Which receptors in the bladder control bladder function?
Muscarinic 3 (M3) Receptors
- cause bladder to retract under parasympathetic stimulation
How doe these drugs work?
Block M3 receptors, not allowing the bladder to retract
Overactive bladder affects —- of Americans.
Overactive bladder affects which people less than 40?
Which people greater than 70?
Symptoms of overactive bladder?
- frequency (8+ times day)
- nocturia (2+ times/night)
- urge incontinence (didn’t make it in time)
Is behavioral therapy as effective as medication for overactive bladder?
Legal Exercises: intentionally stop while going to build up the muscles of the sphincter
DOST Oxy Tol Fenacin
- DariFENACIN (most selective)
A/E of Bladder Meds:
Anticholinergic Effects, especially DRY MOUTH b/c mouth has lots of M3 receptors
How can you reduce the Anticholinergic side effects of bladder meds?
- Long-acting forms (less spike of drug leves
- avoid BBB crossers
- use M3 selective drugs (darifenacin most selective)
What conditions, other than OAB (overactive bladder) can Bladder Meds treat?
Why would the Oxybutynin Patch be preferable to the PO form for some clients?
Absorption is slower and steadier
Bypasses metabolism in the GI wall, and thus isn’t eliminated by liver so soon
Who should NOT take M3 Blockers for OAB?
- Tricyclic Antidepressants
All have prominent anti-Muscarinic actions.
Minimizing A/E with M3 blockers?
- Dry mouth (non-sugar candy)
- Anhidrosis (avoid heat of day)
- Patches (don’t use heat, or shave)