McKenna's Pharmacology for Nursing, 2e

C H A P T E R 5 2 Drugs affecting the urinary tract and the bladder 831

■■ Inflammation and irritation of the urinary tract can cause smooth muscle spasms along the urinary tract. These spasms lead to the uncomfortable effects of dysuria, urgency, incontinence, nocturia and suprapubic pain. ■■ The urinary tract antispasmodics act to relieve spasms of the urinary tract muscles by blocking parasympathetic activity and relaxing the detrusor and other urinary tract muscles. ■■ Pentosan polysulfate sodium is a heparin-like compound that has anticoagulant and fibrinolytic effects and adheres to the bladder wall mucosal membrane to act as a buffer to control cell permeability. This action prevents irritating solutes in the urine from reaching the cells of the bladder wall. It is used specifically to decrease the pain and discomfort associated with interstitial cystitis. ■■ Benign prostatic hyperplasia (BPH) is a common enlargement of the prostate gland in older men. ■■ Drugs frequently used to relieve the signs and symptoms of prostate enlargement include alpha- adrenergic blockers, which relax the sympathetic effects on the bladder and sphincters, and finasteride and dutasteride, which block the body’s production of a powerful androgen. The prostate is dependent on testosterone for its maintenance and development; blocking the androgen leads to shrinkage of the gland and relief of symptoms. Knowing your strengths and weaknesses helps you to study more effectively. Take a PrepU Practice Quiz to find out how you measure up! ONLINE RESOURCES An extensive range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at the text’s accompanying website, located on thePoint at http://thepoint.lww.com. These include Watch and Learn videos, Concepts in Action animations, journal articles, review questions, case studies, discussion topics and quizzes.

WEB LINKS

Healthcare providers and students may want to consult the following Internet sources:

www.andrologyaustralia.org/pageContent. asp?pageCode=PROSTATEPROBLEMS

Andrology Australia information on benign prostatic hyperplasia (BPH), support groups, research and treatment for patients. www.usanz.org.au Home page of the Urological Society of Australia and New Zealand. BIBLIOGRAPHY Farrell, M. & Dempsey, J. (2014). Smeltzer & Bare’s Textbook of Medical-Surgical Nursing (3rd edn). Sydney: Lippincott Williams & Wilkins. Gilchrist, K. (2004). Benign prostatic hyperplasia: Is it a precursor to prostate cancer? Nurse Practitioner, 29(6) , 30–37. Goodman, L. S., Brunton, L. L., Chabner, B. & Knollmann, B. C. (2011). Goodman and Gilman’s Pharmacological Basis of Therapeutics (12th edn). New York: McGraw-Hill. Kirby, R. S. (2004). Selecting long-term medical therapy for BPH. Contemporary Urology, 16(1) , 12, 15–16, 18. Kuteesa, W. (2006). Anticholinergic drugs for overactive bladder. Australian Prescriber, 29 , 22–24. McKenna, L. (2012). Pharmacology Made Incredibly Easy (1st Australian and New Zealand edn). Sydney: Lippincott Williams & Wilkins. McKenna, L. & Mirkov, S. (2014). McKenna’s Drug Handbook for Nursing and Midwifery (7th edn). Sydney: Lippincott Williams & Wilkins. McMurdo, M. E., Bissett, L. Y., Price, R. J., Phillips, G. & Crombie, I. K. (2005). Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in the hospital? A double-blind, placebo-controlled trial. Age and Ageing, 34(3) , 256–261. Mehnert-Kay, S. A. (2005). Diagnosis and management of uncomplicated urinary tract infections. American Family Physician, 72 , 451–456. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Wu, C. & Kapoor, A. (2013). Dutasteride for the treatment of benign prostatic hyperplasia. Expert Opinion on Pharmacotherapy, 14(10) , 1399–1408.