NOCTURAL ENURESIS Flashcards

1
Q

what is nocturnal enuresis

A

involuntary urination during sleep = common children

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2
Q

non-drug tx of nocturnal enuresis

A
  • advice on fluid intake
  • diet
  • toileting behaviour
  • use of reward systems
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3
Q

which age category does noctural enuresis resolve without intervention

A

<5yr

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4
Q

tx if no reponse to lifestyle advice

> 1 -2 wet beds per week

A

enuresis alarm

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5
Q

which age is enuresis alarm given to and when

A
  • <7yr
  • given depending on maturity, motivation, understanding
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6
Q

benefit of enuresis alarm

A

less relaspe than drug tx when discontinued

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7
Q

After how many week does enuresis alarm need to be reviewed

A

4 weeks

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8
Q

what is the min duration of enuresis alarms

A

continue for min 2 weeks of uninterrupted dry nights

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9
Q

drug tx if both advice and enuresis alarm is unsuccesful

A

add in or replace with desmopressin

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10
Q

age category for desmopressin

A

5+

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11
Q

when is desmopressin given for noctural enuresis

A
  • when alarms = undesirable
  • when needing rapid results (cover holidays)
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12
Q

duration and monitoring of desmopressin

A
  • assess 4 weeks after tx and continue for 3 months if response
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13
Q

repeated courses of desmopressin withdrawal

A

withdraw gradually at regular intervals

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14
Q

drug tx of noctural enuresis

including specialist

A

1) desmopressin
2) specialist = desmopressin +/- antimuscarnic (oxyb/tolterdine)
3) no response = imipramine

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15
Q

desmopressin potency and s/e

A
  • more potent + longer duration of action than vasopressin
  • no vasoconstrictor effect
  • s/e = hyponatraemia + nausea
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