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Aging beautifully part 2 urinary incontinence
- 1. We live in a beautiful world. http://www.flickr.com/photos/thinkoutsidethebox2008/5371059213/
- 2. ...where there are many sights to see. http://www.flickr.com/photos/cubagallery/5104802230/sizes/l/in/photostream/
- 4. … and streets to walk. http://www.flickr.com/photos/cwazeewabbit/6085377631/sizes/l/in/photostream/
- 5. It’s a good life. http://www.flickr.com/photos/achua/7135655129/
- 6. but a better life if urinary incontinence was not an issue.
- 7. Aging Beautifully:Visions & Realities Part II: Urinary Incontinence http://www.goodlifeguide.net/wp-content/uploads/2012/09/beach-seniors-X-license.jpg By Christine Hortillosa Pharm.D. 2013 Candidate University of Texas at Austin College of Pharmacy 5. 1. 2013
- 8. Realities.
- 9. 1 in 10 Males 4 in 10 Females UIaffects…
- 10. 3 1 2 It causes…
- 11. NOT all UI are the same. Stress UI Urge UI Mixed Incontinence Overflow Incontinence Functional Incontinence
- 12. NOT all UI are the same. Stress UI Urge UI 1. Leaking during physical activity 2. Usually small urine amount 3. Nocturia 1. Urgency 2. Frequency with urgency 3. Not able to reach toilet 4. Large urine amount
- 15. Stress UI Duloxetine α- 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 • Optional Pharmacologic
- 16. Anticholinergics/ Antispasmodics Tricyclic 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, or desipramine • 25-100mg QHS • If with depression/neuropathic pain • Cream, insert, or ring • If with urethritis/ vaginitis Urge UI Pharmacologic
- 17. 0 20 40 60 80 Dry Mouth Constipation Dizziness Vision Disturbance Oxybutynin IR Oxybutynin XL Oxybutynin TDS Oxybutynin Gel Tolterodine Tolterodine LA Trospium Cl IR Trospium Cl XR Solifenacin Darifenacin Fesoterodine Adverse Event Incidence Rates of Anticholinergics/Antispasmodics
- 18. ..for adverse drug effects and therapy effectiveness.
- 19. http://www.toledoblade.com/image/2012/01/22/800x_b1_cCM_z_cT/pharmacist-bryan-01-23-2012.jpg Pharmacists are critical in effective urinary incontinence management.
- 20. With your help, they can...
- 21. enjoy a better life…
- 24. Discussion.
Editor's Notes
- http://www.flickr.com/photos/thinkoutsidethebox2008/5371059213/
- http://www.flickr.com/photos/cubagallery/5104802230/sizes/l/in/photostream/
- http://www.flickr.com/photos/94123706@N00/183247588/
- http://www.flickr.com/photos/cwazeewabbit/6085377631/sizes/l/in/photostream/
- http://www.flickr.com/photos/achua/7135655129/
- http://www.flickr.com/photos/achua/7135655129/
- Today I will discuss Urinary Incontinence, the 2nd part of the Aging beautifully series.
- The condition affects people of all age groups but the peak incidence in women occur around the age of menopause and in men, with the oldest patient cohorts. Chronic UI is one of the most common reasons cited for institutionalization of the elderly. 4 in 10 females today over the age of 60 and 1 in 10 Males have UI.
- Patient with UI have an overall decreased quality of life. Several studies have objectively shown that UI is associated with increased psychological distress and reduced levels of social and personal activities.
- OxybutyninDose: IR 2.5-5mg up to QID, XL 5-30mg QDay, Patch 1/wk, Gel 1 sachet/dTolterodineDose: IR 1-2mg BID, LA 2-4mg/d
- Pharmacists, we have a role to play… As patient advocates and front-line health care professionals we can educate, recommend better treatment alternatives, ensure their safety, and listen… so someday, our patients can say…
- Dance to their hearts content