with | history of gout |
| contraindications/caution: thiazides may cause severe __ disease | renal |
| contraindications/caution: thiazides may cause impaired __ function | liver |
| contraindications/caution: thiazides if patient will be using for prolonged periods periodic __ __ checks are indicated | serum electrolyte |
| contraindications/caution: thiazides if patient will be using for prolonged periods __ __ are recommended to prevent hypokalemia | potassium supplements |
| contraindications/caution: thiazides if older patient will be using may cause __ __, due to greater sensitivity of patient | low sodium |
| contraindications/caution: thiazides if patient is hypersensitive to | sulfonamide |
| patients prescribed thiazides should be instructed to include __ __ in their diet | potassium-rich foods |
| if thiazides are prescribed for hypertension, a __ __ may be prescribed by physician | low-sodium diet |
| thiazides should be administered with __ to reduce gastric irritation | food |
| thiazides should be administered in __ to prevent sleep-cycle disruption | morning |
| patients on thiazides should rise slowly from reclining position to counter act | postural hypotension |
| thiazides may interact w/NSAIDs; there is a risk of | renal insufficiency |
| thiazides taken w/corticosteroids may increase | potassium loss |
| thiazides is taken with lithium may interact by causing | lithium intoxication |
| thiazides interact w/hypotensive agent which potentiate | blood pressure decrease |
| thiazides taken w/digitalis will increase potential for | digitalis toxicity |
| thiazides may be taken with Probenecid (Benemid) in order to block | uric acid retention |
| thiazides taken with antidiabetic agents can lead to | loss of diabetic control |
| act directly on a specific portion of the kidneys to inhibit sodium & chloride reabsorption | loop diuretics |
| furosemide (Lasix), bumetanide (Bumex), & torsemide (Demadex) a potent diuretics that act in a similar way to __, to increase excretion of water, sodium, chloride, & potassium | thiazides |
| the action of loop diuretics is more __ & __ than thiazides with greater diuresis | rapid; effective |
| furosemide (Lasix), bumetanide (Bumex), & torsemide (Demadex) are __ diuretics | loop |
| loop diuretics are used in the treatment of edema associated w/impaired renal function or __ disease | hepatic |
| loop diuretics are used in the treatment of | congestive heart failure |
| loop diuretics are used in the treatment of __ edema | pulmonary |
| loop diuretics are used in the treatment of __ caused by malignancy or cirrhosis | ascites |
| loop diuretics are used in the treatment of __; if thiazides are ineffective, loops are sometimes combined w/ other ___ | hypertension; antihypertensives |
| side effects of loop diuretics include fluid/electrolyte imbalance w/dehydration, __ __, & chest pain | circulatory collapse |
| side effects of loop diuretics includes ___ w/weakness & vertigo | hypokalemia |
| potassium supplements are recommended for cardiac patients taking loop diuretic in order to prevent | arrhythmias |
| side effects of loop diuretics includes __, close BP checks required | hypotension |
| side effects of loop diuretics includes hyperglycemia & increased | uric acid |
| side effects of loop diuretics includes allergic reactions to furosemide & bumetanide in those allergic to | sulfa |
| contraindications/caution: careful morning monitoring required for patients taking loop diuretics by those with | cirrhosis or other liver disease |
| contraindications/caution: loop diuretics may cause __ impairment | kidney |
| contraindications/caution: loop diuretics may cause __ & dehydration | alkalosis |
| contraindications/caution: loop diuretics may cause cardiac arrhythmias if potassium not supplemented for ___ patients | digitalized |
| contraindications/caution: loop diuretics for __ __ __, regarding Bumex & Demadex | children under 18 |
| in patients w/cirrhosis of liver, torsemide (Demadex) must be given with a potassium-sparing agent to prevent hypokalemia & __ __ | metabolic acidosis |
| interactions of loop diuretics are __ __ those of thiazides | similar to |
| loop diuretics interact w/corticosteroids by potentiating | potassium loss |
| loop diuretics interact w/digitalis w/increased potential for __ __ & arrhythmias | digitalis toxicity |
| loop diuretics interact w/aminoglycosides, increasing the chance for | deafness |
| loop diuretics interact w/indomethacin decreasing | diuretic effect |
| loop diuretics interact w/salicylates, specifically __, by increasing chance of salicylate toxicity | furosemide |
| loop diuretics interact w/anticonvulsants, specifically __, by reducing the diuretic effect of furosemide | phenytoin |
| patients taking loop diuretics should take with __ prior to 6pm | food |
| patients taking loop diuretics should report any changes in urinary output, especially a __ | decrease |
| patients taking loop diuretics should report abrupt or severe | weight loss |
| patients taking furosemide should limit exposure to __, due to __ | sunlight; photosensitivity |
| administered under conditions in which potassium depletion can be dangerous | potassium-sparing diuretics |
| potassium-sparing diuretics such as spironolactone (Aldactone) & triamterene (Dyrenium) counteract increased glucose & uric acid levels associated with | thiazide diuretic therapy |
| diuretic of choice for patients w/cirrhosis | spironolactone |
| spironolactone has been shown very effective in patient with | severe heart failure |
| potassium-sparing diuretics are __ used alone | seldom |
| potassium-sparing diuretics are usually combined w/thiazide diuretics to __ diuretic & hypotensive effects | increase |
| potassium-sparing diuretics are usually combined w/thiazide diuretics to __ danger of hyperkalemia | reduce |
| when combination products, such as Aldactazide or Dyazide, are given __ __ is usually not indicated; varies w/individual & other medications taken concomitantly | supplemental potassium |
| periodic __ __ __ are indicated for patients taking potassium-sparing diuretics | serum electrolyte checks |
| side of effects of potassium-sparing diuretics can lead to hyperkalemia, especially with __ __, which may lead to cardiac arrhythmias | potassium supplements |
| side of effects of potassium-sparing diuretics can lead to fatigue, lethargy, & __ weight loss | profound |
| side of effects of __ diuretics can lead to hypotension | potassium-sparing |
| side of effects of potassium-sparing diuretics can lead to __ with spironolactone | gynecomastia |
| potassium-sparing diuretics is indicated w/patient who have renal insufficiency, cirrhosis & other liver disease, & pregnant/lactating | caution |
| patients taking potassium-sparing diuretics may experience the interaction of ___ when taken w/potassium supplements, ACE inhibitors, ARBs, salicylates, & NSAIDs | hyperkalemia |
| when patients taking potassium-sparing diuretics also take lithium there is a possible interaction of ___ ___ & cause lithium toxicity | reduce clearance |
| patients taking potassium-sparing diuretics should be instructed to __ potassium rich foods & salt substitutes in their diet | avoid |
| patients taking potassium-sparing diuretics should be instructed to report signs of __ __, such as dry mouth, drowsiness, lethargy & fever | excessive dehydration |
| patients taking potassium-sparing diuretics should be instructed to report __ __, such as nausea, vomiting, & diarrhea | GI symptoms |
| patients taking potassium-sparing diuretics should be instructed to report __ headache & mental confusion | persistent |
| patients taking potassium-sparing diuretics should be instructed to report __ heartbeat | irregular |
| patients taking potassium-sparing diuretics should be instructed to take medication __ meals | after |
| frequently use to reduce intracranial/intraocular pressure, prevent/treat acute renal failure, & during certain cardiovascular surgery | osmotic agents |
| thiazide & related diuretics; trade name for indapamide | Lozol |
| thiazide & related diuretics; trade name for hydrochlorothiazide | Esidrix, HydroDIURIL |
| thiazide & related diuretics; trade name for metolazone | Zaroxolyn |
| loop diuretic; trade name for furosemide | Lasix |
| loop diuretic; trade name for bumetanide | Bumex |
| loop diuretic; trade name for torsemide | Demadex |
| potassium-sparing diuretic; trade name for spironolactone | Aldactone |
| potassium-sparing diuretic; trade name for triamterene | Dyrenium |
| combination potassium-sparing/thiazide diuretic; trade name for spironolactone/hydrochlorothiazide | Aldactazide |
| combination potassium-sparing/thiazide diuretic; trade name for triamterene/hydrochlorothiazide | Dyazide, Maxzide |
| osmotic agents; parenteral administration only; trade name for mannitol | Osmitrol |
| osmotic agents; parenteral administration only; trade name for urea | Ureaphil |
| form of arthritis in which uric acid crystals are deposited in & around joints, causing inflammation & pain | gout |
| gout usually begin in the __ or __, but affected joints in any location | knee; foot |
| medications to treat gout include uricosuric agents & allopurinol, which lower | uric acid levels |
| act on the kidney by clocking reabsorption & promoting urinary excretion of uric acid | uricosuric agents |
| uricosuric agent; trade name for probenecid | Benemid |
| uricosuric agents are used in treatment of __ cases of gout & frequent __ attacks of gouty arthritis | chronic; disabling |
| uricosuric agents have no __ or __ activity | analgesic; anti-inflammatory |
| uricosuric agents are __ __ in treatment of acute gout | not effective |
| during acute attacks of gout the probenecid dosage is supplemented with __, which has anti-inflammatory action | colchicine |
| in a gonococcal infection probenecid is sometimes given w/penicillin to __ levels of antibiotic in the blood | potentiate |
| probenecid can also be given with cefoxitin to treat acute | pelvic inflammatory disease |
| if probenecid is not taken with large volumes of fluid, consistently, the side effect can include | kidney stones & renal colic |
| hypersensitivity reactions, rash, hypotension, & anaphylaxis are rare side effects from | probenecid administration |
| patients w/uric acid kidney stone & peptic ulcer history, or renal impairment, or blood dyscrasias are __ for administration of probenecid | contraindicated |
| the action of penicillins/cephalosporins when taken with probenecid can cause potentiation of | therapeutic effects |
| the interaction of oral hypoglycemics & probenecid can cause ___ through potentiation | hypoglycemia |
| salicylates __ uricosuric action | antagonize |
| probenecid decreases __ __ when taken w/NSAIDs | renal clearance |
| uricosuric agents should taken __ food | with |
| acts by decreasing serum & urine levels of uric acid; trade name Zyloprim & Lorpurin | allopurinol |
| blocking sympathetic nerve impulses | anticholinergic |
| anticholinergic in action, used to reduce strength & frequency of contractions of urinary bladder | antispasmodics |
| antispasmodic; used to increase bladder capacity in patients w/neurogenic bladder resulting in incontinence | propantheline (Pro-Banthine) |
| anticholinergic, used as antispasmodic, with adverse effects in older adults | hyoscyamine (Cystospaz, Levsin) |
| chemically similar drugs that exert spasmolytic effects on smooth muscle; used for relief of symptoms such as urgency, frequency, nocturia, & incontinence; adverse effects in older adults | tolterodine (Detrol) & oxybutynin (Ditropan) |
| fewer anticholinergic adverse effects than, and are less than/equally effective to oxybutynin IR | oxybutynin XL, or Oxytrol patch |
| side effects of antispasmodics are anticholinergic | in action |
| includes: drying of all secretions (esp. eyes & mouth); drowsiness/dizziness, urinary retention & constipation; blurred vision; mental confusion (esp. older adults); tachycardia, palpations; nausea, vomiting; rash, urticaria, allergic reactions | side effects of antispasmodics |
| patients w/hepatic/renal disease, obstructive uropathy; bladder/GI obstructions/ulcerative colitis; cardiovascular disease; prostatic hypertrophy; pregnant/nursing; narrow angle glaucoma are advised to use antispasmodics | with caution |
| antispasmodics are contraindicated for | children under 5 |
| cholinergic drug that stimulates parasympathetic nerves to bring about contraction of urinary bladder in cases of nonobstructive urinary retention, usually post-op or postpartum | bethanechol (Urecholine) |
| Urecholine is called the | "pharmacological catheterization" |
| side effects of bethanechol are cholinergic in action and usually __ related | dose |
| GI cramping, diarrhea, nausea, vomiting; sweating & salivation; headache & bronchial constriction; slow heartbeat/reflex tachycardia & orthostatic hypotension; urinary urgency are all | side effects of cholinergics |
| obstruction of GI/urinary tract, hyperthyroidism, peptic ulcer, IBS, asthma, cardiovascular disease/bradycardia, Parkinson, seizure disorder, pregnancy & lactation are all | contraindications of cholinergics |
| when bethanechol has known interactions w/other cholinergic or anticholinesterase agents which can potentiate effects, increasing | possibility of toxicity |
| quinidine/procainamide can __ the cholinergic effects of bethanechol when taken concomitantly | antagonize |
| in cases of cholinergic toxicity __ can be used as an antidote, since it antagonizes the cholinergic effect | Atropine |
| used to relieve burning, pain, & discomfort in urinary tract mucosa | urinary analgesics |
| urinary analgesic or local anesthetic for relief of burning, pain, discomfort, & urgency associated w/urinary tract mucosa for cystitis, cytoscopy/surgery, or trauma | phenazopyridine (Pyridium) |
| phenazopyridine (Pyridium) should not be taken for more than (2) days when used with | antibacterial agents |
| phenazopyridine (Pyridium) is only used for __ __ & not substitute for treatment of causative conditions | symptomatic relief |
| include headache/vertigo, mild GI disturbances, & orange-red urine which may stain fabric & contact lenses | side effects of phenazopyridine (Pyridium) |
| oral urinary antispasmodic medication exhibiting weak anesthetic & analgesic properties for symptomatic relief | flavoxate (Urispas) |
| urinary analgesics are not a __ for antibiotic treatment of UTIs | substitute |
| impaired kidney function (esp. older adults) & severe hepatitis are __ of urinary analgesics | contraindications |
| phenazopyridine (Pyridium) may __ with various urine, kidney function, or liver function tests | interfere |
| used to reduce size & associated urinary obstruction & manifestations (urgency, nocturia, & urinary hesitancy) in patients w/BPH; antiandrogens | finasteride (Proscar) & dutasteride (Avodart) |
| age-associated enlargement of prostate from proliferation of glandular/stromal elements; generally begins in 5th decade of life; interferes with the normal passage of urine from the bladder | benign prostatic hypertrophy (BPH) |
| Proscar 5mg or Avodart 0.5mg daily for minimum of 6-12 months is the treatment for | BPH |
| treatment for BPH appears to be __ rather than __ | suppressive; curative |
| if patient stops BPH treatment __ is likely to to return | hypertrophy |
| includes: impotence, decreased libido/ejaculation, & gynecomastia (incl. breast tenderness/enlargement) | side effects from antiandrogens |
| enlargement of one or both breasts in a male, usually seen in adolescents or elderly men due to excessive estrogen activity; occasionally there is even excretion of milk | gynecomastia |
| patients being administered antiandrogens should be screened first for | cancer, infection, or other urinary dysfunctions |
| antiandrogens may cause __ for patients w/liver function abnormalities | exacerbations |
| crushed tablets & soft gelatin capsules, of antiandrogens, should not be handled by pregnant women because they can cause | fetal damage |
| blocks alpha-1 receptors in smooth muscle in the bladder neck & prostate, causing them to relax | tamsulosin (Flomax) |
| tamsulosin (Flomax) is able to decreased symptoms of BPH because the __ __ rate improves | urine flow |
| alpha-clockers used in treatment of hypertension, as well as for BPH | doxazosin (Cardura) & terazosin (Hytrin) |
| include: dizziness, headache, nasal congestion; orthostatic hypertension; palpitations (not Flomax); ejaculation dysfunction, decreased libido, impotence | side effects from alpha-blockers |
| combination therapy recently shown to significantly reduce overall clinical progression of BPH & may reduce need for invasive therapy compared to either agent alone | Proscar & Cardura |
| uricosuric agent; trade name for probenecid w/colchicine | ColBenemid |
| antispasmodic; trade name for propantheline | ProBanthine |
| antispasmodic; trade name for tolterodine | Detrol, Detrol LA |
| antispasmodic; trade name for oxybutynin | Ditropan, Ditropan XL, Oxytrol patch |
| antispasmodic; trade name for hyoscyamine | Cystospaz, Levsin |
| antispasmodic; trade name for flavoxate | Urispas |
| antispasmodic; trade name for phenazopyridine | Azo Standard |
| antiandrogen; trade name for finasteride | Proscar |
| antiandrogen; trade name for dutasteride | Avodart |
| alpha-blocker; trade name for doxazosin | Cardura |
| alpha-blocker; trade name for tamsulosin | Flomax |
| alpha-blocker; trade name for terazosin | Hytrin |
Created by:
lfrancois
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