Overactive Bladder Management: Cognitive Risk With Anticholinergics and Alternative Management Options for the General Practitioner

Miriam R. Raffeld, Avita K. Pahwa, C. Glowacki
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Abstract

5-10 Given these new data, a focus on alternative oral medication treatments has emerged, including use of selective M2/M3 antagonists such as trospium and β -3 adrenergic agonists mirabegron and vibegron. 11-13 The American Geriatrics Society recently updated the Beers Criteria to include anticholinergic medications as a risk Overactive bladder (OAB) is a symptomatic condition characterized by urinary urgency, with or without incontinence, and is often associated with nocturia and increased frequency. 1 OAB is highly prevalent in the US adult population, affecting women and men similarly (16.9% and 16%, respectively). The prevalence of symptom type and severity, however, significantly differs by sex, with women noting urgency incontinence more frequently than men: 19.1% in women aged 65 to 74 years and 8.2% in men aged 65 to 74 years. 2 In women older than 65 years, the prevalence of OAB increases from 16% to 30%. 3 The hallmark physiologic abnormality responsible for OAB is detrusor overac-VOLUME
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膀胱过度活动的管理:认知风险与抗胆碱能药物和替代管理方案的全科医生
5-10鉴于这些新数据,人们开始关注替代口服药物治疗,包括使用选择性M2/M3拮抗剂,如trospium和β -3肾上腺素能激动剂mirabegron和vibegron。11-13美国老年医学会最近更新了比尔斯标准,将抗胆碱能药物作为一种风险纳入其中。膀胱过动症(OAB)是一种以尿急为特征的症状,伴或不伴尿失禁,常伴有夜尿症和尿频增加。1 OAB在美国成年人中非常普遍,对女性和男性的影响相似(分别为16.9%和16%)。然而,症状类型和严重程度的患病率因性别而有显著差异,女性出现急迫性尿失禁的频率高于男性:65至74岁女性为19.1%,65至74岁男性为8.2%。在65岁以上的妇女中,OAB的患病率从16%增加到30%。造成OAB的标志性生理异常是逼尿肌体积过大
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