Rationale for the use of anticholinergic agents in overactive bladder with regard to central nervous system and cardiovascular system side effects

Korean journal of urology
Bülent Cetinel, Bulent Onal

Abstract

Central nervous system (CNS) and cardiovascular system (CVS) side effects of anticholinergic agents used to treat overactive bladder (OAB) are underreported. Hence, this review aimed to focus on the mechanisms of CNS and CVS side effects of anticholinergic drugs used in OAB treatment, which may help urologists in planning the rationale for OAB treatment. PubMed/MEDLINE was searched for the key words "OAB," "anticholinergics," "muscarinic receptor selectivity," "blood-brain barrier," "CNS," and "CVS side effects." Additional relevant literature was determined by examining the reference lists of articles identified through the search. CNS and CVS side effects, pharmacodynamic and pharmacokinetic properties, the metabolism of these drugs, and the clinical implications for their use in OAB are presented and discussed in this review. Trospium, 5-hydroxymethyl tolterodine, darifenacin, and solifenacin seem to have favorable pharmacodynamic and pharmacokinetic properties with regard to CNS side effects, whereas the pharmacodynamic features of darifenacin, solifenacin, and oxybutynin appear to have an advantage over the other anticholinergic agents (tolterodine, fesoterodine, propiverine, and trospium) with regard to CVS side effects. ...Continue Reading

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Citations

Sep 13, 2014·International Urology and Nephrology·Jun Ho LeeDong-Gi Lee
Dec 9, 2015·International Urogynecology Journal·Zuhal Ozen TunayEbru Ersoy
Mar 22, 2016·Neurourology and Urodynamics·Xavier BiardeauJacques Corcos
Jan 7, 2015·Cell Biochemistry and Biophysics·Mingsen MengWeibing Li
Jan 11, 2020·Expert Opinion on Drug Metabolism & Toxicology·Siobhan M Hartigan, Roger R Dmochowski
Aug 28, 2020·Pharmacoepidemiology and Drug Safety·Douglas BartholdJulie Zissimopoulos
Oct 30, 2020·Hormone Molecular Biology and Clinical Investigation·David EliaEleonora Russo
Sep 15, 2020·Female Pelvic Medicine & Reconstructive Surgery·David SheynJeffrey W Prescott
May 25, 2021·Drugs & Aging·Prajakta P MasurkarRajender R Aparasu
Jun 5, 2021·Pharmacology Research & Perspectives·Brian BellMartin Orrell
Jul 3, 2021·International Urogynecology Journal·Vi DuongCheryl Iglesia

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