Bladder and Urinary Disorders Flashcards
How is incontinence in adults cause by detrusor instability managed?
By a combination of drug therapy, pelvic floor exercises, and bladder training.
How is stress incontinence in adults managed?
By non-drug methods.
How do antimuscarinic drugs reduce symptoms of urinary urgency and urge incontinence and improve bladder capacity?
By exerting a relaxant effect on the urinary smooth muscle.
Which drugs are used in the management of urinary incontinence in adults?
Oxybutynin, tolterodine, solifenicin, trospium.
What class of drugs are oxybutynin, tolterodine, solifenicin and trospium?
Antimuscarinics.
How does mirabegron work to help treat urinary incontinence?
It has a relaxant effect on urinary smooth muscle via selective beta-3 receptor stimulation.
What are the side effects of anti-muscarinic drugs?
Constipation, dry mouth, sweating, dilation of pupils, dry skin, photophobia, skin flushing, effects on the ability to perform skilled tasks.
How is acute urinary retention treated?
By catheterisation.
Is chronic urinary retention associated with pain?
No.
What is the most common cause of chronic urinary retention in men?
Benign prostatic hyperplasia.
How is chronic urinary retention treated in men?
Either surgically or medically using alpha-blockers. Dutasteride or finasteride are alternatives to alpha-blockers.
Give some examples of alpha-blockers.
Alfuzosin, terazosin, prazosin.
How do alpha-blockers work to treat chronic urinary retention in men?
They relax smooth muscle in benign prostatic hyperplasia.
What is the first dose effects seen with the alpha-blockers? How should this be mitigated?
The first dose may cause collapse due to hypotensive effect. Dose should be taken upon retiring to bed. The patient should be advised to lay down if symptoms such as dizziness, fatigue, or sweating develop.
Can alpha-blockers affect one’s performance of skilled tasks?
Yes.
Why is a barrier method of contraception recommended when one is being treated with dutasteride of finasteride?
Both are secreted in semen and the use of barrier methods is recommended if one’s sexual partner is pregnant or likely to become pregnant. These drugs have a teratogenic effect.
Why should women of childbearing potential avoid handling crushed or broken tablets of finasteride or leaking capsules of dutasteride?
Due to the potential teratogenic effect of these medications.
There is an increased risk of male breast cancer when patients use finasteride or dutasteride. What symptoms should be reported to the GP?
Lumps, pain, or nipple discharge.
