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Aging beautifully part 2 urinary incontinence


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Aging beautifully part 2 urinary incontinence

  1. 1. We live in abeautifulworld.
  2. 2. ...where there are many sights to see.
  3. 3. …places to visit.
  4. 4. … and streets to walk.
  5. 5. It’s a good life.
  6. 6. but a better life ifurinary incontinencewas not an issue.
  7. 7. AgingBeautifully:Visions & RealitiesPart II: Urinary Incontinence Christine HortillosaPharm.D. 2013 CandidateUniversity of Texas at Austin College of Pharmacy5. 1. 2013
  8. 8. Realities.
  9. 9. 1 in 10 Males4 in 10 FemalesUIaffects…
  10. 10. 312It causes…
  11. 11. NOT all UIare the same.Stress UI Urge UIMixedIncontinenceOverflowIncontinenceFunctionalIncontinence
  12. 12. NOT all UIare the same.Stress UI Urge UI1. Leaking during physical activity2. Usually small urine amount3. Nocturia1. Urgency2. Frequency with urgency3. Not able to reach toilet4. Large urine amount
  13. 13. NonpharmacologicPharmacologicSurgeryHow tomanage?
  14. 14. 123Nonpharmacologic
  15. 15. Stress UIDuloxetineα- Adrenergic agonist Imipramine• First line therapy• Dose: 40-80 mg/day• Not FDA approved• ADE diminish over time• PSE 15-60mg TID• PE 10mg QID• 25-100mg QHS• OptionalPharmacologic
  16. 16. Anticholinergics/ AntispasmodicsTricyclic Antidepressants Estrogen• 1st line drug therapy• Oxybutynin or Tolterodine = preferred• Oxybutynin XL 5-30mg Qday• Tolterodine LA 2-4mg Qday• Trospium ER, Solifenacin, Darifenacin,Fesoterodine• Imipramine, doxepin, nortriptyline, ordesipramine• 25-100mg QHS• If with depression/neuropathic pain• Cream, insert, or ring• If with urethritis/vaginitisUrge UIPharmacologic
  17. 17. 020406080Dry Mouth Constipation Dizziness VisionDisturbanceOxybutynin IROxybutynin XLOxybutynin TDSOxybutynin GelTolterodineTolterodine LATrospium Cl IRTrospium Cl XRSolifenacinDarifenacinFesoterodineAdverse Event Incidence Rates of Anticholinergics/Antispasmodics
  18. 18. ..for adverse drug effects and therapy effectiveness.
  19. 19. arecritical ineffective urinaryincontinencemanagement.
  20. 20. With your help, they can...
  21. 21. enjoy a better life…
  22. 22. ..and age Beautifully.
  23. 23. Discussion.