Urinary Incontinence

Question 1

Sx of overactive bladder

Answer 1

1. Urinary urgency
2. Urinary frequency
3. Nocturia
4. Urinary incontinence

Question 2

Urge

Answer 2

Sudden and unstoppable urge to urinate (associated with neuropathy)

Question 3

Stress

Answer 3

Urine leaks out due to form of exertion

Question 4

Mixed UI

Answer 4

combination of urge and stress

Question 5

Functional UI

Answer 5

No abnormality in the bladder, but th patient may be cognitively, socially, or physically impaired

Question 6

Overflow UI

Answer 6

Leakage that occurs when the quality of urine stored in the bladder exceeds capacity (BPH)

Question 7

Function of receptor in bladder

Answer 7

M3: emptying contractions and involuntary bladder contractions

Question 8

RF fo OAB

Answer 8

Age >40
Diabetes
Prior vaginal delivery
Obesity
Neurologic conditions
Drugs that ↑ incontinence (alcohol, diuretics, cholinesterase inhibitor, sedatives)

Question 9

Non drug treatment of OAB

Answer 9

Behavioral therapies
Pelvic floor exercises (Kegel)
FLuid management
Avoid bladder irritants (caffeine)

Question 10

Tx for mixed incontinence

Answer 10

Anticholinergic or beta-receptor agonist
Higher efficacy: onabotulinumtoxin A (Botox) but not first line
Last: Nerve stimulation or surgical tx

Question 11

How long should a treatment trial be before adjusting

Answer 11

4-8 wks

Question 12

Long acting anticholinergics used fr OAB

Answer 12

Oxybutynin ER or transdermal Oxytrol (less side effects)

Tolteridine
Trospium

Selective anticholinergic: darifenacin or solifenacin (less cognitive ADRs)

Question 13

Beta-3 agonsit

Answer 13

Mirabegron

Question 14

How often is Oxytrol applied

Answer 14

Twice weekly

Question 15

Oxybutynin ER

Answer 15

Ditropan XL

Question 16

Oxybutynin patch

Answer 16

Oxytrol Rx
Oxytrol for women (OTC)

Question 17

Tolteridine

Answer 17

Detrol, Detrol LA

Question 18

Solfenicin

Answer 18

Vesicare

Question 19

CI of anticholinergics

Answer 19

Glaucoma

Question 20

ADR of anticholinergics

Answer 20

Agitation, confusion, drowsiness, dz, blurred vision, altered mental status, xeroostoma, constipation

Question 21

Which anticholinergic is in OROS

Answer 21

Ditropan XL

Question 22

Indication for OTC Oxytrol

Answer 22

Women ≥18YO

Question 23

Peripheral anticholinergic ADR

Answer 23

Dry mouth
Dry eyes
Urinary retension
Constipation
Tachycardia

Question 24

Central anticholinergic ADR

Answer 24

Sedation
Dizziness
Cognitive impairment

Question 25

How to ↓ dry mouth from anticholinergics

Answer 25

ER formulations Oxybutinin patch or gel Beta-3 agonist Non drug: avoid mouthwashes with alcohol, ice chips, water, sugar-free candy or gum

Question 26

MOA of mirabegron

Answer 26

B3 agonist that relax the depressor muscle to ↑ capacity → less dry mouth due to selectivity

Question 27

Mirabegron

Answer 27

Myrbetriq

Question 28

Virabegron

Answer 28

Gemtesa

Question 29

ADR of b3 agonsit

Answer 29

Urinary retention Mirabegron: ↑ BP

Question 30

Indication for botox

Answer 30

Patents who are refractory to 1st and 2nd line treamtent

Question 31

ADR of botox

Answer 31

UTI, urinary retention, dysuria

Question 32

What is desmopressin

Answer 32

Antidiuretic hormone analog that temporarily ↓ urine production → indicated for nocturia

Question 33

BBW of desmopressin

Answer 33

Severe hyponatremia

Question 34

Desmopressin

Answer 34

DDVAP

Question 35

Where to apply Oxytrol

Answer 35

Abdomen, hips, buttocks