OveractiveBladderFC Flashcards

1
Q

Overactive Bladder (OBA) pathophysiology

A

Detrusor muscle contracts frequently and before the bladder is full

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2
Q

which sympathetic or para that controls the detrussor muscle

A

Detrusor muscle controlled by parasympathetic nervous system

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3
Q

which nervous systme controls the bladder neck and interna sphincter

A

Sympathetic nervous system controls bladder neck and internal sphincter

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4
Q

which nervous syxtem controls the external sphincter of the bladder

A

External sphincter is controlled by somatic nervous system

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5
Q

which recepters control the bladder

A

the bladder is comprised of M2 and M3 muscarinic receptors

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6
Q

Overactive Bladder (OBA) Symptoms

A

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

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7
Q

Forms of Urinary Incontinence

A

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

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8
Q

Risk Factors for Overactive Bladder

A

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

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9
Q

NonPharmacological Therapy

A

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

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10
Q

Pharmacological Therapy

A

Anticholinergics
Beta 3agonist
Botox

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11
Q

Anticholinergics names and brands of 6

A

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

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12
Q

ci of anticholinergics

A

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

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13
Q

se of anticholinergis

A

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

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14
Q

how totake trospium

A

Take trospium on empty stomach

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15
Q

which anticholinergics to decrease dose for renal dysfunciton

A

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

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16
Q

which anticholinergic is the most contipative

A

darifenacin is more constipative

17
Q

when to change oxytrol patch

A

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

18
Q

Anticholinergic Drug Interactions

A

cyp3 a4 intercations, see max doses for these agents

19
Q

Mirabegron (Myrbetriq) MOA

A

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

20
Q

when to dose decrease mirbregon

A

Decrease dose CrCl 1529, CrCl <15 not recommended

21
Q

se mirabegron

A

SE: hypertension, nasopharyngitis, UTI, headache

22
Q

mx mirabegron

A

Monitoring: BP, HR, Urinary symptoms

23
Q

Onabotulinumtoxin A (Botox) moa for over active bladder

A

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

24
Q

botox bbw

A

BBW: spread of toxins

25
Q

ci botox

A

CI: acute Urinary tract infection, acute Urinary retention

26
Q

se botox

A

SE: Detrusor overactivity, Urinary tract infection, Urinary retention