Pharm GU

•     GU Pharm

•     Elimination

•     GU Drug classes

Alpha 1 adrenergic antagonists [Tamsulosin, Doxazosin]

5 Alpha-reductase inhibitors [Finasteride]

Anti-spasmodics [Oxybutynin]

•     BPH

•     Will have difficulty urinating [frequent infections too]

•     Dribbling of urine

•     Elevated PSA levels

•     Will treat with medication first, then TURP

•      Bladder irrigation!

•      Long term foley cath

•     Alpha 1 antagonist- Tamsulosin & Doxazosin

Tamsulosin
(Selective Alpha 1 blocker)

•     Immediate shrinkage of prostate tissue

•     Take with food

•     Watch for orthostatic hypotension

•     Careful with use in PDE5 drugs (Viagra)

Doxazosin

•     Causes dilation peripherally

•     Relieves obstruction caused by BPH

•     Work immediately on symptoms

A nurse is teaching a client following a cystoscopy about his new prescription for tamsulosin. Which of the following adverse effects should the nurse include in the teaching?

•                  Temporary loss of libido

•                  Dizziness

•                  Bradycardia

•                  Burning with urination

•     5-Alpha Reductase inhibitor: Finasteride

•     Prevents thinning of hair (caused by increased DHT) so will treat male pattern baldness

•     Effective for BPH because it BLOCKS the transformation of testosterone to DHT) = more testosterone= shrinkage of prostate

•     NOT for women (teratogenic!) Wear gloves!

•     Combine with OTC Saw Pelmetto for enhanced effects

•     Could take weeks-months to see full effect

•     May cause ED, breast enlargement, testicular pain

A nurse is teaching a client who has benign prostatic hypertrophy and has a new prescription for finasteride. Which of the following instructions should the nurse include in the teaching?

•                  Avoid drinking grapefruit juice when taking this medication

•                  Expect to see a response from the medication within one week

•                  Decreased libido is an adverse effect of the medication

•                  PSA levels will increase while taking this medication

•     Oxybutynin

•     Used as anti-spasmodic (Anti-cholinergic)

•      Less spasms in the bladder (overactive bladder)

•      Incontinence

•      bedwetting