.
An increase; impaired
A decrease; impaired
An increase; improved
A decrease; improved
Oxybutynin
Solifenacin
Darifenacin
Fesoterodine
Alterations in the mucosal and sub-mucosal layers
Decreased vascular density and blood flow
Both A and B
None of the above
Estrogen
Duloxetine
Amitriptyline
Oxybutynin
Gender
Age
Physical activity
Caffeine
Urge UI
Stress UI
Explosive UI
Bladder UI
Alterations in the mucosal and sub-mucosal layers
Increased vascular density
Decreased blood flow
A and C only
Oral syrup
Gelnique 400mg/gm
Oral tablet
Transdermal jelly 100mg/gm
Compliance; once daily
Tolerance; twice daily
Efficacy; once daily
Efficacy; three times daily
Detrusor overactivity (DO)
Diminished detrusor contractile strength
Obstruction due to the prostate
A and B
Vesicare
Enablex
Oxybutynin
Sanctura
Dry mouth
Constipation
Alopecia
Altered cognition
Decreased post-voiding residual volume
Increased post-voiding residual volume
Decreased nocturia
Increased detrusor contractile strength
Alterations in the mucosal and sub-mucosal layers
Decreased vascular density and blood flow
Both A and B
None of the above
Detrusor overactivity (DO)
Detrusor underactivity (DU)
Pyloric sphincter overactivity (PO)
None of the above
Tolerodine
Oxybutynin
Darlfenacin
Solifenacin
Pelvic organ prolapse
Prior surgery
Prostate disease
A and B only
Tolterodine
Oxybutynin
Darifenacin
Solifenacin
Detrusor overactivity (DO)
Detrusor underactivity (DU)
Pyloric sphincter overactivity (PO)
None of the above
Solifenacin
Darifenacin
Oxybutinin
None of the above
Ditropan
Detrol
Diprivan
A and B
Oxybutynin
Tolterodine
Darifenacin
All of the above have similar efficacies in reducing urge UI and resulting in cure
Constipation
Cognitive impairment
Diarrhea
UTI
Major age-related changes in the bladder include increased involuntary contractions
Urinary incontinence can be attributed to detrusor overactivity alone
Diminished detrusor contractile strength is a major age-related change
Urethral closure pressure decreases with age
Smaller voided volumes
Higher urine flow rate
Smaller bladder capacity
Increased post-voiding residual volume
Trospium
Darifenacin
Oxybutinin
Solifenacin
Increased intra-abdominal pressure
Sphincter damage impairing closure
Detrusor overactivity
Impaired uretheral support
All antimuscarinics are metabolized by CYP-450 enzymes
During antimuscarinic therapy with older adults a major drug related ADE of concern is cognitive impairment
Currently there is insufficient evidence that one agent with in this class is "safer" for all older patients
Agents within this class prescribed for UI may be associated with drug-disease interactions ie advance diabetes, and parkison's disease
Hypokalemia
Hypocalcemia
Hyponatremia
Hypoalbuminemia
Differences in the incidence of ADEs
Formulation and manufacturer of the drug
Avoidance of ADEs to which the patient may be susceptible
Additional patient-based issues that may complicate the use of the drug
Detrusor overactivity
Diminished detrusor contractile strength
Increased number and density of striated and smooth muscle
Small bladder capacity
Detrusor overactivity
Impaired compensatory mechanisms
Bladder outlet obstruction
A and B only
Alpha adrenergic receptors
Beta adrenergic agonists
Serotonergic receptors
Muscarinic receptors
Topical; lowest
IV; lowest
Topical; highest
IV; highest
Solefenacin
Darifenacin
Detrol LA
Oxybutynin IR
Increased urethral closing pressure
The number but NOT density of striated fibers decreases
Prostate-induced mechanical urethral obstruction is common in females
None of the above
“dense bands” in smooth muscle
Decreased axon sensitivity
Narrowing of spaces between muscle cells
Acetylcholine accumulation
Detrol, Vesicare, Enablex, Toviaz
Sanctura, Vesicare, Toviaz, Enablex
Detrol, Enablex, Toviaz, Vesicare
Sanctura, Oxytrol, Enablex, Evista
Diarrhea
Anticholinergic effects
Nausea and vomiting
Constipation
5 mg
10 mg
4 mg
15 mg
Elderly patients are at risk for developing adverse effects of UI medications
Etiology is usually a specific condition of the lower urinary tract
Concurrent medications should be considered for the cause of UI
UI is associated with an increase in fall risk
Increased involuntary contractions
Detrusor overactivity
Decreased involuntary contractions
Diminished detrusor contractile strength
Decrease in density of striated and smooth muscle
Prior surgery
Increased involuntary contractions due to detrusor overactivity
Pelvic organ prolapse
Tolterodine
Darifenacin
Oxybutynin
Fesoterodine
Duloxetine
Oxybutynin
Tolterodine
Darifenacin
Increased vascular density and blood flow
Diminished detrusor contractile strength
Alterations in the mucosal and submucosal layers
"ultra-close abutments" in smooth muscle cells to facilitate
NSAIDS
Estrogens
Statins
TCAs
Detrol LA 2mg
Solifenacin 10 mg
Oxybutynin 5mg
Solifenacin 5 mg
Quiz Review Timeline (Updated): Aug 26, 2020 +
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