Exam 4 Flashcards
Urge urinary incontinence (overreactive bladder) MOST COMMON
What? Hyperactivity of detrusor muscle causing a sudden and poorly predictable voiding
How much? large or small volume
Symptoms:
Urgency (unpredictable)
Medication (acetylcholinesterase inhibitors used for alzheimer’s)
Treatment: non-pharm, anticholinergic or B3 agonist, surgery or botox
Stress Urinary incontinence
What? outlet incompetence where the external urethral sphincter does not work as well as it should associated with abdominal pressure
How much? small volume
Risk factors: multiple childbirths, estrogen deficiency
Causes: alpha antagonists
Symptoms: cough, laugh, alcohol, caffeine
Treatment: Kegel non pharm, duloxetine, topical estrogen, surgery
Overflow incontinence
What? outlet obstruction or uncoordinated detrusor contraction
causes: BPH, prostatic blockage of urethra, kidney stones
symptoms: abdominal discomfort, frequency
treatment: address obstruction, alpha- adrenergic blockers, doxazosin, catheterization
Neurogenic
What? disruption in neurologic innervation of bladder and uncoordinated detrusor contraction
How much? small volume
Causes: stroke, neuropathy, spinal cord injury
Symptoms: loss of feeling bladder is full, dribbling, frequency and urgency, risk of UTI, risk of kidney stones
Treatment: intermittent catheterization, botox, surgery
Medication causes for incontinence
Frequency: diuretics and alpha antagonists
Urgency: acetylcholinesterase inhibitors
Overflow: antihistamines and alpha antagonists
Anticholinergics
Oxybutynin
Tolterodine
Fesoterodine
Solifenacin
darifenacin
trospium
SE of anticholinergics
dry mouth
constipation
fatigue
confusion
tachycardia
B3 agonists
Mirabegron
Vibegron
B3 agonist SE
UTI, Increased BP
