Chapter 52: Urinary Incontinence Flashcards

1
Q

Urge incontinence is associated with

A

Neuropathy

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2
Q

What is stress incontinence

A

Urine leaks out during any form of exertion

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3
Q

What is the most common cause of overflow incontinence

A

BPH

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4
Q

The detrusor muscle is innervated mainly by the ___ nervous system

A

parasympathetic (Ach acts on muscarinic receptors)

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5
Q

Which receptor is responsible for both emptying contractions as well as involuntary bladder contractions

A

M3

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6
Q

Risk factors for overactive bladder

A

Age > 40 years
Diabetes
Prior vaginal delivery
Drugs that increase incontinence

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7
Q

First-line to improve overactive bladder symptoms

A

Behavioral therapies (pelvic floor muscle exercises - Kegel exercises)

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8
Q

First-line drugs for urge/mixed incontinence

A

Anticholinergics (e.g., oxybutinin)

B3 receptor agonist (i.e., mirabegron)

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9
Q

Which formulation of anticholinergics are preferred for OAB

A

ER due to a lower risk of dry mouth

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10
Q

Anticholinergics should be avoided in

A

elderly 65+ due to risk of delirium and cognitive impairment (BEERS criteria)

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11
Q

Oxybutinin XL brand name

A

Ditropan CL

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12
Q

Oxybutinin patch brand name

A

Oxytrol

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13
Q

How often is oxybutinin patch applied

A

twice weekly

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14
Q

Tolterodine brand name

A

Detrol

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15
Q

How should trospium be taken

A

on empty stomach

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16
Q

Solifenacin brand name

A

Vesicare

17
Q

Anticholinergic CI

A

narrow angle glaucoma

18
Q

Anticholinergic warnings

A

agitation, confusion, drowsiness, blurred vision

19
Q

Anticholinergic SE

A

dizziness

drowsiness (greatest with oxybutinin), xerostomia

constipation

dry mouth,

dry eyes, blurred vision

urinary retention

sedation

cognitive impairment

20
Q

Ditropan XL counseling point

A

OROS formulation - ghost tablet

21
Q

Oxybutinin patch and gel cause less

A

dry mouth

22
Q

Which anticholinergic is also available OTC

A

oxybutinin patch

23
Q

Which drug has a lower incidence of dry mouth and can be used in patients who cannot tolerate anticholinergics

A

Mirabegron

24
Q

Mirabegron MOA

A

relaxes detrusor muscle and increases bladder capacity by activating B3 receptors

25
Q

Mirabegron warning

A

urinary retention

26
Q

Mirabegron SE

A

HTN

27
Q

Which drug is used for nocturia

A

desmopressin (ADH analog)

28
Q

Desmopressin MOA

A

temporarily decreases urine production (ADH analog)

29
Q

Desmopressin BW

A

hyponatremia

30
Q

Desmopressin CI

A

fluid retention

31
Q

Desmopressin monitoring

A

serum NA