Pharm: Week 4 Knowledge Check

A _______-day course of pain medication is usually sufficient to allow time for symptomatic response to antimicrobial therapy and minimize inflammation for UTI pain

2

Drink a minimum of ______ of fluid a day with BPH

2 quarts

Without treatment, __________% of uncomplicated acute cystitis cases in women resolve spontaneously

25-42

Which statement(s) suggests to the health care provider that the patient has an understanding of appropriate adjunctive therapies for the treatment of prostatitis? Select all that apply. A. "I am pleased with the results of taking docusate." B. "I have limited my caffeine intake to a cup of coffee after each meal. C. "I have been taking a sitz bath at least twice a day and that has really seemed to help." D. "It was initially uncomfortable urinating while taking a bath but it does help my urine flow." E. "I have stopped taking my paroxetine right away so it will not interfere with treating this prostatitis."

A. "I am pleased with the results of taking docusate." C. "I have been taking a sitz bath at least twice a day and that has really seemed to help." "It was initially uncomfortable urinating while taking a bath but it does help my urine flow."

Before prescribing a phosphodiesterases-5 (PDE5) inhibitor, the health care provider will ensure what action(s) is taken and reviewed? Select all that apply. A. Perform complete cardiac history B. Order a referral to a urologist C. Order a serum Glucose level D. Order a testosterone level E. Order serum lipid levels

A. Perform complete cardiac history C. Order a serum Glucose level D. Order a testosterone level E. Order serum lipid levels

First line of treatment for BPH

Alpha-adrenergic blocker

Use caution when prescribing Alpha-adrenergic blocker if on another antihypertensive medication, as ________ may intensify its effect

Alpha-adrenergic blocker

When the patient presents with BPH and no enlarged prostate, first line is ________ and second line therapy is ______

Alpha-adrenergic blocker; 5-alpha reductase

________ relax the smooth muscle of the prostate and bladder neck without interfering with bladder contractility, thereby (increasing/decreasing) bladder resistance to urinary outflow

Alpha-adrenergic blocker; decreasing

___________ cause smooth muscle relaxation in the lower urinary tract.

Alpha-adrenergic blockers

Medications used for stress incontinence

Anticholinergic (oxybutinin) or Mirabegron

Which is a common side effect(s) of tamsulosin HCL, used for benign prostatic hyperplasia (BPH)? Select all that apply. A. Orthostatic hypotension B. Dizziness C. Headache D. Retrograde Ejaculation E. Tachycardia

B. Dizziness C. Headache D. retrograde ejaculation

On what criteria will the health care provider base the decision to initiate specific treatment for a diagnosis of uncomplicated cystitis in a 15-year-old sexually active female adolescent? A. There is a strong likelihood the infection will resolve spontaneously. B. If symptoms persist for 4 days or longer, antibiotic therapy is initiated. c. Antibiotic therapy is indicated in all diagnosed cases of urinary tract infection. D. Medication therapy should begin with a six-dose prescription for phenazopyridine 200 mg three times daily.

C. Antibiotic therapy is indicated in all diagnosed cases of urinary tract infection.

Doxazosin is prescribed for a 50-year-old man diagnosed with benign prostatic hypertrophy. What comorbid condition will be positively affected by this medication? A. Chronic Heart failure B. Mild depression C. Hypertension D. Dementia

C. Hypertension

Which medication is most likely to result in dry mouth? A. Tamsulosin B. Estradiol C. Oxybutynin IR D. Mirabegron

C. Oxybutynin IR

Treatment for gonorrhea

Ceftriaxone 250 mg IM in a single dose AND (azithromycin 1 g PO single dose)

__________, an alpha-adrenergic blockers, is known to have secondary benefits to patients with cardiac disease, such as hypertension.

Doxazosin

First line treatment when pyelonephritis is suspected

Fluoroquinolones

gold standard for testing for gonorrhea

Nucleic acid amplification testing (NAAT)

Side effects associated with tamsulosin's relaxation of smooth muscles include _____, _____, _____, & ______

Orthostatic hypotension, headache, dizziness, and ejaculation problems

Tamsulosin is a _______

alpha adrenergic antagonist

the standard therapy for all urinary tract infections is _________ regardless of length of time since onset of symptoms.

antibiotic treatment

Oxybutynin (Ditropan) is a _______

anticholinergic medication

The ___________should not be stopped suddenly, but rather follow a gradual taping down of the dosage

antidepressant

If possible, withdrawal from _____, ____, or ______may also help bladder function

antidepressants, anticholinergics, or sedatives

Doxazosinis to be prescribed with caution for a patient diagnosed with _________

chronic heart failure

Alpha-adrenergic blockers may be associated with increasing a risk for _________

depression

S/S of gonorrhea

dysuria yellow, green or white urethral discharge pelvic pain fever menstrual irregularities

Caffeine should not be limited but rather ________

eliminated

T/F: Tachycardia is associated with tamsulosin

false

Goal of treatment for BPH

improve urinary flow and reduction in symptoms

A complete cardiac history must be taken. If there is any question as to the stability of the cardiac status, further testing must be done with ________ (drug class)

phosphodiesterases-5 (PDE5) inhibitor

Voiding in a warm bath (to _________) and discontinuation of alcohol and caffeinated beverages can also help to relieve symptoms with prostatitis

relax pelvic muscles

Mirabegron is a _______

selective beta-3-adrenoreceptor. agonist

Adjunctive therapies that may be beneficial include the use of _____ & ______ for prostatitis

sitz baths and stool softeners like docusate

It is important to include _________ in counseling about erectile dysfunction (ED)

the significant other

Estradiol is _______

topical estrogen

T/F: Tamsulosin typically does not cause dry mouth

true

T/F: There is no research to support significant positive effects on cognitive function when taking doxazosin

true

T/F: mirabegron causes less dry mouth than oxybutynin IR

true

For some patients with cystitis, a _________ may be useful to relieve discomfort caused by severe dysuria.

urinary analgesic

A _______ consult is required if the patient does not respond to the PDE5 inhibitor as expected for treatment of ED

urology

_____, _____< & _____levels must be determined in all cases of ED

- Testosterone - serum glucose (or alternatively glycosylated hemoglobin) - serum lipid

SE of Alpha-adrenergic blockers

- dizziness - Fatigue

Side effects of fluoroquinolones

- photosensitivity - GI upset

_________ are used when the patient presents with BPH and enlarged prostate

5-alpha reductase