Urinary incontinence mixed

Other Orthostatic Hypotension, Worsening of urge or mixed urinary incontinence... 

Mixed Incontinence and Other Types of Urinary Incontinence... 

Dmochowski RR, Sand PK, Zinner NR, et al. Comparative efficacy and safety of transdermal oxybutynin and oral tolterodine versus placebo in previously treated patients with urge and mixed urinary incontinence. Urology 2003 62 237-242. 

Urinary incontinence—Involuntary leakage of urine. May result from urethral underactivity (stress urinary incontinence), urethral overactivity (overflow incontinence), or mixed pathophysiologic mechanisms. 

In the case of duloxetme, a benzene ring has been replaced by a thiophene nucleus which is a commonly used approach during the process of lead modification. The number of atoms is not the same hence it may be described as a non-classical isostere The phenoxy group has also been transformed, which provides an example of a ring fusion, resulting in the presence of a naphthalenyl-oxy group. This dmg is non-selective, which makes it a mixed SERT/NAT inhibitor. It is indicated for the treatment of major depression, diabetic neuropathy and urinary incontinence. Duloxetine is used as the (S)-enantiomer hydrochloride salt and is available as capsules (30 mg). A typical adult daily dose for the treatment of major depression and diabetic neuropathy is 60 mg. In case of urinary incontinence, 40 mg twice daily have been recommended. 

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