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At least 631 records · Page 35Linked to original sources
PubMed2005

Pharmacodynamic effects of darifenacin, a muscarinic M selective receptor antagonist for the treatment of overactive bladder, in healthy volunteers.

OBJECTIVE: To evaluate the pharmacodynamic effects of darifenacin (a muscarinic M(3) selective receptor antagonist) and dicyclomine (an M(1) selective receptor antagonist) in healthy male volunteers. SUBJECTS AND METHODS: In this double-blind, four-way crossover study, 27 healthy men (aged 19-44 years) were randomized to receive darifenacin 7.5 mg or 15 mg once daily, dicyclomine 20 mg four times daily or matching placebo. Each 7-day treatment period was separated by a 7-day washout. Multiple assessments of cognitive function, quantitative electroencephalogram (EEG) recordings, salivation, visual nearpoint, heart rate and heart rate variability were made on day 7 in each treatment period. RESULTS: Compared with placebo, neither dose of darifenacin affected cognitive function, whereas dicyclomine impaired performance on five of the 12 variables 2 h after dosing; simple reaction time (P = 0.009), speed of numeric (P = 0.012) and spatial (P = 0.048) working memory, and speed (P = 0.04) and sensitivity (P = 0.03) of picture recognition. These cognitive changes were accompanied by slowing of the EEG for dicyclomine. Darifenacin showed no clinically relevant effect on EEG. Darifenacin 7.5 and 15 mg once daily did not differ from placebo in effects on visual nearpoint, heart rate or heart rate variability. By contrast, dicyclomine significantly increased the maximum visual nearpoint, decreased heart rate and increased heart rate variability, relative to placebo. Both agents decreased salivary flow rate vs placebo. Treatment-related adverse events were comparable in all groups, the most common being dry mouth; none led to treatment discontinuation. CONCLUSIONS: Darifenacin did not affect cognitive, cardiac or visual function in healthy volunteers, a profile that may reflect its relative M(3) receptor selectivity and M(1)/M(2) sparing properties.

Adult↗
PubMed2002

Overactive bladder: a challenge for primary care.

The important role that members of the primary health care team play in the treatment of urinary incontinence is widely recognized (Department of Health (DH), 2000). Incontinence within the general population is increasing and is known to be an embarrassing and distressing condition. It remains a taboo subject that is difficult to talk about even with a trusted health professional. As a result patients suffer from social isolation and a reduction in self-esteem. Members of the primary health care team are well placed to raise awareness about the treatment options. Nurses' involvement in the treatment and management of incontinence is set to increase (DH, 2001). This article aims to review the types of incontinence and the treatment options available to members of the primary health care team. The 'National Service Framework for Older People' (DH, 2001) has set us the task of establishing integrated continence services by 2004. This provides nurses with the opportunity to work in partnership to target this distressing and embarrassing condition.

Drug-Related Side Effects and Adverse Reactions↗
PubMed2006

Botulinum toxin and the overactive bladder.

Botulinum toxin is now a treatment for many conditions. It is undergoing increasing use in several different unlicensed urological clinical situations which are outlined in this article. The article discusses the available evidence relating to its use, effectiveness and safety.

Botulinum Toxins, Type A↗
PubMed1999

Tolterodine: a new antimuscarinic agent for the treatment of the overactive bladder.

Bladder hyperactivity is a debilitating problem that affects many individuals. A plethora of therapeutic options have been investigated to combat this condition, antimuscarinic therapy being the most widely used. Nevertheless, this medication group has historically been of limited benefit, due to its side-effect profile. Tolterodine is a new muscarinic receptor antagonist that has been shown to be equally effective when compared to oxybutynin. However, the side-effect profile for tolterodine is much better than this commonly used anticholinergic. It has reduced affinity for the salivary glands in animal studies, and, in clinical trials, there has been a reduced incidence of dry mouth with this medication. In Phase III studies, tolterodine has been shown to decrease the number of micturitions per day, decrease the number of incontinence episodes per day and increase the mean volume voided per micturition. The maximal effect of this medication may not be seen for 6 - 8 weeks after initiation of the drug although the exact explanation for this finding has yet to be completely elucidated. The recommended dose is 2 mg b.i.d., which should be adjusted for those with liver failure or those on drugs that inhibit the cytochrome P450 isoenzyme known as CYP3A4. In summary, tolterodine is an effective well-tolerated antimuscarinic which should be considered as a first-line treatment due to its more favourable side-effect profile when than other available medications.

Journal Article↗