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MANAGING GENITO-URINARY PROBLEMS THE ROLE OF THE PHARMACIST

MANAGING GENITO-URINARY PROBLEMS THE ROLE OF THE PHARMACIST. Dr Rebekah Moles Faculty of Pharmacy Rebekah.moles@sydney.edu.au. URINARY INCONTINENCE. LECTURE AVAILABLE FROM. http://www.rhef.com.au/programs/program-1/?program_id=135#. URINARY SYSTEM.

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MANAGING GENITO-URINARY PROBLEMS THE ROLE OF THE PHARMACIST

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  1. MANAGING GENITO-URINARY PROBLEMS THE ROLE OF THE PHARMACIST Dr Rebekah Moles Faculty of Pharmacy Rebekah.moles@sydney.edu.au

  2. URINARY INCONTINENCE

  3. LECTURE AVAILABLE FROM • http://www.rhef.com.au/programs/program-1/?program_id=135#

  4. URINARY SYSTEM http://www.umm.edu/urology-info/images/utract1.gif

  5. TYPES OF INCONTINENCE • STRESS (small leakage during physical activity) • Weak Pelvic Floor Muscles • Relaxed Sphincter (can be caused by drugs) http://myhealth.ucsd.edu/library/healthguide/en-us/images/media/medical/hw/nr55551951.jpg

  6. TYPES OF INCONTINENCE • URGE (loss of urine with strong desire to urinate, unable to get to toilet in time) • Detrussor Overactivity • MIXED (combination of stress and urge)

  7. TYPES OF INCONTINENCE • OVERFLOW(leakage from overfull bladder) • poor bladder emptying

  8. PROSTATE GLAND http://www.daviddarling.info/images/prostate_gland.jpg

  9. TYPES OF INCONTINENCE • NOCTURNAL ENURESIS (Bedwetting) • Detrussor Instability • FUNCTIONAL(inability to reach toilet in time) • Physical Factors • Environmental Factors • REFLEX(spontaneous emptying of bladder with no sensation or control) • Neurological Damage

  10. Australian Pharmacist: Feb 2003

  11. MANAGEMENT OF INCONTINENCE LIFESTYLE • PELVIC FLOOR EXERCISES • LOOSE EXCESS WEIGHT • DECREASE CAFFEINE • AVOID ALCOHOL • AVOID CONSTIPATION(increase fluids) • BLADDER TRAINING

  12. MANAGEMENT OF INCONTINENCE MEDICATIONS • ANTICHOLINERGICS • OXYBUTYNIN • PROPANTHELINE • TOLTERODINE • DARIFENACIN • SOLIFENACIN • TCA’s – IMIPRAMINE / NORTRIPTYLINE / AMITRIPTYLINE

  13. MANAGEMENT OF INCONTINENCE MEDICATIONS • ANTIDIURETIC HORMONE • DESMOPRESSIN • HORMONE REPLACEMENT THERAPY ?(NO) • CHOLINERGICS? • ALPHA AGONISTS?

  14. MANAGEMENT OF INCONTINENCE MEDICATIONS • ALPHA BLOCKERS • ALFUZOSIN • PRAZOSIN • TAMSULOSIN • TERAZOSIN • 5-ALPHA-REDUCTASE INHIBITORS • FINESTERIDE • DUTASTERIDE

  15. MANAGEMENT OF INCONTINENCE INCONTINENCE AIDS • ABSORBANT PADS AND PANTS • ABSORBENT COVERS (beds and chairs) • CATHETERS • DRAINAGE BAGS • URINARY CONDOMS • ODOUR NEUTRALISERS • ENURESIS ALARMS

  16. Drugs which can Cause Incontinence

  17. Drugs which can Cause Incontinence

  18. Drugs which can Cause Incontinence

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