Test 4 - Bladder Medications (Josh)

Question 1

Which receptors in the bladder control bladder function?

Answer 1

Muscarinic 3 (M3) Receptors

• cause bladder to retract under parasympathetic stimulation

Question 2

How doe these drugs work?

Answer 2

Block M3 receptors, not allowing the bladder to retract

Question 3

Overactive bladder affects —- of Americans.

Answer 3

33 %

Question 4

Overactive bladder affects which people less than 40?

Which people greater than 70?

Answer 4

Mostly women

Mostly men

Question 5

Symptoms of overactive bladder?

Answer 5

• urgency
• frequency (8+ times day)
• nocturia (2+ times/night)
• urge incontinence (didn’t make it in time)

Question 6

Is behavioral therapy as effective as medication for overactive bladder?

Answer 6

Yes

Legal Exercises: intentionally stop while going to build up the muscles of the sphincter

Question 7

Bladder Meds:

Answer 7

DOST Oxy Tol Fenacin

• DariFENACIN (most selective)
• Oxybutynin
• SoliFENACIN
• Tolterodine

Question 8

A/E of Bladder Meds:

Answer 8

Anticholinergic Effects, especially DRY MOUTH b/c mouth has lots of M3 receptors

Question 9

How can you reduce the Anticholinergic side effects of bladder meds?

Answer 9

• Long-acting forms (less spike of drug leves
• avoid BBB crossers
• use M3 selective drugs (darifenacin most selective)

Question 10

What conditions, other than OAB (overactive bladder) can Bladder Meds treat?

Answer 10

Bladder contractions

Question 11

Why would the Oxybutynin Patch be preferable to the PO form for some clients?

Answer 11

Absorption is slower and steadier

Bypasses metabolism in the GI wall, and thus isn’t eliminated by liver so soon

Question 12

Who should NOT take M3 Blockers for OAB?

Answer 12

• Antihistamines
• Tricyclic Antidepressants
• Phenothiazines

All have prominent anti-Muscarinic actions.

Question 13

Minimizing A/E with M3 blockers?

Answer 13

• Dry mouth (non-sugar candy)
• Anhidrosis (avoid heat of day)
• Patches (don’t use heat, or shave)