Urinary Incontinence Flashcards
Also known as?
Involuntary urination
Which drugs can exacerbate incontinence?
• antipsychotics
• antidepressants
• BZDs
• diuretics
• beta blockers
• HRT
Causes of bed wetting?
• lack of antiduretic secretion at night
• bladder issue
• issues with brain arousal
Pharmacological treatment for young people (>5)
Desmopressin
Non-pharmacological treatment?
- heathy diet
- adequate water intake
- appropriate toileting
- alarm
ADH hormones
• released from posterior pituitary
• acts on V2 in kidney tubule to increase reabsorption of water
What advice would you give to someone taking desmopressin?
• can cause hyponataemic convulsions - seizures
• avoid drinking water before taking the medicine
• avoid fluid overload
Which cholinergic receptors are present in the bowel?
M1, M2, M3
Role of the M3 Chollinergic receptors?
Receptor - responsible for contraction of the bladder
Stimulating the receptor with acetylcholine - smooth muscle contraction
Which class drugs are used to prevent muscle contraction?
Antimuscarninic
When can anticholinergics be used in combination with desmopressin?
• Bed wetting in young people who also have day time symptoms
• bed wetting has partially or has not responded to desmopressin
• bed wetting has not responded to alarm + desmopressin
When are TCA indicated?
• bed wetting
• should be given with Imipramine
What are the 5 types of incontinence?
• stress - damage to the muscle which prevents urination
• urgency
• overflow - damage to the bladder
• total - issue of the bladder from birth
• mixed
Choice of drugs used for women with UI & overactive bowel
• Oxybutynin - antimuscarinic
• solifenacin
• tolerodine
What side affects are associated with antimuscarinics (Oxybutynin)?
• dry eyes & mouth
• constipation
• QT prolongation
• reduced cognitive function (can pass BBB)
