OveractiveBladderFC

Question 1

Overactive Bladder (OBA) pathophysiology

Answer 1

Detrusor muscle contracts frequently and before the bladder is full

Question 2

which sympathetic or para that controls the detrussor muscle

Answer 2

Detrusor muscle controlled by parasympathetic nervous system

Question 3

which nervous systme controls the bladder neck and interna sphincter

Answer 3

Sympathetic nervous system controls bladder neck and internal sphincter

Question 4

which nervous syxtem controls the external sphincter of the bladder

Answer 4

External sphincter is controlled by somatic nervous system

Question 5

which recepters control the bladder

Answer 5

the bladder is comprised of M2 and M3 muscarinic receptors

Question 6

Overactive Bladder (OBA) Symptoms

Answer 6

Urinary urgency with or without urge incontinence
Urinary fequency (voiding >8 times/day)
Nocturia (>2 awakenings to void/night)

Question 7

Forms of Urinary Incontinence

Answer 7

Functional: cognitively, socially, or physically impaired
Overflow
Stress: any form of exertion
Urge: associated with neuropathy (diabetes, stokes, dementia, Parkinson’s, MS)
Mixed: urge and Stress

Question 8

Risk Factors for Overactive Bladder

Answer 8

Age >40
diabetes
Restricted mobility
Obesity
Proir vaginal delivery
Neurologic conditions
Hysterectomy
Medication: diuretics, antihistamines, TCAs, cholinesterase inhibitors, alpha antagonists
Pelvis injury

Question 9

NonPharmacological Therapy

Answer 9

Kegal exercises
bladder diary
bladder training
Regulate fluid intake
Eliminate bladder irritants

Question 10

Pharmacological Therapy

Answer 10

Anticholinergics
Beta 3agonist
Botox

Question 11

Anticholinergics names and brands of 6

Answer 11

Drugs: oxybutynin (Ditropan), tolterodine (Detrol), trospium (Sanctura), solifenacin (Vesicare), darifenacin (Enablex), fesoterodien (Toviaz)

Question 12

ci of anticholinergics

Answer 12

CI: Urinary retention, bladder obstruction, gastric retention, decreased gastric motility, uncontrolled narrow angle glaucoma

Question 13

se of anticholinergis

Answer 13

SE: dry mouth, constipation, dry eyes/blurred vision, Urinary retention, somnolence, dizziness, cognitive impairment

Question 14

how totake trospium

Answer 14

Take trospium on empty stomach

Question 15

which anticholinergics to decrease dose for renal dysfunciton

Answer 15

Decrease dose if CrCl is <30 (fesoterodine, solifenacin, tolterodine, trospium)

Question 16

which anticholinergic is the most contipative

Answer 16

darifenacin is more constipative

Question 17

when to change oxytrol patch

Answer 17

Oxytrol patch is changed twice weekly (applyto abdomen, hips, butt)

Question 18

Anticholinergic Drug Interactions

Answer 18

cyp3 a4 intercations, see max doses for these agents

Question 19

Mirabegron (Myrbetriq) MOA

Answer 19

Beta 3agonist Relaxes the detrusor muscle during the storage phase of the fillvoid cycle by activation of beta3 receptors which increases bladder capacity

Question 20

when to dose decrease mirbregon

Answer 20

Decrease dose CrCl 1529, CrCl <15 not recommended

Question 21

se mirabegron

Answer 21

SE: hypertension, nasopharyngitis, UTI, headache

Question 22

mx mirabegron

Answer 22

Monitoring: BP, HR, Urinary symptoms

Question 23

Onabotulinumtoxin A (Botox) moa for over active bladder

Answer 23

Efferent pathways of Detrusor activity via inhibition of acetylcholine release. Inhibit afferent neurotransmitters and sensory pathways

Question 24

botox bbw

Answer 24

BBW: spread of toxins

Question 25

ci botox

Answer 25

CI: acute Urinary tract infection, acute Urinary retention

Question 26

se botox

Answer 26

SE: Detrusor overactivity, Urinary tract infection, Urinary retention