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