Urology A spasmolytic anticholinergic GI and GU tract colic used to ↓ urge incontinence, overactive bladder, bladder Sx associated with neurogenic bladder–eg, frequency, urgency, dysuria, urinary leakage Contraindications Urinary retention, gastric retention, narrow-angle glaucoma Adverse effects Dry mouth, constipation, somnolence, diarrhea, blurred vision, dry eyes, dizziness, rhinitis.
) is an anticholinergic medication used to relieve urinary and bladder difficulties, including frequent urination and inability to control urination (urge incontinence), by decreasing muscle spasms of the bladder. It also has direct spasmolytic effects on bladder smooth muscle as a calcium antagonist and local anesthetic, but at concentrations far above those used clinically. The (R)-enantiomer is a more potent anticholinergic than either the racemate or the (S)-enantiomer, which is essentially without anticholinergic activity at doses used in clinical practice.
Detrusor overactivity is a major cause of incontinence in patients with neurogenic bladder disorders.
Angel's trumpet, jimsonweed, scopolia: increased anticholinergic effects Drug-behaviors.
Alcohol use: additive CNS depression• Tell patient he may take with or without food.
The first-line treatment of detrusor overactivity is with antimuscarinic drugs, but the evidence for their efficacy is limited, with only five high-quality published studies in adults., trospium, propantheline, and tolterodine have all been shown to produce clinical and some urodynamic improvement in detrusor overactivity.
Adverse events are due to nonspecific anticholinergic actions and include dry mouth, blurred vision for near objects, tachycardia, and constipation.