Antimuscarinics, Genitourinary Uses

Question	Answer
Give eg's of & indications for genitourinary antimuscarinics.	eg's: oxybutynin, tolterodine, solifenacin Indications: • Overactive bladder - reduces urinary frequency, urgency, & urge incontinence. 1st line pharmacological Rx if bladder training is ineffective.
MOA of genitourinary antimuscarinics.	Antimuscarinic drugs bind to muscarinic receptors, where they act as a competitive inhibitor of acetylcholine. Contraction of the smooth muscle of the bladder is under parasympathetic control. Blocking muscarinic receptors therefore promotes bladder relaxation, ^bladder capacity. In pt's with overactive bladder, this may reduce urinary frequency, urgency & urge incontinence. Antimuscarinics useful in treating overactive bladder tend to be relatively selective for the M3 receptor, which is the main muscarinic receptor subtype in the bladder.
SE's of genitourinary antimuscarinics.	• Dry mouth • Tachycardia • Constipation • Blurred vision
CI's, cautions, & important interactions of genitourinary antimuscarinics.	CI's: • UTI Cautions: • CNS SE's can be especially problematic in the elderly & those with dementia • Pt's susceptible to angle-closure glaucoma • Pt's at risk of arrhythmias • Pt's at risk of urinary retention Important interactions: Adverse effects are more pronounced when combined with other drugs that have antimuscarinic effects, such as tricyclic antidepressants.

Resource summary

	Created by Andrew Street about 8 years ago