-
What are the requirements for use of the oxytrol patch?
- Indicated for WOMEN with 2 of the following symptoms for 3 months:
- 1) Urinating 8 or more times per day
- 2) Urgent need to urinate
- 3) Inability to control the urge to go
-
What are the CIs for the Oxytrol patch?
- UTI or GERD symptoms
- Uncontrolled narrow angle glaucoma
- Esophagitis
-
Other than Oxybutynin, what other drugs are first line for Urge UI?
- Tolterodine (Detrol)
- Fesoterodine (Toviaz)
-
What class of drug is Tolterodine?
Muscarinic receptor antagonist
-
What are the dosage forms available for Tolterodine (Detrol)?
LA and XL
-
What special characteristic does the LA form of Tolterodine (Detrol) have?
More effective than the XL form, but may take up to 8 weeks to be effective
-
How is Tolterodine metabolized?
By 2D6, 3A4
-
What DDIs does Tolterodine (Detrol) have?
Antacids cause rapid release of the drug in the LA form
-
What are the AE of Tolterodine (Detrol)?
- Dry mouth
- Dyspepsia
- HA
- Constipation
- Dry eyes
-
Fesoterodine (Toviaz) is related to Tolterodine in what way?
Prodrug (5-hydroxymethyl tolterodine)
-
What is the dose of Fesoterodine (Toviaz) when CrCl < 30 mL/min or taking potent CYP3A4 inhibitor?
4 mg/day
-
What are the AE for Fesoterodine (Toviaz)?
Dry mouth, constipation, dry eyes
-
What is Trospium (Sanctura) FDA approved for?
Overactive bladder with accompanying urgency
-
How should you take IR and XR Trospium (Sanctura)?
- Must be taken on empty stomach 1 hr before
- OR
- 2 hours after meals
- XR - alcohol should not be consumed within 2 hours
-
Which formulation of Trospium (Sanctura) requires renal dose adjustment?
- IR
- XR not recommended in renal failure
-
Solifenacin (Vesicare) is what class of drug?
M1, M2, M3 antagonist
-
Dose limits exist for Solifenacin (Vesicare) in what situations?
Renal and hepatic dysfunction
-
For Solifenacin (Vesicare), don’t exceed 5 mg under what situations?
If on other CYP3A4 inhibitors
-
Darifenacin (Enablex) is what class of drug?
M1, M3, M5 antagonist
-
What form of Darifenacin (Enablex) has increased bioavailability?
ER (compared to IR)
-
How is Darifenacin (Enablex) metabolized?
CYP 2D6 and 3A4
-
What is the Beta 3 agonist used for Urge UI?
Mirabegron (Myrbetria)
-
When is Mirabegron (Myrbetria) recommended?
For patients who don’t tolerate or respond to antimuscarinics
-
Should you combine Mirabegron (Myrbetria) with antimuscarinics?
- Not enough evidence for
- How is Mirabegron (Myrbetria)
- Metabolized?
- 2D6
-
What drug can Mirabegron (Myrbetria) increase the levels of?
Digoxin
-
What UI drug increases Digoxin?
Mirabegron (Myrbetria)
-
What are the AE for Mirabegron?
- N/D
- Consitpation
- Dizziness
- HTN
- HA
-
When is Mirabegron (Myrbetria) not recommended?
Uncontrolled HTN >180/110
-
What drugs are available for Urge UI?
- Oxybutynin (Ditropan)
- Oxytrol patch
- Tolterodine (Detrol)
- Fesoterodine (Toviaz)
- Solifenacin (Vesicare)
- Darifenacin (Enablex)
- Mirabegron (Myrbetria)
- Botulinum toxin A (Botox)
-
Is Botox approved for Urege UI by the FDA?
Yes
-
What is the MOA of Botox?
Inhibits acetylcholine release
-
What is the OOA of Botox?
3-7 days
-
How often must Botox be re-administered for Urge UI?
4-8 months
-
What are the AE for botox in the treatment of UI?
- Urinary retention
- Dysuria
- Hematuria
- UTI
-
What are the CIs for Botox in the treatment of UI?
UTI or other infection
-
What are the treatment options for Overflow incontinence?
Intermittent catheterization Bethanechol
-
What are the treatment options for Functional incontinence?
- Scheduled toileting
- Placement of urinal or commode at bedside
|
|
