Overactive Bladder Flashcards
What are some risk factors for overactive bladder?
- Age >40 years
- DM
- Restricted mobility
- Obesity
- Neurological conditions
- Prior vaginal delivery
- Hysterectomy
- Drug (e.g alcohol, cholinesterase inhibitors, diuretics, sedatives)
- Pelvic injury
What is the first line treatment for overactive bladder?
Behavioral therapies:
- Scheduled voiding
- Kegel exercises
- Fluid management
What are the 2 class of drugs used to treat overactive bladder? MOA?
- Anticholinergic drugs aka antimuscarinic drugs
MOA: Competitively bind to muscarinic receptors and block acetylcholine from binding - Beta-3 receptor agonists
MOA: relaxes the detrusor muscle and increases bladder capacity by activating beta-3 receptors
Why are extended release anticholinergic agents preferred over immediate release?
Lower risk of dry mouth with ER
What is the Beers Criteria recommendation wrt Anticholinergic agents?
Avoid in patients 65 years and older
Anticholinergic agents (3)
- Oxybutynin (Ditropan)
- Tolterodine (Detrol)
- Solifenacin (Vesicare)
Anticholinergic ADE
- Dry mouth
- Dry eyes/blurred vision
- Urinary retention
- Constipation
- Sedation
- Dizziness
- Cognitive impairment
Method in which to avoid dry mouth ADE of Anticholinergic
- ER formulation
- Oxybutynin gel or patch
- Mirabegron (Myrbetriq)
Beta-3 receptor agonists agent
Mirabegron (Myrbetriq)
Mirabegron AED
Hypertension
What is the increased benefit of Mirabegron over Anticholinergic agents?
Less dry mouth
What is the 1 FDA approved treatment for nocturia in adults?
ADE?
Desmopressin
Hyponatremia
