Ch.7 Urinary Drugs

Urinary drugs include

diuretic drugs
potassium supplements
drugs used to treat UTIs
urinary analgesic drugs
urinary antispasmodic
drugs used to treat overactive bladder, BPH, prostatitis and ED

Diuretic drugs

keep sodium and potassium from bing reabsorbd from the tubules back into the blood

Diuretic drugs categories are

based on the site of drugs effect in the nephron of the kidney

Diuretic drugs categories

thiazide drugs
loop diuretic drugs
potassium-sparing
osmotic
carbonic anhydrase inhibitor

Thiazide drugs

act on the loop of Henle and distal convulted tubule in the nephron

Loop diuretic drugs

act at the proximal convoluted tubule, the loop of Henle, and the distal convoluted tubule, but they derive their action at the loop of Henle.

These drugs block sodium and potassium from being reabsorbed from the tubule back into the blood

Loop diuretic drugs:
Bumex (bumetanide)
Lasix (furosemide)

Potassium-Sparing diuretic drugs

act at the proximal convoluted tubule and the loop of Henle. They cause sodium and water to be excreted in the urine but they spare potassium by allowing it to be reabsorbed from the tubule back into the blood.

These are potassium-sparing diuretic drugs:

amiloride (Midamor)
spironolactone (Aldactone)
triamterene (Dyrenium)

Osmotic diuretic drugs

it is the presence of this drug in the filtrate within Bowman's capsule (which always stays in an inactive form) that causes the diuretic effect

This is an osmotic diuretic drug

mannitol (Osmitrol)

carbonic anhydrase

is an enzyme that is normally present inside cells in the wall of the proximal convoluted tubule. It reacts with carbon dioxide and water to produce bicarbonate and hydrogen

Carbonic Anhydrase Inhibitor Diuretic Drug

is used to treat edema associated with congestive heart failure (CHF)

acetazolamide (Diamox)

Carbonic anhydrase inhibitor

Combination Diuretic Drugs

contain a thiazide diuretic drug (hydrochlorothiazide) and a potassium sparing diuretic drug (amiloride, spironolactone, triamterne)

hydrochlorothiazide + triamterene
(Diazide, Maxzide)

Combination diuretic drugs

Potassium Suplements

are frequently prescribed for patients taking thiazide and loop diuretic drugs. Different forms: liquids, powders, effervescent tablets, caps, and tabs. Doses are measured in milliequivalents (mEq)

Drugs used to Treat UTIs

are particulary effective against gram negative bacteria

Categories of drugs to treat UTIs

*antibiotics: penicillin-type, cephalosporin, quinolone, fluroquinolone
*sulfonamide anti-infective drugs
*folic acid antagonist drugs
*other antibiotic drugs

ampicillin
(penicillin-type antibiotic drug) is structurally related to

cephalosporin antibiotic drugs

These drugs are used to treat UTIs as well as other types of infections in the body

ampicillin
cephalosporin

The suffix -floxacin is common to generic

fluoroquinolone antibiotic drugs

Sulfonamide drugs

also knowuns as "sulfa drugs" inhibit one step in the formation of folic acid by certain bacteria

Sulfonamide Anti-infective Drugs for UTIs

sulfadiazine
sulfisoxazole (Gantrisin Pediatric)

Folic Acid Agonist Drugs for UTIs

these anti-infective drugs block the formation of folic acid in bacterial cells

trimethoprim
(Primsol, Proloprim)

Folic acid anti-infective drugs

Other Antibiotic-Type Drugs for UTIs

These antibiotic-type drugs have a special affinity for the tissues of the urinary tract

nitrofurantoin
(Macrobid, Marcodantin)

Other antibiotic-type drugs for UTIs

Combination Antibiotic and Anti-infective Drugs for UTIs

These drugs contain an antibiotic drug (trimethoprim) and an anti-infective sulfa drug (sufamethoxazole)

sulfamethoxazole + trimethoprim
(Bactrim, Septra)

Combination antibiotic and anti-infective drugs for UTIs
(for treatment of UTIs, prostatitis and other types of infections)

Urinary Analgesic Drugs

exert a local pain-relieving effect on the mucous membranes of the urinary tract

dimethyl sulfoxide (DMSO, Rimso-50)
pentosan (Elmiron)
phenazopyridine (Pyridium, Urogesic)

Urinary Analgesic Drugs:

Urinary Antispasmodic Drugs

these drugs relax the smooth muscle in the walls of the ureters and bladder and promote normal bladder function

flavoxate (Urispas)
oxybutynin (Ditropan)

Urinary antispasmodic drugs:

Combination antibiotic, analgesic, and antispasmodic drugs

Urised
(atropine, hyosciamine, methenamine, methylene blue, phenyl salicylate)

Pyridium
Pyridium Plus

turn urine red-orange in color

Dolsed
Urised
Urogesic Blue

turn the urine a blue-green color because of the presence of methylene blue

Drugs to treat Overactive Bladder

solifenacin (Vesicare)
tolterodine (Detrol)

Drugs to treat BPH

Androgen inhibitor drugs: finasteride (Proscar)
and alpha1-receptor blocker drugs: tamsulosin (Flomax)

Prostatitis

is an acute or chronic bacterial infection of the prostate gland due to urinary tract infection or STD. Is treated with antibiotic and anti-infective drugs

Drugs to treat Prostatitis

ciprofloxin (Cipro)
levofloxacin (Levaquin)
norfloxacin (Noroxin)

Drugs used to treat ED

*PDE5 inhibitor drugs for ED - inhibit the enzyme PDE5 that inactivates cGMP
*Prostaglandin E1 drugs for ED - acts locally to relax the muscle in the arteries of the penis

PDE5 inhibitor drugs for ED

sildenafil (Viagra)
tadafil (Cialis)
vardenafil (Levitra)

Prostaglandin E1 drugs for ED

(alprostadil)
Caverject, Edex - local injection (into de side of the penis)
Muse - pellet (insterted in the urethra)