Urinary frequency, enuresis and incontinence Flashcards
First line treatment for men with overactive bladder?
Oxybutynin (immediate release), tolterodine (immediate release), or darifenacin (once daily preparation) can be used first line.
If the first-line drug treatment is not effective or tolerated in treating overactive bladder in men, what would be alternative ?
mirabegron
How often should The need for continuing therapy for urinary incontinence be reviewed ?
every 4–6 weeks until symptoms stabilise, and then every 6–12 months.
Which drug can be prescribed for stress incontinence ?
duloxetine: in women only for moderate to severe stress incontinence, avoid abrupt withdrawal
Patient comes into your pharmacy asking why her child was advised to use enuresis alarm instead of medication and for how long they should use it for ?
enuresis alarm is a first line treatment
should continue until 2 weeks of uninterrupted dry nights
Child is 6 years of age, parents tried enuresis alarm but it did not work, what would be second line treatment ?
demsporessin which is suitable for 5+
child has been prescribed desmopressin, however parent is asking you wether it can be given as intranasal formulation, what would you say ?
use as sublingual or oral tablet, since it should not be given intranasally for nocturnal enuresis due to increased s/e
How should you counselling patients treated with desmopressin for primary nocturnal enuresis ?
- avoid fluid overload ( including during swimming), restrict fluid intake 1 hour before and until 8 hours after desmopressin
- stop desmopressin in vomitting/diarrohea until normal fluid balance. Avoid concomitant drugs that increase vasopressin production : TCA
What are side effects of desmopressin ?
serious side effect: hyponatraemic convulsions
Patient is on oxybutinin IR tablets but is experiencing unpleasant side effects, what can be done ?
MR if effective and has fewer side effects
