Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
IOS 9 Exam 2
Urinary Incontinence/BPH
| Question | Answer |
|---|---|
| Risk foctors for Uninary Incontinence | Immobility, Gender (female), parity (childbirth), UTI, Menopause, GU surgery, lack of pastpartum exercise, various medications |
| Clinical, Psychological, and social impact of Urinary Incontinence | Rashes, pressure sores, skin&UTi's, ordor, restricted activities, embarrassment, isolation, depression, sexual dysfunctio, institutionalation |
| Stress Incontinence cause | Dysfunction of the urethral spincter leading to loss when intra-abdominal pressure increases |
| Stress Incontinence S/S | Pressure cause release-coughing, sneezing, bending, lifting, and less common at night since muscle are relaxed and no pressure exerted |
| Detrusor Instability/OVeractive bladder and Urge Incontinence cause | CNS dysregulation such as stroke, Parkinsons disease, alzehimers disease-No warning |
| Detrusor Instability/OVeractive Bladder and Urge Incontinence S/S | No warning Voiding-No characteristic features on PE, s/s -Nocturia, frequent small volume voiding |
| Overflow Incontinence causes | Bladder outlet is obstructed, spinal cord lesions, Diabetic neuropathy, muscle relaxants, calcium channel blockers, anticholinergics |
| Overflow Incontinence S/S | Palpable and percussable bladder, that is tender. Low flow rates, and post-void residual volume |
| Functional Incontinence cause | Musculoskeleta limitations, unfamilular setting |
| Iatrogenic Incontinence cause | Drugs: diuretics, hypnotics, muscle relaxants, alpha 1 agonist (pseudoephedrine), alpha antagonsts (terazosin, prazosin), anticholinergics, calcium channel blockers |
| Treatment of Detrusor instability | Anticholinergis decrease detrusor contractions, and increase bladder capacity to decrease urgency. Darifenacin, Solifenacin, Tropium, Tolterodine, Tolterodine LA, Oxybutin (pathch and XL and generic) |
| Side effects of anticholingergics | Dry mouth, constipation, cognitive impairment |
| Treatment of Stress Incontinence | Kegel exercises, topical estrogens/estring for atrophic vaginitis, pseudoephedrine, or duloxetine will all help to increase resistance to sudden intra-abdominal pressure |
| Treatment of Overflow incontinence | Improve drainage of bladder by giving: alpha antagonist (prazosin, terazosin,doxazosin, phenoxybenzamine, bethanechol) or 5 alpha reductase inhibitor (Proscar, avodart) |
| Side effects of duloxetine | HA, fatigue, insomnia, constipation, dry mouth, dizziness, increased BP |
| Side effects of alpha antagonists | Hypotension, tachycardia, impotence |
| Treatment for Functional Incontinence | Remove underlying cause, get bedside commode, schedule bathroom visits, remove sedatives |
| When behavioral interventions are used in combination with medication therapies | Excellent results. Medications alone have been shown to be minor benefit especially in nursing home patients |
| What is the role of alpha antagonists in Overflow incontinence- bladder obstruction | alpha 1 receptors inhibit the contraction of prostatic smooth muscle thus relieve bladder obstruction. |
| Contraindications of alpha antagonist | Pregnancy, blood donation for 6 months |
| What is the role of 5 alpha reductase inhibitors in bladder obstruction | Finasteride and dutasteride reduce DHT levels thus reduce the size of the prostate. Useful in men with enlarged prostrates requires 3-6 months but no change in urine flow and less symptom relief than alpha-blockers |
| AUA symptoms Index for Mild | 0-7 |
| AUA symptoms Index for Moderate | 8-19 |
| AUA symptoms Index for severe | 20-35 |
| Combination therapy for overflow incontinence when patient has | Alpha antagonist & 5 alpha reductase inhibitor if: Lower urinary tract symptoms and enlarged prostrate |
| Symptoms improvement from alpha antagonist should occur | days to weeks |
| Pharmacological selectivity of an alpha antagonsit means | No BP effects and selectivly inhibits alpha 1 |
| Functional selectivity of a alpha antagonsit means | Low peripheral BP effects although it is designed as a alpha 1 |
| No uroselectivity means | Have BP effects=terazosin and doxazosin |
| Extended release formulations of alpha antagonists | Alfuzosin, and Tamsulosin |
| Monitoring paramenters for overflow incontience | BP, volume, orthostatic hypotension |
| Psuedoephedrine not recommended for Stress incontinence patients who have | HTN |
| Drugs that cause stress incontinence | terazosin, prazosin, anticholinergics, muscle relaxants |
Created by:
liza001
Popular Pharmacology sets