Pharmacologic Therapy for Urinary Incontinence
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Questions and Answers

Which of the following statements about oxybutynin is correct?

  • Oxybutynin is excreted in the feces.
  • Oxybutynin is contraindicated in patients with cardiovascular instability. (correct)
  • Oxybutynin is primarily metabolized in the kidneys.
  • Oxybutynin is a potent anticholinergic drug.

    • What is the onset of action of transdermal oxybutynin?

  • 24 to 48 hours (correct)
  • 4 to 6 hours
  • 1 to 2 hours
  • 12 to 24 hours

    • What is the duration of action of transdermal oxybutynin?

  • 24 hours
  • 96 hours (correct)
  • 48 hours
  • 12 hours

    • What is the main mechanism of action of oxybutynin?

    <p>Relaxation of smooth muscle</p> Signup and view all the answers

    What is the recommended maximum dosage of oxybutynin for older adults?

    <p>2.5 mg PO two to three times per day</p> Signup and view all the answers

    What are the most commonly reported CNS adverse effects of oxybutynin?

    <p>Drowsiness, dizziness, and blurred vision</p> Signup and view all the answers

    What are the contraindications to oxybutynin?

    <p>All of the above</p> Signup and view all the answers

    What is the potential interaction between oxybutynin and phenothiazines?

    <p>Increased anticholinergic effects</p> Signup and view all the answers

    What is the main therapeutic effect of darifenacin?

    <p>Decreased urinary incontinence</p> Signup and view all the answers

    What is the metabolism of darifenacin primarily dependent on?

    <p>CYP3A4 and CYP2D6 enzymes</p> Signup and view all the answers

    Which type of medication is considered first-line for urge incontinence?

    <p>Anticholinergic agents</p> Signup and view all the answers

    What medication should be used with caution in patients with hypertension due to its potential to increase blood pressure?

    <p>Beta-3 adrenergic agonists</p> Signup and view all the answers

    Which medication can decrease bladder contractions as well as increase bladder neck resistance?

    <p>Tricyclic antidepressants</p> Signup and view all the answers

    Which medication may be used to treat stress incontinence but needs to be used with caution in men with prostatic hyperplasia and in patients with hypertension?

    <p>Alpha-adrenergic receptor agonists</p> Signup and view all the answers

    Which class of drugs is considered the drug of choice for their antispasmodic effects on smooth muscle to relieve the symptoms of urinary incontinence and frequency that accompany an overactive bladder?

    <p>Anticholinergic drugs</p> Signup and view all the answers

    Which medication is the prototype urinary antispasmodic that is available in oral and transdermal forms?

    <p>Oxybutynin</p> Signup and view all the answers

    What is the onset of action of the oral preparation of oxybutynin?

    <p>30 to 60 minutes</p> Signup and view all the answers

    What is the peak of the oral preparation of oxybutynin?

    <p>3 to 6 hours</p> Signup and view all the answers

    What is the duration of the oral preparation of oxybutynin?

    <p>6 to 10 hours</p> Signup and view all the answers

    What type of interventions does pharmacologic therapy work best when used as an adjunct to?

    <p>Behavioral interventions</p> Signup and view all the answers

    Which drug is indicated for the treatment of overactive bladder with symptoms of urgency, urge incontinence, and frequency?

    <p>Solifenacin (Vesicare)</p> Signup and view all the answers

    Which drug is more selective for muscarinic receptors in the urinary bladder than in other areas of the body, such as the salivary glands?

    <p>Tolterodine (Detrol, Detrol LA)</p> Signup and view all the answers

    Which drug reduces the tone of smooth muscle in the bladder, exerting an antispasmodic effect?

    <p>Trospium chloride</p> Signup and view all the answers

    Which drug is well absorbed after oral administration, 98% bound to plasma proteins, and extensively metabolized in the liver by CYP3A4 enzymes?

    <p>Solifenacin (Vesicare)</p> Signup and view all the answers

    Which drug should be taken at least 1 hour before meals or on an empty stomach due to its absorption characteristics?

    <p>Trospium chloride</p> Signup and view all the answers

    Which drug is recommended to have reduced dosages for patients with moderate renal or hepatic impairment?

    <p>Solifenacin (Vesicare)</p> Signup and view all the answers

    Which drug has the potential for interaction with other drugs that are eliminated by active tubular secretion, resulting in increased serum concentration of either the drug or the coadministered drug?

    <p>Trospium chloride</p> Signup and view all the answers

    Which drug is not recommended for patients with severe hepatic impairment?

    <p>Solifenacin (Vesicare)</p> Signup and view all the answers

    Which drug is available in an extended-release form?

    <p>Tolterodine (Detrol, Detrol LA)</p> Signup and view all the answers

    Which drug may prolong QT intervals, especially at higher dosages, potentially resulting in dysrhythmias?

    <p>Solifenacin (Vesicare)</p> Signup and view all the answers

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