NOCTURAL ENURESIS Flashcards
what is nocturnal enuresis
involuntary urination during sleep = common children
non-drug tx of nocturnal enuresis
- advice on fluid intake
- diet
- toileting behaviour
- use of reward systems
which age category does noctural enuresis resolve without intervention
<5yr
tx if no reponse to lifestyle advice
> 1 -2 wet beds per week
enuresis alarm
which age is enuresis alarm given to and when
- <7yr
- given depending on maturity, motivation, understanding
benefit of enuresis alarm
less relaspe than drug tx when discontinued
After how many week does enuresis alarm need to be reviewed
4 weeks
what is the min duration of enuresis alarms
continue for min 2 weeks of uninterrupted dry nights
drug tx if both advice and enuresis alarm is unsuccesful
add in or replace with desmopressin
age category for desmopressin
5+
when is desmopressin given for noctural enuresis
- when alarms = undesirable
- when needing rapid results (cover holidays)
duration and monitoring of desmopressin
- assess 4 weeks after tx and continue for 3 months if response
repeated courses of desmopressin withdrawal
withdraw gradually at regular intervals
drug tx of noctural enuresis
including specialist
1) desmopressin
2) specialist = desmopressin +/- antimuscarnic (oxyb/tolterdine)
3) no response = imipramine
desmopressin potency and s/e
- more potent + longer duration of action than vasopressin
- no vasoconstrictor effect
- s/e = hyponatraemia + nausea