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Will the evolution of overactive bladder delivery systems increase patient compliance?
MedLine Citation:
PMID:  19680525     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
The negative impact of overactive bladder (OAB) on daily quality of life drives the large market of pharmacotherapy targeted at symptoms of urinary frequency and urgency, with or without urinary urge incontinence. Currently, the primary pharmacologic treatment modality is aimed at modulation of the efferent muscarinic receptors (M2 and M3) predominant in detrusor smooth muscle and responsible for involuntary or unwanted bladder contractions. However, due to drug effects in the muscarinic receptors of the salivary glands and intestinal smooth muscle, as well as extensive first-pass metabolism in the liver and intestinal tract yielding parent drug metabolites, adverse side effects are common and can be quite bothersome. These issues, encountered with many of the oral antimuscarinic formulations, limit their tolerability and affect long-term patient compliance and satisfaction. Thus, the benefit of pharmacotherapy for OAB must be a balance between efficacy and tolerability, also known as therapeutic index. This article reviews the current pharmacologic delivery systems available for the treatment of OAB, patient compliance, and reasons for discontinuation of medication.
Authors:
Nirit Rosenblum
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Reviews in urology     Volume:  11     ISSN:  1523-6161     ISO Abbreviation:  Rev Urol     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-14     Completed Date:  2011-07-14     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  100889067     Medline TA:  Rev Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-51     Citation Subset:  -    
Affiliation:
New York University Langone Medical Center New York, NY.
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