Other

  • Erythropoietin (EPO)
  • Worsening Hypertension (30%), less common in Subcutaneous route
    • Prevention: Slow Hematocrit rise (goal 30-35%)
    • Hypertensive encephalopathy
    • Treatment
    • Dialysis
  • Headaches (15%), Flu-like symptoms (5%)
  • Red Cell Aplasia
  • PDE-5 Inhibitors
  • Sildenafil, Vardenafil, Tadalafil
    • All used for ED and pulmonary hypertension
    • Tadalafil can also be used for BPH
  • SE: Cyanopsia (hypotension worse w/nitrates, alpha blockers), Blue color vision, non-arteritic anterior ischemic optic neuropathy, priapism, flushing, headache, heading loss
    • Contraindicated in patients taking alpha blockers, nitrates due to hypotension
  • Cholinergic Receptors
  • Found on the dome of the bladder, contraction of which facilities voiding
  • Phenazopyridine
  • Analgesic for urinary tract mucosa frequently used to treat the dysuria of cystitis (after infection or instrumentation)
  • May worsen stone formation
  • L-Methylfolate (Deplin)
  • Stimulates WBC and platelet production in Folate Deficiency Anemia
  • Improves antidepressants effect in people with BMI ≥35
  • Ofatumumab (Kesimpta)
  • Dimethyl Fumarate (Tecfidera)
  • SE: Nausea, vomiting, upper abdominal pain, elevated LFTs
  • Other
  • Permethrin
    • Inhibits Na+ Channel Deactivation
    • Causing membrane depolarization
  • Malathion
    • Acetylcholinesterase inhibitor
    • Neurotoxicity
  • Lindane
    • Blocks GABA channels
    • Neurotoxicity
  • BPH Meds
  • Alpha 1 Adrenergic Antagonists
    • First Line Therapy
    • Tamsulosin, doxazosin, terazosin, alfuzosin, and prazosin
    • Decrease systemic vascular resistance and resistance to urinary flow by relaxing the smooth muscle of the bladder neck and prostate gland, prostate capsule and urethra, reduce outlet obstruction
    • SE: Orthostatic hypotension, dizziness, night sweats
  • 5-alpha-reductase inhibitors
    • Finasteride, dutasteride
    • Use with Severe symptoms, ≥40g prostates, alpha-1s not working, hypotensive patient, taking sildenafil
    • Inhibit conversion of testosterone to dihydrotestosterone
    • Reduce prostate gland size, takes 6-12months
    • SE: Decreased libido, erectile dysfunction
  • Antimuscarinics
    • Tolterodine
    • Used to treat overactive bladder (urinary frequency, urgency and incontinence
    • SE: Urine retention, dry mouth
  • Memantine
  • NMDA receptor (glutaminergic) antagonist
  • Useful if pt with dementia cannot tolerate other drugs 2/2 nausea or vomiting
  • SE: hallucinations
  • Testosterone
  • Topical (Fortesta, Vogelxo, Androgel, Testim)
  • Subq (Androderm, Xyosted)
  • Oral (Jantenzo)
  • IM (Aveed)
  • Alcohol Cessation
  • Combo of naltrexone and acamprosate preferred
  • Naltrexone
    • Mu-opioid receptor antagonist
    • Can't be used on patients on opioids, liver disease (check lfts)
    • Reduces 30-day readmission and ED visits when given
    • SE: Nausea 10%, headache 7%, dizziness 4%, anxiety 2%
  • Acamprosate
    • NMDA/glutamate modulation
    • Contraindicated in severe renal disease
    • Usually used after withdrawal phase
  • Discourage alcohol relapse
    • Disulfiram (2nd line)
    • Inhibits acetaldehyde dehydrogenase
    • Monitor liver function (check flts)
    • Can only be given to abstinent and highly motivated patients
    • CI in severe cardiac disease, pregnancy, psychosis
  • Topiramate
  • Smoking Cessation
  • 1) Varenicline with nicotine replacement therapy
    • Varenicline (Chantix)
    • Alpha 4 beta 2 acetylcholine receptor partial agonist, diminish cravings
    • Mood changes, suicidality, CV risk
      • Not any more
    • Nicotine Replacement Treatment
  • Bupropion
  • Topiramate (Topamax)
  • Nicotine Withdrawal
  • Nicotinic acetylcholine receptors
  • Irritability, fatigue, difficulty concentrating, headaches, constipation