Skip to main content
SpringerLink
Log in

Polypharmacy and incontinence

Polypharmazie und Inkontinenz

  • Beiträge zum Themenschwerpunkt
  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Abstract

Polypharmacy as well as urinary incontinence are common geriatric problems. Possible adverse drug effects remain a matter of concern in geriatric medicine and must be considered in urinary incontinence. The occurrence or aggravation of lower urinary tract symptoms might be caused by medication, especially when the symptom is newly diagnosed. On the other hand geriatric patients are at an increased risk for adverse effects of medications, commonly used for treatment of urinary incontinence. Especially antimuscarinic drugs reveal several complex anticholinergic adverse effects. Therefore, knowledge of inappropriate medication and of possible adverse drug effects is important in the diagnostic evaluation and therapeutic considerations to prevent a cascade of symptom-related medications.

Zusammenfassung

Polypharmazie wie auch Inkontinenzleiden stellen häufige geriatrische Probleme dar. Nicht selten können sich beide Konditionen gegenseitig beeinflussen und verstärken. Harninkontinenz kann in manchen Fällen ein Hinweis für eine Medikamentennebenwirkung sein. Andererseits können Medikamente, in erster Linie Anticholinergika, die in der Therapie von Inkontinenzleiden eingesetzt werden, bei geriatrischen Patienten schwere unerwünschte Medikamentennebenwirkungen und -interaktionen verursachen. Grund dafür sind veränderte pharmakokinetische und pharmakodynamische Eigenschaften. Daher muss bei diesen Patienten sowohl bei der Evaluierung als auch in der Therapie von Inkontinenzsymptomen ein besonderes Augenmerk auf mögliche Medikamentennebenwirkungen und -interaktionen gelegt werden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Asplund R, Aberg H (1991) Diurnal variation in the levels of antidiuretic hormone in the elderly. J Intern Med 229(2):131–134

    Article  PubMed  CAS  Google Scholar 

  2. Beers MH, Ouslander JG, Rollingher I et al (1991) Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med 151(9):1825–1832

    Article  PubMed  CAS  Google Scholar 

  3. Boudreau DM, Yu O, Gray SL et al (2009) Concomitant use of cholinesterase inhibitors and anticholinergics: prevalence and outcomes. J Am Geriatr Soc 57:1238–1244

    Article  Google Scholar 

  4. Callaway E, Halliday R, Naylor H (1992) Cholinergic activity and constraints on information processing. Biol Psychol 33:1–22

    Article  PubMed  CAS  Google Scholar 

  5. Chapple CR, Khullar V, Gabriel Z et al (2008) The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol 54:543–562

    Article  PubMed  CAS  Google Scholar 

  6. Cigolle CT, Langa KM, Kabeto MU et al (2007) Geriatric conditions and disability: the Health and Retirement Study. Ann Intern Med 147:156–164

    PubMed  Google Scholar 

  7. DuBeau CE, Kuchel GA, Johnson T et al (2009) Incontinence in the frail elderly. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) 4th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse and Faecal Incontinence. 4th ed. Health Publication Ltd, Paris, pp 961–1024

    Google Scholar 

  8. Gallagher P, Ryan C, Byrne S et al (2008) STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther 46(2):72–83

    PubMed  CAS  Google Scholar 

  9. Gill SS, Mamdani M, Naglie G et al (2005) A prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs. Arch Intern Med 165:808

    Article  PubMed  Google Scholar 

  10. Hogan DB (1997) Revisiting the O complex: urinary incontinence, delirium and polypharmacy in elderly patients. CMAJ 157(8):1071–1077

    PubMed  CAS  Google Scholar 

  11. Holroyd-Leduc JM, Mehta KM, Covinsky KE (2004) Urinary incontinence and its association with death, nursing home admission, and functional decline. J Am Geriatr Soc 52:712–718

    Article  PubMed  Google Scholar 

  12. Holt S, Schmiedl S, Thürmann PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Ärztebl 107:543–551

    Google Scholar 

  13. Kessler TM, Bachmann LM, Minder C et al (2011) Adverse event assessment of antimuscarinics for treating overactive bladder: a network meta-analytic approach. PLoS ONE 6(2):e16718. doi: 10.1371/journal.pone.0016718

    Article  PubMed  CAS  Google Scholar 

  14. Laroche ML, Charmes JP, Merle L (2007) Potentially inappropriate medications in the elderly: a French consensus panel list. Eur J Clin Pharmacol 63:725–731

    Article  PubMed  Google Scholar 

  15. Madhuvrata P, Cody JD, Ellis G et al (2012) Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev 1:CD005429

    PubMed  Google Scholar 

  16. Milsom I, Altman D, Lapitan MC et al (2009) Epidemiology of urinary and faecal incontinence and pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) 4th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse and Faecal Incontinence. 4th ed. Health Publication Ltd., Paris, France, pp 35–111

    Google Scholar 

  17. Modi A, Weiner M, Craig BA et al (2009) Concomitant use of anticholinergics with acetylcholinesterase inhibitors in Medicaid recipients with dementia and residing in nursing homes. J Am Geriatr Soc 57:1238

    Article  PubMed  Google Scholar 

  18. Novara G, Galfano A, Secco S et al (2008) A systematic review and meta-analysis of randomized controlled trials with antimuscarinic drugs for overactive bladder. Eur Urol 54(4):740–764

    Article  PubMed  CAS  Google Scholar 

  19. Österreichisches Basisassessment. http://www.geriatrie-online.at. Accessed 12 June 2012

  20. Ouslander JG, Johnson TM (1998) Incontinence. In: Hazzard WR, Blass JP, Ettinger WH et al (eds) Principles of Geriatric Medicine and Gerontology. 4th Ed. McGraw-Hill, New York, pp 1595–1613

  21. Ouslander JG et al (1998) Arginine vasopressin levels in nursing home residents with nighttime urinary incontinence. J Am Geriatr Soc 46:1274–1279

    PubMed  CAS  Google Scholar 

  22. Mann E, Böhmdorfer B, Frühwald T et al (2012) Potentially inappropriate medication in geriatric patients: the Austrian consensus panel list. Wien Klin Wochenschr 124(5–6):160–169

    Google Scholar 

  23. Robinson D, Cardozo L (2012) Antimuscarinic drugs to treat overactive bladder. BMJ 344:e2130. doi:10.1136/bmj.e2130

    Article  PubMed  Google Scholar 

  24. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel (2012) AGS updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 60(4):616–631

    Article  Google Scholar 

  25. Kerrebroeck P van et al (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:179–183

    Article  PubMed  Google Scholar 

  26. Weiss JP, Blaivas JG, Bliwise DL et al (2011) The evaluation and treatment of nocturia: a consensus statement. BJU Int 108:6–21

    Article  PubMed  Google Scholar 

  27. Woodford H, George J (2007) NICE guidelines on urinary incontinence in women. Age Ageing 36:349–350

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Internal and Geriatric Medicine, Hochzirl Hospital, 6170, Zirl, Austria

    H. Talasz MD & M. Lechleitner MD

Authors
  1. H. Talasz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Lechleitner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Talasz MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Talasz, H., Lechleitner, M. Polypharmacy and incontinence. Z Gerontol Geriat 45, 464–467 (2012). https://doi.org/10.1007/s00391-012-0358-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-012-0358-7

Keywords

Schlüsselwörter

Search

Navigation