Anticholinergics
Thus,
anticholinergic drugs act by binding to a receptor on the bladder wall. And
when they do, they prevent anything in the body from binding to this receptor.
Usually, when the body binds a molecule to this receptor, it causes the bladder
to contract, so this drug suppresses the contraction or constriction of the
bladder.
Then you can
imagine that if this receptor cannot be activated, you will have a less strong
contraction, so you slow down the contractions. All of this will later reduce
the amount of urge you feel, that strong urge to leave, and how strong that
urge will be when you receive it. It will also give you more time to go to the
bathroom, so you will have fewer accidents, increase your bladder size, and
have more time between urinations.
So if you walk a
lot during the day, you will have more room between bathroom shoots. Studies
have compared taking these drugs to a placebo or sugar pill. And, in fact, they
found that people taking antibiotics had less urinary incontinence, fewer urge
episodes, less urination, and more canceled karmic registrations, which means
that when they go to the bathroom, they empty more bladder volume. ... This
medication replaces information about the size of your bladder or the amount of
urine it can hold.
Fine. So these
drugs are working. So why aren't people with overactive bladders taking these
medications all the time? Well, there are some really serious side effects.
These may include blurred vision, constipation, dry eyes, and dry mouth. There
are also some cognitive changes, so people may have less attention and reaction
time, and there may be a slight decrease in their short-term memory. This does
not happen to everyone, but it certainly can. Thus, these drugs are not
prescribed for people who already have some of the initial signs or symptoms of
changes in their cognitive abilities or brain activity. Also, you cannot take
these medications if you have any type of urinary retention.
You should also
ask your ophthalmologist if you have narrow-angle glaucoma because it will
prevent you from taking this drug if you potentially need it. The same is true
if you have so-called gastroparesis, and gastroparesis is when your intestines
do not digest well the food you eat.
Beta3 agonists
Moving on to a
second type of drug called beta3 agonists, or again, Mirabegron is the only
drug currently on the market in the United States. And the way this drug works
is that it actually binds to a receptor and mimics what normally binds to that
receptor and causes the bladder to relax.
Thus, this drug
works by causing a decrease in what we call sensory urges or the sensation or
feeling that you have to leave, and it also increases the capacity of your
bladder or increases it and allows it to hold more.
This drug has
very few side effects. We advise all patients to have their blood pressure
checked approximately one week after starting. It can raise your blood pressure
very slightly by about 10 millimeters of mercury, but we want you to keep it in
check and not fall into the category in which your blood pressure is too high.
Other side effects may include nasal congestion or headaches; You should
consult your doctor if you are taking any medications that need to be adjusted
with this medication.
The most common
drug that sometimes requires some adjustment in the dose you are taking is a
drug called a beta blocker or metoprolol and all that. In general, this drug is
very well tolerated. Many people do well. The problem is that it is still a
brand name drug, which sometimes makes it expensive depending on insurance. And
so, despite a slightly better side effect profile, most people cannot afford it
and are forced to try a different class of drugs.