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drugs used in bladder dysfunction

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1. incomplete emptying

  • cholinergic agents
    • carbachol } use of both of these drugs has
    • bethanecol } been superseded by catheterisation

  • anticholinesterases
    • distigmine bromide - inhibits the acetylcholine breakdown. It may be useful in the management of patients with an upper motor neurone neurogenic bladder

2. retention

  • alpha-blockers e.g. prazosin, indoramin - used to relax smooth muscle in benign prostatic hypertrophy resulting in an increase in urinary flow rate and an improvement in obstructive symptoms

3. detrusor instability

  • anticholinergics e.g. oxybutynin hydrochloride, flavoxate hydrochloride - result in increased bladder capacity by diminishing unstable detrusor contractions

Drugs in groups 1 and 2 may be combined. Combinations from groups 2 and 3 are inappropriate (1).

Reference:

  • Prescribers Journal (1990). Vol 30(3), 110
 
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General Practice Notebook
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