Urinary Incontinence Flashcards
what receptors are present in the bladder that are targets for incontinence tx? What is the density of these receptors?
M2 and M3 with a 3:1 ration accordingly
B3
risk factors for UI
> 40 yo
DM
vaginal birth/delivery given
obesity
neuro (psych, stroke)
hysterectomy
restricted mobility
what drugs cause UI
diuretics
alcohol
sedatives
AChE-i
non-pharm options
examples
where do these fall in the tx approach
first line!
Kegel exercies
fluid management
bladder training
dietary (dec caffeine)
dc offending drugs
when initiating anticholinergics for UI, what are approaches to minimize anticholinergic ADE
ER>IR to dec xerostomia
M3 selectivity with darifenacin, solifenacin, fesoterodine
which anticholinergics are M3 selective
solifenacin, darifenacin, fesoterodine
oxybutynin
brand name
dosing
pearls
Ditropan
IR: 5mg PO BID-QID
ER: 5-30mg PO QD
patch and gel are twice a week
tolterodine
brand name
dosing
Detrol
IR: 1-2mg PO BID
ER: 2-4mg PO QD
solfenacin
brand name
dosing
Vesicare
5-10mg PO QD
which anticholinergics for UI need a dec dose in renal impairment
solifenacin
anticholinergics solifenacin, oxybutynin and tolterodine are CI in
narrow angle glaucoma
urinary retention
dec gastric motility
gastric retentino
major ADE of UI antchols
xerostomia, constipation
drowsiness, agitation, dizziness, confusion, blurred vision, hallucinations
B3 agonists for UI
mirabegron (Myrbetriq)
virabegron (Gemtesa)
mirabegron
dosing
CI
ADE
25-50mg PO QD
dec dose in CrCl 15-30
CI CrCl <15
ADE: HTN and UTI!!!
virabegron
dosing
CI
ADE
75mg PO QD
no CI
minimal ADE
