Please enable JavaScript.
Coggle requires JavaScript to display documents.
urinary Incontinence, More side effects - Coggle Diagram
urinary Incontinence
Drugs
Muscarinic
M3 antagonists
Quaternary amines
(charged hydrophilic)
less CNS effects
Non-selective
Trospium
Take on empty stomach
Tertiary amines
(more lipophilic)
cross BBB
Non selective
Oxybutinin
(Ditropan)
⚠️3A4
Moderate M3 selective
Tolterodine
(Detrol)
⚠️3A4, 2D6
To active
Fesoterodine
⚠️3A4, 2D6
Activated theough plasma esterases
PRODRUGS
High M3 selective
Darifenacin
⚠️3A4, 2D6
Solifenacin
⚠️3A4
β3 agonists
Mirabegron
Less dry mouth
⚠️2D6 inh.
ADE
HTN
3Yo< treat neurogenic detrusor overactivity
Treatment
1st line
all types
Non-pharm
2nd line
SUI
stress urinary incontinence
Estrogens
Topical
(especially post-menopausal)
α-adrenergic agonists
Ephedrine
Norfenefrine
Midodrine
Contra
renal failure
heart diseases
SNRI
duloxetine
Venlafaxine
UUI
bladder overactivity
Anticholinergics
Trospium
Take on empty stomach
Formulations
IR
XR
Darifenacin
ER daily
Solifenacin
Daily
Tolterodine
(Detrol)
⚠️3A4, 2D6
To active
Formulations
BID
XR
Daily
Less dry mouth
8 weeks til MAX benefit
Fesoterodine
Activated theough plasma esterases
Oxybutinin
(Ditropan)
Formulations
Gel
Patch
extended release formulations first line bc of less CNS effects
β-3 adrenergic agonists
Mirabegron
Less dry mouth
ADE
HTN
Efficacy 4-8 weeks
Increase dose
AFTER 8 weeks
Daily
Overflow inconinence
Desmopressin
DDAVP
Formulations
IN
30min before bedtime
SL tab
1 hr before bedtime
3rd line
Botox
Catheterization
More side effects
Less side effects
