MP is a 55-year-old woman who presents with complaint of inability to hold urine. She describes incidents where laughing or coughing results in a small to moderate release of urine. She has star
MP is a 55-year-old woman who presents with complaint of inability to hold urine. She describes incidents where laughing or coughing results in a small to moderate release of urine. She has started wearing Peri Pads to avoid embarrassment. Past Medical History ?? Six vaginal deliveries, all to full term ?? Osteoarthritis ?? Postmenopausal Medications ?? Boniva, 150 mg once a month ?? Calcium, 500 mg daily ?? Vitamin D3, one daily Family History ?? Mother, alive and well; hypertension, type 2 diabetes ?? Father, deceased; cardiovascular disease, myocardial infarction at age 77 Social History ?? No alcohol intake ?? Previous smoker ?? Walks 2 miles/day Physical Examination ?? Vital signs normal ?? Palpation of uterus suggests enlargement Labs ?? Liver function: Normal
Discussion Questions
1. What factors in MP’s history would help support a diagnosis of overactive bladder?
2. The clinician prescribes oxybutynin 10 mg (extended-release). What does MP need to know about this drug?
3. If oxybutynin is ineffective, the clinician could use mirabegron, a beta-3 agonist. What does MP need to know about this new drug?
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