Rationale for the Use of Anticholinergic Agents in Overactive Bladder With Regard to Central Nervous System and Cardiovascular System Side Effects

Çeti̇nel, Bülent; Önal, Bülent

doi:10.4111/kju.2013.54.12.806

Cited by 38 publications

(19 citation statements)

References 72 publications

(146 reference statements)

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“…The bladder and prostatic smooth muscle were important in human urinary system, under normal physiological status, the cholinergic receptor and adrenal gland could effectively control their contraction and relaxation, M choline receptor and α1 receptor could act on prostate and bladder detrusor to result in normal extraction [6,7], and act on the trigone of urinary bladder and urethral sphincter to result in relaxation [8,9]. In clinic, the anticholinergic agents were universally and widely applied, in human's some tissues and organs like salivary gland and gastric and intestinal smooth muscle, M3 receptors were widely distributed.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of solifenacin succinate combined with other drugs in treating overactive bladder after transurethral resection of the prostate

Hu¹,

Zhang²,

Guan³

2018

biomedicalresearch

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Purpose: This research was aimed to explore the clinical situations of solifenacin succinate combined with tamsulosin in treating OAB after TURP. Methods: During experiment, the diagnosed subjects were randomly included into the treatment group and control group, the treatment lasted 7~10 d, 5 mg of solifenacin succinate and 0.2 mg of tamsulosin were given by oral administration once every one day. Scores were assessed as per relevant reference standards (OABSS, IPSS and QOP) before and after treatment. Results: In treatment group, compared with before treatment group, OABSS, IPSS and QOP after treatment decreased significantly after treatment (p<0.05). In control group, compared with before control group, OABSS, IPSS and QOP after treatment decreased significantly after treatment (p<0.05). Conclusion: It can be seen that the solifenacin succinate combined with other drugs has obvious curative effects and less side effects, which can benefit patients in the quality of life and disease treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical effects of solifenacin succinate combined with other drugs in treating overactive bladder after transurethral resection of the prostate

Hu¹,

Zhang²,

Guan³

2018

biomedicalresearch

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“…They are widely distributed throughout the body; with the brain, heart, eyes, salivary glands, and gastrointestinal tract relying on muscarinic receptor subtypes for optimal functioning (18). This distribution pattern, together with the relative binding affinity of antimuscarinics to each muscarinic receptor subtype and the ability of antimuscarinics to cross the blood-brain barrier (BBB) ( Table 1), accounts for the commonly encountered side effects of antimuscarinic agents, such as constipation, dry mouth, blurred vision, increased heart rate, and dizziness (19).…”

Section: Current Challenges In the Management Of Overactive Bladdermentioning

confidence: 99%

Insights into the Management of Overactive Bladder: What Difference Can Mirabegron Make?

Acar¹,

Erton²,

Tarcan³

2019

jus

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Oral pharmacotherapy constitutes second-line treatment for overactive bladder (OAB) after lifestyle modifications, bladder retraining, and pelvic floor muscle exercises. Antimuscarinics have an established role in the treatment of OAB. However, antimuscarinics are known to have low persistence rates in clinical practice. Mirabegron is an oral β3-adrenoreceptor agonist which has emerged as an alternative to antimuscarinics for managing OAB. Overall, mirabegron has similar clinical efficacy to antimuscarinics and is superior to placebo. Mirabegron has been generally well tolerated in both interventional and non-interventional studies. Persistence has been shown to be higher with mirabegron than with antimuscarinics in realworld studies. Increased blood pressure is associated with mirabegron and therefore its use is contraindicated in patients with severe uncontrolled hypertension. However, a low rate of treatment cessation due to cardiovascular issues has been noted in clinical trials. Mirabegron's utility in the elderly patient population has been well supported with promising efficacy and safety outcomes. New data from a prospective placebo-controlled randomized trial in older OAB patients is expected to be published soon. Mirabegron does not interfere with detrusor contractions during the emptying phase of the micturition cycle and hence lacks any significant effect on post-void residual volume. Mirabegron can be combined with antimuscarinics to synergize clinical effectiveness. Overall, mirabegron represents a well-tolerated and effective medical treatment option for OAB. Mirabegron could be used as an alternative to antimuscarinics, especially in patients who do not improve with antimuscarinics and/or experience bothersome side effects for whom anticholinergic load may be a relevant consideration.

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“…Diminished penetration of the central nervous system has been demonstrated 23 and hypothetically this should minimize the cognitive impact of this agent, but this has not been conclusively demonstrated in clinical experience. 24 , 25 Darifenacin was proposed to specifically target bladder M3 receptors, thereby minimizing muscarinic side effects attributable to nonbladder M3 receptors as well as M1 and M2 receptors. 26 Further, limited data suggest a favorable effect on cognitive function in older patients.…”

Section: Treatment Of Oab In the Vulnerable Elderlymentioning

confidence: 99%

Overactive bladder in the vulnerable elderly

Wolff¹,

Kuchel²,

Smith³

2014

RRU

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Overactive bladder (OAB) is a common problem that may occur in individuals of all ages. It has a considerable impact on patient quality of life, and although moderately effective management strategies do exist, this condition often remains undiagnosed and untreated. OAB needs to be viewed as a symptom complex. Its presentation and management are complicated in the vulnerable elderly by the presence of baseline frailty and multiple coexisting chronic conditions. Furthermore, and beyond a simple understanding of symptomatology, providers must address patient goals and motivations as well as the expectations of caretakers. These multiple levels of perception, function, expectations, and treatment efficacy/risks must be tailored to the individual patient. While the vulnerable elderly patient may often have evidence of urinary tract dysfunction, OAB and urge urinary incontinence in this population must be understood as a multifactorial geriatric syndrome and viewed in the context of medical and functional baseline and precipitating risk factors. Expectations and goals must be tailored to the resources of vulnerable elderly patients and their caregivers, and care must be coordinated with other medical care providers. The management of OAB in the vulnerable elderly often poses significant management challenges. Nonetheless, with a thoughtful approach and an aim towards future research specifically for this population, significant reductions in morbidity and mortality long with enhancement in health-related quality of life are possible.

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Rationale for the Use of Anticholinergic Agents in Overactive Bladder With Regard to Central Nervous System and Cardiovascular System Side Effects

Cited by 38 publications

References 72 publications

Clinical effects of solifenacin succinate combined with other drugs in treating overactive bladder after transurethral resection of the prostate

Clinical effects of solifenacin succinate combined with other drugs in treating overactive bladder after transurethral resection of the prostate

Insights into the Management of Overactive Bladder: What Difference Can Mirabegron Make?

Overactive bladder in the vulnerable elderly

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