Week 8 Flashcards
Type of incontinence where muscles of the bladder are weakened with force to include cough, sneezing, heavy lifting, or prolapsed pelvic organs.
Stress
Type of incontinence with strong sudden urge to urinate and patient is unable to control urine resulting in involuntary release sooner than expected.
Urge
What nerve maintains external sphincter and pelvic muscle tone?
Pudenal
What nerve stimulates bladder contraction?
Pelvic nerve
What nerve stimulates internal sphincter closure and detrusor relaxation?
Hypogastric
Overactive bladder characteristic:
Nocturnal at a minimum of 2 times per night
Urinary urgency and frequency of at least 8 times in a 24-hour period
First line therapy in overactive bladder overview:
Anticholinergics/ antimuscarinics
MOA of anticholinergics:
Cause an increase bladder capacity and initial urge to void.
Side effects of anticholinergics:
Dry mouth, urinary retention, constipation, vision changes, cognitive impairment
Anticholinergic medications:
Oxybutin (ditropan) Tolterodine (Detrol) Darifenacin ( enablex) Solifenacin (vesicare) Fesosterodine (toviaz)
What other medications can be used with overactive bladder?
TCAs, SNRIs, Alpha adrenergic antagonists
What is used in enuresis in children?
TCAs
Example of a TCA:
Imipramine (tofranil)
What is the MOA of SNRIs for overactive bladder?
Enhances urinary sphincter tone, improves bladder control and urinary storage.
Factors that worsen the condition of overactive bladder?
Stroke Spinal cord injury Diabetes Sleep apnea Depression Estrogen deficiency UTI Urinary obstruction