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Flashcards in OveractiveBladderFC Deck (26):
1

Overactive Bladder (OBA) pathophysiology

Detrusor muscle contracts frequently and before the bladder is full

2

which sympathetic or para that controls the detrussor muscle

Detrusor muscle controlled by parasympathetic nervous system

3

which nervous systme controls the bladder neck and interna sphincter

Sympathetic nervous system controls bladder neck and internal sphincter

4

which nervous syxtem controls the external sphincter of the bladder

External sphincter is controlled by somatic nervous system

5

which recepters control the bladder

the bladder is comprised of M2 and M3 muscarinic receptors

6

Overactive Bladder (OBA) Symptoms

Urinary urgency with or without urge incontinence
Urinary fequency (voiding >8 times/day)
Nocturia (>2 awakenings to void/night)

7

Forms of Urinary Incontinence

Functional: cognitively, socially, or physically impaired
Overflow
Stress: any form of exertion
Urge: associated with neuropathy (diabetes, stokes, dementia, Parkinson's, MS)
Mixed: urge and Stress

8

Risk Factors for Overactive Bladder

Age >40
diabetes
Restricted mobility
Obesity
Proir vaginal delivery
Neurologic conditions
Hysterectomy
Medication: diuretics, antihistamines, TCAs, cholinesterase inhibitors, alpha antagonists
Pelvis injury

9

NonPharmacological Therapy

Kegal exercises
bladder diary
bladder training
Regulate fluid intake
Eliminate bladder irritants

10

Pharmacological Therapy

Anticholinergics
Beta 3agonist
Botox

11

Anticholinergics names and brands of 6

Drugs: oxybutynin (Ditropan), tolterodine (Detrol), trospium (Sanctura), solifenacin (Vesicare), darifenacin (Enablex), fesoterodien (Toviaz)

12

ci of anticholinergics

CI: Urinary retention, bladder obstruction, gastric retention, decreased gastric motility, uncontrolled narrow angle glaucoma

13

se of anticholinergis

SE: dry mouth, constipation, dry eyes/blurred vision, Urinary retention, somnolence, dizziness, cognitive impairment

14

how totake trospium

Take trospium on empty stomach

15

which anticholinergics to decrease dose for renal dysfunciton

Decrease dose if CrCl is <30 (fesoterodine, solifenacin, tolterodine, trospium)

16

which anticholinergic is the most contipative

darifenacin is more constipative

17

when to change oxytrol patch

Oxytrol patch is changed twice weekly (applyto abdomen, hips, butt)

18

Anticholinergic Drug Interactions

cyp3 a4 intercations, see max doses for these agents

19

Mirabegron (Myrbetriq) MOA

Beta 3agonist Relaxes the detrusor muscle during the storage phase of the fillvoid cycle by activation of beta3 receptors which increases bladder capacity

20

when to dose decrease mirbregon

Decrease dose CrCl 1529, CrCl <15 not recommended

21

se mirabegron

SE: hypertension, nasopharyngitis, UTI, headache

22

mx mirabegron

Monitoring: BP, HR, Urinary symptoms

23

Onabotulinumtoxin A (Botox) moa for over active bladder

Efferent pathways of Detrusor activity via inhibition of acetylcholine release. Inhibit afferent neurotransmitters and sensory pathways

24

botox bbw

BBW: spread of toxins

25

ci botox

CI: acute Urinary tract infection, acute Urinary retention

26

se botox

SE: Detrusor overactivity, Urinary tract infection, Urinary retention