KINE 2475 Chapter Notes - Chapter 5.9: Polyuria, Benign Prostatic Hyperplasia, Nocturia
18 Jan 2021
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Classification of uti is necessary for appropriate pct: goals to reduce symptoms, minimize adverse effects, improve qol. Second line: antimuscarinic for urgency incontinence, mirabegron (b3-adrenergic agonist) for urgency incontinence in patients after antimuscarinic tried: duloxetine, a-adrenergic receptor agonist & topical estrogen for urethral underactivity (stress incontinence) Anatomy: motor input to detrusor muscle of bladder is parasympathetic. Ach is primary nt which act on muscarinic receptors. M2 is prominent receptor in bladder smooth muscle. M3 receptors responsible for involuntary bladder contractions > thus ui drugs are anti-m3 based: anti-m3 drugs results in detrusor smooth muscle relaxation & reduce bladder over activity. Inhibit contractions: beta-3-adernergic receptor agonist results in detrusor muscle relaxation. Urinary incontinence: to prevent incontinence, the sphincter must remain closed until voluntary voiding is initiated, overactivity or under-activity of bladder/urethra may result in incontinence. Urethral under-activity (stress-urinary incontinence, sui: brief burst of incontinence with activity (coughs, sneezing, due to decreased or inadequate urethral closure.
