Drugs used in urology

Question 1

What is the role of anti-muscarinic drugs in urology?

Answer 1

Urge incontinence due to detrusor overactivity

Question 2

Examples of antimuscarinic agents used in urology? (3)

Answer 2

Oxybutynin
Solifenacin
Tolterodine

Question 3

Selective B3 agonist licensed for overactive bladder?

Answer 3

Mirabegron

Question 4

When should patients be given mirabegron?

Answer 4

If antimuscarinics are not tolerated, ineffective or contraindicated

Question 5

Cautions for antimuscarinics?

Answer 5

Autonomic neuropathy
Elderly frail patients
Angle closure glaucoma
Hiatus hernia with reflux oesophagitis

Question 6

Effects of parasympathetic stimulation? (and corresponding effects of antimuscarinic drugs)

Answer 6

Slow heart rate (increase heart rate)

Increase gastric motility (slow gastric motility)

Increase secretions in eye/mouth (cause dry mouth, eyes)

Constrict pupil (dilates pupil)

Question 7

Conditions which can be worsened by antimuscarinics?

Answer 7

Hyperthyroidism
Heart failure
Hypertension
Arrythmias
Tachycardia

Question 8

Contraindications to antimuscarinics?

Answer 8

Myasthenia gravis
Bladder outflow obstruction/retention
GI obstruction
Ulcerative colitis

Question 9

Why are antimuscarinics contraindicated in outflow obstruction?

Answer 9

Parasympathetic system relaxes the external sphincter during micturition; inhibiting this increases the resistance to urinary flow

Question 10

Side effects of antimuscarinics?

Answer 10

Dry mouth
Dry eyes
Blurred vision
Constipation
Dizziness
Difficulty in micturition
Palpitations
Reduction of sweating