Antimuscarinic

Question 1

Antimuscarinic - indication for genitourinary use

Answer 1

URGE INCONTINENCE

Question 2

Antimuscarinic - MOA

Answer 2

Contraction of smooth muscle of the bladder is under parasympathetic control

• Competitive inhibitors of acetylcholine on muscarinic receptors (M3 receptors)
• Blocks muscarinic receptors
• This promotes bladder relaxation
• This reduces urinary frequency, urgency and urge incontinence in overactive bladder

Question 3

Antimuscarinic - adverse effects

Answer 3

dry mouth (most common)

tachycardia

constipation

blurred vision

Question 4

Antimuscarinic - contraindications (1)

Answer 4

UTI

prevents stasis of urine

Question 5

Antimuscarinic - (caution)

Answer 5

Urinary retention

dementia

elderly

angle-closure glaucoma

arrhythmias

Question 6

Antimuscarinic - interactions

Answer 6

other antimuscarinics = more pronounced adverse effects

e.g.- tricyclicantidepressants (TCA)

Question 7

Antimuscarinic - administration

Answer 7

taken at a similar time each day

swallowed whole, NOT crushed

Question 8

Antimuscarinic - monitoring

Answer 8

arrange to follow up in 1 month of starting medication to review response and side effects

Question 9

Antimuscarinic - communication

Answer 9

giving medication to relax the bladder - this should hopefulyl reduce the urgency and frequency of urination

explain that dry mouth is a VERY common side effect (1 in 10 patients)- advise chewing gum or sucking on sweets to alleviate

Question 10

Antimuscarinic - examples

Answer 10

oxybutynin

tolterodine
solifenacin