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Cerebral Palsy, Cerebellar Ataxia, AIDS, Phacomatosis, Neuromuscular Disorders, and Epilepsy
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Treatment of incontinence related to epilepsy should be aimed toward treating seizures by antiepileptic drugs. Oxybutynin might be beneficial in selected patients.7 However, anticholinergics may not be effective, particularly if incontinence is related to autonomic seizures.
Continence
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Catherine W. McGrother, Madeleine Donaldson
Oxybutynin is the most established antimuscarinic drug in use today. Trials comparing oxybutynin to placebo have consistently shown a reduction in symptoms and urodynamic parameters with the active drug (Table A4.5). Oxybutynin is thus the drug against which all new preparations are compared. Drug-related unwanted side effects occur in the majority of patients taking standard doses of oxybutynin and these can result in about 1 in 4 patients discontinuing treatment.197,198 It has been suggested that oxybutynin should be started at a low dose and gradually increased, titrating the dose against side-effects and efficacy. Inevitably this will lead to more hospital appointments with associated cost.199
Urinary incontinence
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Antimuscarinic (oxybutynin) therapy acts by decreasing the involuntary bladder contractions and increasing the bladder capacity. Yeung et al. have found that 30% or more of children with refractory enuresis have detrusor overactivity and in these children the success rate is between 67% and 90%. Oxybutynin therapy should also be considered in children with day and night wetting and in DDAVP non-responders.
Single-dose intravesical amikacin instillation for pyocystis in a patient with autonomic dysreflexia: A case report
Published in The Journal of Spinal Cord Medicine, 2022
Erin Sherwin, Cynthia King, Howard Hasen, Shari May
The patient had been initiated on vancomycin and piperacillin-tazobactam for a stage 4 left ischial pressure injury, osteomyelitis, and sepsis secondary to Escherichia coli bacteremia. Approximately five weeks into the admission, he developed bladder spasms with lower abdominal pain accompanied by signs of AD. He was sweating on exam and stated, “I do not feel right.” His vitals were stable. A one-time dose of oxybutynin 5 milligrams was administered but ineffective. A bladder catheter was inserted which returned 200 milliliters of malodorous mucous. His pain and symptoms of AD resolved and vitals remained normal. Urology was consulted and a computed tomography (CT) scan of the pelvis showed diffuse thickening of the bladder wall with no nodules or masses. A repeat bladder catheterization provided 50 milliliters of bloody, purulent material which was sent for culture. It grew E. coli susceptible to amikacin and ceftriaxone but resistant to oral antibiotics, gentamicin, and tobramycin. Urology documented that the symptoms and presentation suggested pyocystis.
Oxybutynin addiction: two case reports
Published in Journal of Substance Use, 2021
Harun Olcay Sonkurt, Ali Ercan Altınöz
An anticholinergic agent, oxybutynin has been widely used in general practice since 1972. The primary use cases of oxybutynin are overactive bladder syndrome and neurogenic overactive bladder. It is a safe and efficient agent with pregnancy category B, which means that animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women (U.S. Department of Health & Human Services, 2020). It has been approved for use in children five years of age and older by the U.S Food and Drug Administration (Jirschele & Sand, 2013). There are many forms and application types of oxybutynin: oral form, rectal and vaginal suppositories, transdermal patch and gel, intravesical administration, vaginal gel and vaginal ring. The central nervous system side effects of oxybutynin are well known. As it can cross the blood-brain barrier, it can cause adverse effects on cognitive functions (Jirschele & Sand, 2013). In a study carried out with oxybutynin users with enuresis, it was found that oxybutynin can cause drowsiness, cognitive impairment and sometimes hallucinations (Ferrara et al., 2001).
Pharmacotherapeutic options for the treatment of menopausal symptoms
Published in Expert Opinion on Pharmacotherapy, 2021
Andrea R. Genazzani, Patrizia Monteleone, Andrea Giannini, Tommaso Simoncini
Oxybutynin, an oral anticholinergic agent, used primarily for urge incontinence due to overactive bladder. In a prospective, double-blind, clinical trial, oxybutynin, at a dose of 15 mg daily, determined significant reductions in the frequency and severity of hot flashes at 12 weeks [217]. This dose, however, causes excess toxicity and, by consequence, treatment discontinuation. Adverse effects are very commonly dry mouth, less common diarrhea, nausea and dyspepsia, somnolence and rarely central nervous system excitation (e.g. restlessness, tremor, irritability, convulsions, delirium, hallucinations), cardiac arrhythmia, and urinary retention. At the daily dose of 5–10 mg (2.5 mg or 5 mg twice daily), oral oxybutynin seems to be as efficient as the 15 mg daily dose on the relief from vasomotor symptoms, with less diarrhea and dyspepsia [218]. Moreover, it seems to be as efficient as gabapentin or SSRIs standard doses in alleviating vasomotor symptoms, although no head-to-head trials are available for this drug [218]. The advantage of oxybutynin over most antidepressants lies in the lack of interference with CYP2D6 and, therefore, with the anticancer effect of tamoxifen treatment in breast cancer patients. When considering the use of oxybutynin, it is crucial to take into account that this drug has been associated with an increased risk of dementia before the age of 80 due to its anticholinergic action. Anticholinergic drugs should, therefore, be prescribed with caution in middle-aged and older people [219].