Embed Size (px)
Citation preview
MANAGING GENITO-URINARY
PROBLEMS
THE ROLE OF THE PHARMACIST
Dr Rebekah Moles
Faculty of [email protected]
URINARY INCONTINENCE
LECTURE AVAILABLE FROM
http://www.rhef.com.au/programs/program-1/?program_id=135#
URINARY SYSTEM
http://www.umm.edu/urology-info/images/utract1.gif
TYPES OF INCONTINENCESTRESS (small leakage during physical activity)
Weak Pelvic Floor Muscles
Relaxed Sphincter (can be caused by drugs)
http://myhealth.ucsd.edu/library/healthguide/en-us/images/media/medical/hw/nr55551951.jpg
TYPES OF INCONTINENCE
URGE (loss of urine with strong desire to urinate, unable to get to toilet in
time) Detrussor Overactivity
MIXED (combination of stress and urge)
TYPES OF INCONTINENCE
OVERFLOW(leakage from overfull bladder) poor bladder emptying
PROSTATE
GLAND
http://www.daviddarling.info/images/prostate_gland.jpg
TYPES OF INCONTINENCENOCTURNAL ENURESIS (Bedwetting)
Detrussor Instability
FUNCTIONAL(inability to reach toilet in time) Physical Factors Environmental Factors
REFLEX(spontaneous emptying of bladder with no sensation or control)
Neurological Damage
Australian Pharmacist: Feb 2003
MANAGEMENT OF INCONTINENCELIFESTYLE
PELVIC FLOOR EXERCISES
LOOSE EXCESS WEIGHT
DECREASE CAFFEINE
AVOID ALCOHOL
AVOID CONSTIPATION(increase fluids)
BLADDER TRAINING
MANAGEMENT OF INCONTINENCE
MEDICATIONS
ANTICHOLINERGICS OXYBUTYNIN PROPANTHELINE TOLTERODINE DARIFENACIN SOLIFENACIN TCA’s – IMIPRAMINE / NORTRIPTYLINE / AMITRIPTYLINE
MANAGEMENT OF INCONTINENCEMEDICATIONS
ANTIDIURETIC HORMONE DESMOPRESSIN
HORMONE REPLACEMENT THERAPY ?(NO)
CHOLINERGICS?
ALPHA AGONISTS?
MANAGEMENT OF INCONTINENCEMEDICATIONS
ALPHA BLOCKERS ALFUZOSIN PRAZOSIN TAMSULOSIN TERAZOSIN
5-ALPHA-REDUCTASE INHIBITORS FINESTERIDE DUTASTERIDE
MANAGEMENT OF INCONTINENCEINCONTINENCE AIDS
ABSORBANT PADS AND PANTS
ABSORBENT COVERS (beds and chairs)
CATHETERS
DRAINAGE BAGS
URINARY CONDOMS
ODOUR NEUTRALISERS
ENURESIS ALARMS
Drugs which can Cause IncontinenceDrugs which can Cause Incontinence
Type of DrugType of Drug ExamplesExamples EffectsEffects
AlcoholAlcohol
Polyuria, Polyuria, frequency, frequency, urgency, urgency, sedation, sedation,
AnticholinergicsAnticholinergics Antihistamines, Antihistamines,
TCAsTCAs
Urinary Urinary retention, retention, delirium, delirium,
constipation, constipation, sedationsedation
Drugs which can Cause IncontinenceDrugs which can Cause Incontinence
Type of DrugType of Drug ExamplesExamples EffectsEffects
DiureticsDiuretics Frusemide, CaffeineFrusemide, CaffeinePolyuria, Polyuria,
frequency, frequency, urgency, urgency,
NarcoticsNarcotics OpioidsOpioids
Urinary Urinary retention, retention,
Constipation, Constipation, Sedation, Sedation, DeliriumDelirium
Alpha-blockersAlpha-blockers PrazosinPrazosin Urethral Urethral relaxationrelaxation
Drugs which can Cause IncontinenceDrugs which can Cause Incontinence
Type of DrugType of Drug ExamplesExamples EffectsEffects
Alpha agonistsAlpha agonists PseudoephedrinePseudoephedrine Increase Increase prostate tone prostate tone
ACE InhibitorsACE Inhibitors Captopril, LisinoprilCaptopril, Lisinopril CoughCough
