6- RTS- disorders of the urinary tract Flashcards
What are the treatments for stress incontinence in women
Pelvic floor muscle training
Duloxetine
Topical vaginal oestrogen therapy (post-menopausal)
How does duloxetine work and how does it help with incontinence
A selective serotonin and noradrenaline reuptake inhibitor.
Relaxes detrusor muscle
Increases external sphincter activity
How is urge incontinence managed
Pelvic floor muscle training
Reduction of excessive fluid and caffeine intake
Topical vaginal oestrogen
M3 muscarinic receptor agonist (males)- solifenacin
What type of drug is solifenacin
M3 muscarinic receptor antagonist
What are side effects of solifenacin
Dry mouth, blurred vision, constipation, tachycardia
What are side effects of duloxetine
Dry mouth
Sedation
What absorbent materials are used in incontinence
Incontinence pads, pull ups, bedding
Tampons for stress incontinence
- Large tampons in vagina exert pressure on bladder neck
Lifestyle advice for incontinence
Reduce caffeine intake
Modify fluid intake
Reduce weight
What are invasive and surgical approaches for incontinence
Invasive- Botulinum Toxin A
Surgical- Synthetic mid-urethral tap procedure
What is used for the treatment for lower urinary tract symptoms in men
Tamsulosin hydrochloride
Finasteride
Solifenacin
How does tamsulosin help with LUTS in men
It is an alpha 1 adrenoreceptor blocker which inhibits the contraction of prostatic and bladder neck smooth muscle.
Increases urinary flow rate, reduces dribbling, incomplete emptying.
What does tamsulosin not affect
Prostate size, growth rate or PSA
What is the criteria for supplying tamsulosin OTC
45-75 years old
No symptoms of infection or blood in urine
No diabetes, heart or liver disease
No hypertension
No previous prostate surgery
What type of medication is finasteride and how does it work
5 alpha-reductase inhibitors
Inhibits the metabolism of testosterone to dihydrotestosterone.
Side effects of finasteride
Loss of libido and ejaculatory dysfunction
