Top 300 - Genitourinary

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.