Karin Glavind1, Michael Chancellor. 1. Department of Gynecology and Obstetrics, Aalborg Sygehus Nord, 9000 Aalborg, Denmark. glavind@dadlnet.dk
Abstract
INTRODUCTION AND HYPOTHESIS: Antimuscarinic agents appear to exert their therapeutic activity in overactive bladder (OAB) via blockade of the M(3) muscarinic receptor subtype. Antimuscarinics are broadly similar in efficacy, but their safety and tolerability profiles vary, which may reflect differences in muscarinic receptor selectivity profiles. METHODS: This review of available literature aims to determine whether antimuscarinic agents with greater M(3) selectivity have clinical advantages over less selective drugs. RESULTS: Antimuscarinic agents differ widely in their propensity to cause cognitive and cardiovascular (CV) effects, which appear mainly to be related to differences in their relative selectivity for binding to non-M(3) receptors, including M(1) receptors in the brain and cardiac M(2) receptors. CONCLUSIONS: Cognitive and CV effects are especially pertinent for the OAB patient who tends to be older with various comorbidities and is often taking multiple medications. Hence, it is important to consider the risk/benefit balance of antimuscarinic agents when selecting OAB treatment.
INTRODUCTION AND HYPOTHESIS: Antimuscarinic agents appear to exert their therapeutic activity in overactive bladder (OAB) via blockade of the M(3) muscarinic receptor subtype. Antimuscarinics are broadly similar in efficacy, but their safety and tolerability profiles vary, which may reflect differences in muscarinic receptor selectivity profiles. METHODS: This review of available literature aims to determine whether antimuscarinic agents with greater M(3) selectivity have clinical advantages over less selective drugs. RESULTS: Antimuscarinic agents differ widely in their propensity to cause cognitive and cardiovascular (CV) effects, which appear mainly to be related to differences in their relative selectivity for binding to non-M(3) receptors, including M(1) receptors in the brain and cardiac M(2) receptors. CONCLUSIONS: Cognitive and CV effects are especially pertinent for the OABpatient who tends to be older with various comorbidities and is often taking multiple medications. Hence, it is important to consider the risk/benefit balance of antimuscarinic agents when selecting OAB treatment.
Authors: C J Fowler; J N Panicker; M Drake; C Harris; S C W Harrison; M Kirby; M Lucas; N Macleod; J Mangnall; A North; B Porter; S Reid; N Russell; K Watkiss; M Wells Journal: Postgrad Med J Date: 2009-10 Impact factor: 2.401
Authors: Joshua S Benner; Michael B Nichol; Eric S Rovner; Zhanna Jumadilova; Jose Alvir; Mohamed Hussein; Kristina Fanning; Jeffrey N Trocio; Linda Brubaker Journal: BJU Int Date: 2009-11-12 Impact factor: 5.588
Authors: Michael J Cima; Heejin Lee; Karen Daniel; Laura M Tanenbaum; Aikaterini Mantzavinou; Kevin C Spencer; Qunya Ong; Jay C Sy; John Santini; Carl M Schoellhammer; Daniel Blankschtein; Robert S Langer Journal: J Control Release Date: 2014-05-04 Impact factor: 9.776
Authors: Nandita Kachru; Holly M Holmes; Michael L Johnson; Hua Chen; Rajender R Aparasu Journal: J Gen Intern Med Date: 2020-02-05 Impact factor: 5.128
Authors: Laura K Triantafylidis; Jenna S Clemons; Emily P Peron; John Roefaro; Kristin M Zimmerman Journal: Drugs Aging Date: 2018-01 Impact factor: 3.923
Authors: Nandita Kachru; Holly M Holmes; Michael L Johnson; Hua Chen; Rajender R Aparasu Journal: Curr Med Res Opin Date: 2021-05-13 Impact factor: 2.705
Authors: Nandita Kachru; Holly M Holmes; Michael L Johnson; Hua Chen; Rajender R Aparasu Journal: Int J Geriatr Psychiatry Date: 2020-11-18 Impact factor: 3.850
Authors: Douglas Barthold; Zachary A Marcum; Shelly L Gray; Julie Zissimopoulos Journal: Pharmacoepidemiol Drug Saf Date: 2020-08-27 Impact factor: 2.732