Chapter 52: Urinary Incontinence

Question 1

Urge incontinence is associated with

Answer 1

Neuropathy

Question 2

What is stress incontinence

Answer 2

Urine leaks out during any form of exertion

Question 3

What is the most common cause of overflow incontinence

Answer 3

BPH

Question 4

The detrusor muscle is innervated mainly by the ___ nervous system

Answer 4

parasympathetic (Ach acts on muscarinic receptors)

Question 5

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

Answer 5

M3

Question 6

Risk factors for overactive bladder

Answer 6

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

Question 7

First-line to improve overactive bladder symptoms

Answer 7

Behavioral therapies (pelvic floor muscle exercises - Kegel exercises)

Question 8

First-line drugs for urge/mixed incontinence

Answer 8

Anticholinergics (e.g., oxybutinin)

B3 receptor agonist (i.e., mirabegron)

Question 9

Which formulation of anticholinergics are preferred for OAB

Answer 9

ER due to a lower risk of dry mouth

Question 10

Anticholinergics should be avoided in

Answer 10

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

Question 11

Oxybutinin XL brand name

Answer 11

Ditropan CL

Question 12

Oxybutinin patch brand name

Answer 12

Oxytrol

Question 13

How often is oxybutinin patch applied

Answer 13

twice weekly

Question 14

Tolterodine brand name

Answer 14

Detrol

Question 15

How should trospium be taken

Answer 15

on empty stomach

Question 16

Solifenacin brand name

Answer 16

Vesicare

Question 17

Anticholinergic CI

Answer 17

narrow angle glaucoma

Question 18

Anticholinergic warnings

Answer 18

agitation, confusion, drowsiness, blurred vision

Question 19

Anticholinergic SE

Answer 19

dizziness

drowsiness (greatest with oxybutinin), xerostomia

constipation

dry mouth,

dry eyes, blurred vision

urinary retention

sedation

cognitive impairment

Question 20

Ditropan XL counseling point

Answer 20

OROS formulation - ghost tablet

Question 21

Oxybutinin patch and gel cause less

Answer 21

dry mouth

Question 22

Which anticholinergic is also available OTC

Answer 22

oxybutinin patch

Question 23

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

Answer 23

mirabegron

Question 24

Mirabegron MOA

Answer 24

relaxes detrusor muscle

increases bladder capacity by activating B3 receptors

Question 25

Mirabegron warning

Answer 25

urinary retention

Question 26

Mirabegron SE

Answer 26

HTN

Question 27

Which drug is used for nocturia

Answer 27

desmopressin (ADH analog)

Question 28

Desmopressin MOA

Answer 28

temporarily decreases urine production (ADH analog)

Question 29

Desmopressin BW

Answer 29

hyponatremia

Question 30

Desmopressin CI

Answer 30

fluid retention

Question 31

Desmopressin monitoring

Answer 31

serum NA