Chapter 46 Urinary Incontinence Sample Questions
1. KP is a 52-year-old female patient diagnosed with urge incontinence. She has hypertension, type 2 diabetes mellitus and moderate renal dysfunction with a CrCl 25 ml/min. She is on ASA EC81 mg po daily, losartan daily, metformin and gliclazide. She has implemented bladder training but has not achieved improvement of symptoms. Which medication would be the most effective and safe alternative treatment for urge incontinence for KP?
- A. Pelvic floor muscle training
- B. Oxybutynin extended release 10 mg daily PO
- C. Duloxetine
- D. Solifenacin
Ans:
B
Tips: Anticholinergics are second line treatment for urge incontinence when nonpharmacological options fail to provide relief. Solifenacin should be avoided in patients with severe hepatic insufficiency. Do not exceed 5 mg daily in severe renal impairment (ClCr <30 mL/min).
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