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Brand names of Oxybutynin?
Ditropan, Gelnique Top Gel, Oxytrol TD patch
Class of oxybutynin?
Antimuscarinic
Indication of oxybutynin?
Overactive or neurogenic bladder (primary hyperhidrosis- off-label)
MOA of oxybutynin?
Competitive muscarinic receptor antagonist; antispasmodic
Major contraindications for oxybutynin?
hypersensitivity to oxybutynin, gastric retention, glaucoma, urinary retention.
BBW of oxybutynin?
NONE
ADRs Common for Oxybutynin?
constipation, xerostomia, blurred vision.
ADRs Rare for oxybutynin?
Prolonged QTc interval, seizures, tachycardia.
Counseling for oxybutynin?
Anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Impaired cognitive function - elderly
Brand name of mirabegron?
Myrbetriq
Class of mirabegron?
beta-3 adrenergic receptor agonist
Indication of mirabegron?
Overactive bladder, neurogenic detrusor overactivity (children/adolescents).
MOA of mirabegron?
activates beta-3 adrenergic receptors resulting in relaxation of the detrusor smooth muscle and increasing bladder capacity.
Major contraindications of mirabegron?
hypersensitivity
BBW of mirabegron?
NONE
ADRs common of mirabegron?
HTN (vibregron does not have this same concern!!!!)
ADRs Rare of mirabegron?
atrial fibrillation, angioedema, hallucinations, increased liver function enzymes.
Counseling for mirabegron?
Monitor BP and HR and contact HCP for fast heartbeat or elevations in BP, bladder irritation or difficulty with urination
Brand name of finasteride?
Proscar, Propecia
Class of finasteride?
5-alpha-reductase inhibitor (5-ARI)
Indication of finasteride?
Benign prostatic hyperplasia (BPH), male pattern alopecia (hirsutism - off-label)
MOA of finasteride?
inhibits the conversion of testosterone to 5a-dihydrotestosterone (DHT) by 5a-reductase, isoform 2. Results in decreases in static component of BPH (hyperplasia)
Major contraindications of finasteride?
hypersensitivity, pregnancy (including women of child-bearing age coming in contact), use in children
BBW of finasteride?
NONE
ADRs common for finasteride?
impotence, reduced libido, gynecomastia, dizziness.
ADRs rare of finasteride?
heart failure, angioedema, allergic skin reactions, male breast cancer, prostate cancer (high grade)
Counseling for finasteride?
Delayed effects (3 months alopecia, 3-6 month BPH), absorption through skin or from semen can prevent development of genitalia in an unborn male, avoid blood donation as recipient may be pregnant
Brand name of Tamsulosin?
Flomax
Class of tamsulosin?
alpha-blocker
Indication of tamsulosin?
Benign prostatic hyperplasia (off-label uses: neurogenic bladder, bladder outlet obstruction (BOO) symptoms such as ureteral stones and expulsion.)
MOA of tamsulosin?
selectively block postsynaptic a-1-adrenergic receptors, specifically a-1A (prostate) and a-1D (bladder neck) reducing dynamic muscle tone
Major contraindications of tamsulosin?
hypersensitivity
BBW of tamsulosin?
NONE
ADRs common for tamsulosin?
dizziness, headache, abnormal ejaculation, rhinitis
ADRs Rare for tamsulosin?
retinal detachment, priapism
Counseling for tamsulosin?
orthostatic hypotension with 1st generation drugs. 2nd generation less likely to cause hypotension due to specificity to prostate receptors
Brand name of tadalafil?
Cialis, Adcirca
Class of tadalafil?
phosphodiesterase type 5 (PDE5) inibitor
Indication for tadalafil?
erectile dysfunction (ED); BPH; Pulmonary HTN
MOA of tadalafil?
inhibition of phosphodiesterase type 5 (PDE5) increases cyclic guanosine monophosphate (c-GMP); results in vascular smooth muscle relaxation resulting in increased blood flow into the corpus cavernosum (ED) and vasodilation in the pulmonary bed (pulmonary HTN)
Major contraindication of tadalafil?
hypersensitivity to PDE5 inhibitors, concurrent nitrates, concurrent HIV protease inhibitors when used for treating pulmonary HTN, concurrent guanylate cyclase stimulators.
BBW of tadalafil?
NONE
ADRs common for tadalafil?
flushing, nausea, headache, visual disturbances, lack of blue/green color discrimination.
ADRs rare for tadalafil?
AMI, seizures, strokes, sudden hearing loss, priapism.
Counseling for tadalafil?
take 30 min-4hour prior to anticipated sexual activity, but not more frequently than q24h. Sexual stimulation is required to initiate response; the inhibition of PDE5 has no effect in the absence of sexual stimulation.
Brand name of phenazopyridine?
Pyridium (OTC: Azo, Uristat)
Class of phenazopyridine?
urinary tract analgesic
Indication of phenazopyridine?
Dysuria (off-label uses: diagnostic aid, for ureteral or bladder visualization)
MOA of phenazopyridine?
topical analgesic effect on the mucosa of the urinary tract; relieves pain, burning, urgency, and frequency. The precise MOA is unknown.
Major contraindications for phenazopyridine?
hypersensitivity, renal failure
BBW for phenazopyridine?
NONE
ADRs common for phenazopyridine?
GI upset
ADRs Rare for phenazopyridine?
anaphylaxis, methemoglobinemia, hemolytic anemia, hepatotoxicity, nephrotoxicity.
Counseling for phenazopyridine?
drug may discolor urine and sclera to red or orange, causing staining of undergarments and contact lenses. Take drug with food to minimize gastric irritation. Limit to 2 days of therapy.