Medicine II: GU Pharm

Nocturnal/Diurnal Enuresis

DDAVP (Desmopressin Acetate)

+/- Oxybutynin ("Overactive Bladder")

*Postinfectious (Strep) Glomerulonephritis

HCTZ (or other Diuretic)

+/- Penicillin V (if active Strep)

NO STEROIDS

*IgA Nephropathy

Lisinopril (ACEi) + Dapagliflozin (SGLT2)

OR

Sparsentan (Endothelin & Ang II Antagonist)

+/- Budesonide

*IgA Vasculitis

Hydration + NSAIDs

+/- Prednisone

*Goodpasteur's (Anti-GBM) Syndrome

Inpatient Daily Plasma Exchange

+

Prednisone + Cyclophosphamide (Chemo)

*Pauci-Immune Glomerulonephritis (ANCA-driven)

STEP 1: IV Methylprednisolone

STEP 2: PO Prednisone x 3mo

STEP 3: Cyclophosphamide (Chemo) x 3-6mo

STEP 4: Rituximab x 4eva

***Follow ANCA labs

*Lupus Nephritis (Class I-II)

ACEi/ARBs

*Lupus Nephritis (Class III-V)

STEP 1: Prednisone + Cyclophosphamide (Chemo)

STEP 2: Mycophenolate (Good in AA individuals)

*Lupus Nephritis (Class VI)

Cooked (none)

'Minimal Change Disease (Effacement)

Prednisone

(Cyclophosphamide ONLY for Relapsive)

'Membranous Nephropathy (Primary: PLA2R)

Furosemide + Lisinopril + Atorvastatin

+/-

Prednisone + Cyclophosphamide + Rituximab

'Focal Segmental Glomerulosclerosis (Primary: Hyperpermeable)

Furosemide + Lisinopril + Atorvastatin

+

Prednisone + Rituximab

'Diabetic Nephropathy

STRICT Glucose Control

+

Lisinopril + Spironolactone

+

Semaglutide (GLP1) OR Empagliflozin (SGLT2i)

CKD: HTN

1: Lisinopril (ACEi) +/- HCTZ

(+/- Verapamil (CCB))

CKD: Hyperphosphatemia

Calcitriol (Vit D) + Cinacalcet (Anti-PTH)

+/- Calcium Acetate (Bind PO4)

PHOSPHOROUS RESTRICTION

CKD: Anemia

Ferrous Sulfate + Epoetin Supplementation

CKD: Coagulopathy

Desmopressin

(Apparently raises vWF & Factor VIII)

Tx for SYMPTOMATIC ONLY

CKD: Hyperkalemia (Acute)

Calcium Gluconate

+

IV Dextrose + Insulin

OR

Sodium Bicarbonate

CKD: Hyperkalemia (Chronic)

Furosemide

+/-

Veltassa (Fecal Elimination)

CKD: Acidosis

Sodium Bicarbonate

**Dialysis

BPH

Tamsulosin (Alpha-1)

+/-

Finasteride (5-Alpha)

Hypogonadotropic Hypogonadism

HCG Injections

+/-

CLOMID/Anastrozole

Retrograde Ejeculation

STOP: Tamsulosin

REPLACE WITH: Pseudoephedrine

Phimosis: Pharm

Betamethasone Cream

Balanitis/Balanoposthitis: MOST COMMON Tx

CANDIDA: Miconazole Topical

Balanitis/Balanoposthitis: Bacterial

Cephalexin PO

Neurogenic Bladder OR Overactive

Oxybutinin (Anticholinergic)

OR

Mirabegron (Beta-3 Agonist)

Underactive Bladder

Bethanechol (Cholinergic)

Nephrolithiasis

Tamsulosin (At night) + Analgesic

Nephrolithiasis: Calcium

HCTZ (Thiazides)

+/-

Potassium Citrate (in Hypocitraturia)

Nephrolithiasis: Uric Acid

Potassium Citrate + Sodium Bicarb (↑ pH)

Nephrolithiasis: Struvite

Percutaneous Removal

Nephrolithiasis: Cysteine

Penicillamine (Binds to metals) + Sodium Bicarb

UTI: Uncomplicated

Nitrofurantoin

OR

TMP-SMX

UTI: Single Dose

Fosamycin

UTI: Complicated, Non-Septic

TMP-SMX

OR

Ciprofloxacin (Always a Backup)

UTI: Septic, No Shock

Ceftriaxone

UTI: Septic, Shock

Cefepime

UTI: Nosocomial

Piperacillin-Tazobactam

UTI: Pregnancy

Uncomplicated: Amoxicillin, Nitrofurantoin (not in 3rd)

Complicated: 3/4 Cephs

UTI: Pain Relief

Phenazopyridine (AZO)

Interstitial Cystitis

1: Stress Management + Pain Tx

2: **PT + Pentosan Polysulfate Sodium (Elmiron)

2: PT + Amitriptyline (TCA)

Prostatitis: Acute

IV: Ampicillin + Gentamycin

Outpt: TMP-SMX OR Ciprofloxacin

Prostatitis: Chronic

Ciprofloxacin PO

Prostatitis: Non-Bacterial &

Chronic Pelvic Pain Syndrome (CPPS)

CBT + PT

+

Tamsulosin + Amitriptyline

Chlamydia & Gonorrhea (Urethritis/Prostatitis/Epididymitis/Orchitis)

Ceftriaxone + Doxycycline

ADPKD

- Tolvaptan (Vasopressin Antagonist)

- ACEi

- Aspirations

- ↓Sodium; ↑Water

Prerenal Acute Renal Failure: Pharm Causes

- **ACEi/ARBs

- NSAIDs

- Metformin

- Diuretics

Intrinsic Acute Renal Failure: ATN Pharm Causes

- **Aminoglycosides

- Cocaine

- Iodinated Contrast

- Statins (Rhabdo)

Intrinsic Acute Renal Failure: AIN Pharm Causes

- **PCN

- Sulfa Abx

- NSAIDs

- Lithium

Obstructive Acute Renal Failure: Pharm Causes

- Methotrexate

- Acyclovir

- Phosphate + Calcium

Acute Renal Failure (Prerenal/ATN/AIN/Obstructive)

IV (Crystalloid) Fluids + Diuretics

Fluids Balance First; Then Tlectrolytes