drugs for urinary incontinence/retention

Question 1

antimuscarinic quaternary amine

Answer 1

trospium

Question 2

antimuscarinic metabolism and elimination

Answer 2

CYP matabolism (3A4 and 2D6) and urinary elimination; 
exception: trospium - no cyp metab; rapid hydrolysis

Question 3

antimuscarinic with >M3 selectivity

Answer 3

darifenacin

Question 4

antimuscarinic issues

Answer 4

urinary retention;
CV effects-palpitations, tachycardia, QT prolongation;
GI effects: constipation
CNS: sedation, confusion, hallucinations, sleep disruption

Question 5

anticholinergics

Answer 5

darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, trospium, botulinum toxin

Question 6

sympathomimetics

Answer 6

mirabegron, pseudoephedrine, ephedra

Question 7

botox moa

Answer 7

inhibition of vesicular release of excitatory neurotransmitters and axonal expression of other SNARE-complex-dependent proteins in the urothelium/suburothelium mediating intrinsic or spinal reflexes thought to cause detrusor overactivity

Question 8

mirabegron metabolism

Answer 8

CYP3A4»2D6, butylcholinesterase, UGT, and alcohol dehydrogenase

Question 9

mirabegron adverse effects

Answer 9

HTN (need to monitor) and tachycardia

Question 10

pseudoephedrine adverse effects

Answer 10

HTN, tachycardia, atrial fibrillation, anxiety and restlessness, MAOI interaction

Question 11

ephedra adverse effects

Answer 11

HTN, tachyarrhythmia, CHF, MI, insomnia, symptoms of CNS stimulation, MAOI interaction

Question 12

methionine moa

Answer 12

creates ammonia-free urine by acidifying urine pH

Question 13

bovine collagen use

Answer 13

incontinance due to sphincter deficiency

Question 14

bovine collagen adverse effects

Answer 14

forms a soft cohesive network of fibers increasing tissue bulk around the urethral lumen

Question 15

bovine collagen adverse effects

Answer 15

urinary retention, hematuria, injection site reaction, worsening incontinence, erythema, urticaria, abscess formation

Question 16

bovine collagen interactions

Answer 16

immunosuppressive therapy and corticosteroids

Question 17

bethanecol moa

Answer 17

mucscarinic agonist in urinary bladder and GI tract; doesn’t cross BBB

Question 18

neostigmine moa

Answer 18

inhibits acetylcholinesterase, augments action of Ach at both muscarinic and nicotinic receptors

Question 19

bethanechol adverse effects

Answer 19

CV: syncope
GI: diarrhea, cramps
neurologic: dizziness
opthalmic: excessive tearing, miosis
renal: urgent desire to urinate

Question 20

neostigmine adverse effects

Answer 20

AV block, bradycardia, cardiac arrest, cardiac dysrhythmia, hypotension, syncope, tachycardia