Incontinence
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1
Calcium channel blockers cause
urinary retention
2
Narcotics cause
urinary retention from impaired contractility
3
sedative hypnotic cause
functional incontinence
4
Anticholinergics cause
urinary rention
5
Hypogastric nerve acts on which receptors?
beta 3
alpha 1
alpha 1
6
Pelvic nerve acts on which receptors?
M3
7
Pudendal nerve acts on the?
external urethral sphincter
8
What is the MOA of alpha adrenergic agonists?
increase bladder outlet resistance by contracting the bladder neck
9
What is the indication for alpha adrenergic agonists?
stress incontinence
10
What are the three alpha adrenergic agonists?
pseudophedrine
phenylephrine
midodrine
phenylephrine
midodrine
11
What are the contraindications for pseudophedrine?
severe hypertension with severe CAD
cannot be used within 14 days of MAOI therapy
cannot be used within 14 days of MAOI therapy
12
What is the box warning associated with midodrine?
may cause marked elevation of supine blood pressure
13
What is the first line medical therapy in women with urge incontinence?
anticholinergic and antimuscarinic agents
14
What are the 5 anticholinergic and antimuscarinic agents?
tolterodine
fesoterodine
trospium
solifenacin
darifenacin
fesoterodine
trospium
solifenacin
darifenacin
15
What is the MOA of anticholinergic and antimuscarinic agents?
inhibit binding of ACh to the cholinergic receptor which supresses involuntary bladder contraction
16
M1 receptors control
exocrine glands
17
M2 receptors inhibit
cardiac
18
M3 receptors excite
exocrine glands
GI
lungs
sphincters
bladder
GI
lungs
sphincters
bladder
19
M4/M5 receptors are responsible for
memory
arousal
attention
analgesia
arousal
attention
analgesia
20
What are the adverse effects of anticholinergic and antimuscarinic agents?
blurred vision
heart palpitations
drowsiness
dry mouth
facial flushing
heart palpitations
drowsiness
dry mouth
facial flushing
21
What are the contraindications for anticholinergic antimuscarinic agents?
narrow angle glaucome
UC
urinary retention
bowel obstruction
myasthenia gravis
severe heart disease
UC
urinary retention
bowel obstruction
myasthenia gravis
severe heart disease
22
Tolterodine differs from other anticholinergic types because
it has selectivity for UB over salivary glands
23
Oxybutynin chloride is a?
muscarinic antagonist
24
What are the underlying reversible causes for incontinence in the elderly?
delirium
infection
atrophic vaginits
psychological
pharmacological
endocrine
restricted mobility
stool impaction
infection
atrophic vaginits
psychological
pharmacological
endocrine
restricted mobility
stool impaction
25
Type of incontinence that has involuntary leakage accompanied by or immediately preceded by urgency?
urge
26
Type of incontinence with inappropriate contraction of detrusor muscle during bladder filling?
overflow
27
Which type of incontinence is the inability to hold urine due to reasons other than neurologcical and lower urinary tract dysfunction?
functional
28
Which type of incontinence is due to urine leakage associated with increased abdominal pressure?
stress
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