Urinary incontinence anticholinergics

TABLE 50-3. Anticholinergic/Antispasmodic Drugs Recommended For Urge Urinary Incontinence... 

Guay DRP. Trospium chloride an update on a quaternary anticholinergic for the treatment of urge urinary incontinence. Ther Clin Risk Manag 2005 1 157-166. 

Oxytrol is a three- or four-day patch used for the treatment of urinary incontinence that was recently approved by the FDA. It delivers the active ingredient oxybutynin. Oxybutynin is an antispasmotic and anticholinergic agent with a molecular weight of 357. Oxybutynin is considered to be a lipophilic drug. Oxytrol is a matrix-type patch with a surface area of 39 cm2 and contains 36 mg of oxybutynin. Oxytrol has an in vivo delivery rate of approximately 3.9mg/day. 

As noted previously, anticholinergic agents have undergone something of a renaissance due to their use as drugs to treat urinary incontinence. The synthesis of one of these muscarinic antagonsists starts with the classic... 

Terodiline, an anticholinergic drug that was originally used for urinary incontinence (1), but was withdrawn in most countries in 1991 because of multiple reports of drug-related cardiac dysrhythmias (SEDA-17,174). 

Side effects/ adverse reactions Frequent Nausea, vomiting, diarrhea, anorexia Occasional Abdominal pain, insomnia, depression, headache, dizziness, fatigue, rhinitis Rare Tremors, constipation, confusion, cough, anxiety, urinary incontinence Adverse/toxic Overdose can cause cholinergic crises (increased salivation, lacrimation, urination, defecation, bradycardia, hypotension, increased muscle weakness). Treatment aimed at general supportive measures, use of anticholinergics (e.g., atropine)... 

Trade names Albert (Oxybutynin) Cystrin Ditropan (Ortho-McNeil) Dridase Novitropan Oxyban Tropax Indications Neurogenic bladder, urinary incontinence Category Anticholinergic Muscarinic antagonist Half-life 1-2.3 hours... 

Anticholinergic effects, a-antagonist effects Polyuria, frequency, urgency, sedation, delirium Cough as a result of ACEIs may aggravate stress urinary incontinence by increasing intra-abdominal pressure... 

Davila GW, Daugherty CA, Sanders SW. A short-term, multicenter, randomized double-blind dose titration study of the efficacy and anticholinergic side effects of transdermal compared to immediate release oral oxybutynin treatment of patients with urge urinary incontinence. J Urol 2001 166 140-145. 

Darifenacin is an anticholinergic agent that blocks muscarinic cholinergic receptors. Darifenacin is indicated in treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. 

Oxybutynin chloride is an anticholinergic that increases bladder capacity, diminishes frequency of uninhibited contractions of detrusor muscle and delays initial desire to void. It is indicated in the treatment of symptoms of bladder instability associated with voiding in patients with uninhibited and reflex neurogenic bladder (e.g., urinary leakage, dysuria) and treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. 

Siegler EL, Reidenbe M Treatment of urinary incontinence with anticholinergics in patients taking cholinesterase inhibitors for dementia. Clin Pharmacol 77ier(2004) 75,484-8. 

Mechanism of Action A quaternary ammonium compound that has anticholinergic properties and that inhibits action of acetylcholine at postganglionic parasympathetic sites. Therapeutic Effect Reduces gastric secretions and urinary frequency, urgency, and urge incontinence. 

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