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Urinary Incontinence- Urge (UUI): Bladder Overactivity, Claudia Lopez NRS…
Urinary Incontinence- Urge (UUI): Bladder Overactivity
Anticholinergic/antispasmodic (First line of tx)
MOA
Suppressing premature detrusor contractions
Enhance bladder storage -> relief sxs
Contraindications
Urinary bladder neck obstruction
BPH
Uncontrolled narrow-angle glaucoma
Alzheimers
Adverse Effects
Urinary retention
Blurred vision
Orthostatic Hypotension
Drugs
Oxybutynin
Darifenacin
Tolterodine
Antimuscarinic Agents
Immediate Release
Oxybutynin
Tolterodine
Extended Release
Oxybutynin XL
Trospium (Quaternary amine- hydrophilic -> can't cross BBB -> less CNS SE)
Tolterodine LA
Fesoterodine
Darifenacin
Solifenacin
Metabolized by 3A4 inhibitor ex. Trospium
Adverse Effects
Dry mouth
Blurred Vision
Hot and flushed skin
Mirabegron
Adverse Effects
HTN
Urinary retention
UTI
Tachycardia
HA
DDI
2D6 inhibitor (moderate)
Digoxin -> increased digoxin AUC by 27% -> monitor level
Selective Beta- 3 agonist
relax bladder smooth muscle
Claudia Lopez
NRS 273
11/2/20