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
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
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…