Maximizing anticholinergic therapy for overactive bladder: has the ceiling been reached?

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Maximizing anticholinergic therapy for overactive bladder: has the ceiling been reached?

机译：最大化膀胱过度活动症的抗胆碱能疗法：是否达到上限？

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Urinary incontinence affects an estimated 20-33% of adults the USA and 55% of the country's elderly [1], having a more substantial impact on the physical and mental dimension of quality of life than other common chronic diseases. Muscarinic receptor antagonists, including oxybutynin, tolterodine, trospium chloride, darifenacin, and solifenacin, are front-line therapies for overactive bladder (OAB), with an efficacy of 65-75% in reducing major symptoms. Strategies to increase the therapeutic index have included behavioural therapy, flexible dosing, and dose escalation, as well as newer formulations that reduce anticholinergic side-effects. Among approved OAB agents, the oxybutynin transdermal-delivery system has been associated with a lower incidence of dry mouth than immediate- and extended-release formulations of traditional agents. With a low propensity for drug interactions and dry mouth, it is a likely candidate for older patients taking multiple medications. The transdermal patch bypasses systemicand first-pass metabolism, avoiding higher plasma concentrations of the active metabolite (N-desethyloxybutynin) thought to be associated with dry mouth symptoms. Anticholinergics have a significant role to play in the management of OAB; newer drugs targeted toward muscarinic receptors, and novel delivery systems, continue to increase the therapeutic index for this condition.

机译：尿失禁影响了美国约20-33％的成年人和该国老年人的55％[1]，比其他常见的慢性疾病对生活质量的身心影响更大。毒蕈碱受体拮抗剂，包括奥昔布宁，托特罗定，氯化钾，达利福星和索非那新，是膀胱过度活动症（OAB）的一线治疗方法，其缓解主要症状的功效为65-75％。提高治疗指数的策略包括行为疗法，灵活剂量和剂量递增，以及减少抗胆碱能副作用的新型制剂。在批准的OAB药物中，奥昔布宁透皮递送系统的口干发生率低于传统药物的立即和延长释放制剂。由于药物相互作用和口干的可能性低，因此它可能是服用多种药物的老年患者的候选药物。透皮贴剂可绕过系统性和首过代谢，从而避免了血浆中较高浓度的活性代谢产物（N-去乙基羟丁宁）被认为与口干症状有关。抗胆碱药在OAB的管理中起着重要作用。针对毒蕈碱受体的新型药物和新颖的递送系统，继续增加了针对这种情况的治疗指数。

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《BJU international》 |2007年第3期|共5页
作者
MacDiarmid SA;
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正文语种 eng
中图分类泌尿科学（泌尿生殖系疾病）;
关键词
Cholinergic Antagonists; Urinary Bladder; Overactive; Urinary Incontinence; 胆碱能拮抗剂; 尿失禁;

机译：Cholinergic Antagonists;Urinary Bladder;Overactive;Urinary Incontinence;胆碱能拮抗剂;尿失禁;

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专利

1. Maximizing anticholinergic therapy for overactive bladder: has the ceiling been reached? [J] . MacDiarmid SA BJU international . 2007,第Suppla3期

机译：最大化膀胱过度活动症的抗胆碱能疗法：是否达到上限？
2. OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder [J] . Sievert K-D, Chapple C., Herschorn S., International journal of clinical practice . 2014,第10期

机译：OnaboTulinumtoxina 100u提供尿失禁患者过度活性膀胱症状的显着改善，无论使用的抗胆碱能疗法的数量或过度活跃的膀胱管理不足的原因
3. RATE AND PREDICTIVE FACTORS OF THE ANTICHOLINERGIC ADD-ON THERAPY IN MEN WITH RESIDUAL OVERACTIVE BLADDER SYMPTOM AFTER 4 WEEKS OF (-BLOCKER MONOTHERAPY [J] . International urogynecology journal and pelvic floor dysfunction . 2010,第Suppla1期

机译：（-阻滞剂单疗法）4周后残余过度活动性膀胱症状的男性抗胆碱补充疗法的发生率和预测因素
4. An optimized electrotherapy device for overactive bladder treatment [C] . Pierre-Antoine Sauriol, Magdy Hassouna, Mohamad Sawan IEEE biomedical circuits and systems conference . 2017

机译：一种用于膀胱过度活动症的优化电疗设备
5. A case-control study exploring the relationships between risk factors of detrusor underactivity and bladder outlet obstruction and incomplete bladder emptying in community-dwelling women aged 65 or older who have overactive bladder symptoms [D] . Park, Jeongok. 2011

机译：病例对照研究探讨了逼尿肌活动不足和膀胱出口梗阻的危险因素与膀胱过度活跃症的65岁以上社区居民妇女膀胱排空不完全之间的关系
6. OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder [O] . K-D Sievert, C Chapple, S Herschorn, -1

机译：无论使用何种抗胆碱能疗法或膀胱过度活动症治疗不足的原因OnabotulinumumxinA 100U均可显着改善尿失禁患者的膀胱过度活动症
7. OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder [O] . Sievert K-D., Chapple C., Herschorn S., 2014

机译：Onabotulinumtoxina 100U可显着改善尿失禁患者膀胱过度活动症状，无论使用何种抗胆碱能疗法或膀胱过度活动症管理不当的原因

Maximizing anticholinergic therapy for overactive bladder: has the ceiling been reached?

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