trospium

(redirected from Trosec)

trospium

(tros-pee-yum) ,

Sanctura

(trade name),

Sanctura XR

(trade name),

Trosec

(trade name)

Classification

Therapeutic: urinary tract antispasmodics
Pharmacologic: antimuscarinics
Pregnancy Category: C

Indications

Overactive bladder with symptoms of urge urinary incontinence, urgency and urinary frequency.

Action

Antagonizes the effect of acetylcholine at muscarinic receptors in the bladder; this parasympatholytic action reduces bladder smooth muscle tone.

Therapeutic effects

Increased bladder capacity and decreased symptoms of overactive bladder.

Pharmacokinetics

Absorption: Less than 10% absorbed following oral administration; food significantly ↓ absorption.
Distribution: Mostly distributed to plasma.
Metabolism and Excretion: Of the 10% absorbed, 40% is metabolized. Unabsorbed drug is mainly excreted in feces. Of absorbed drug, 60% is eliminated in urine as unchanged drug via active tubular secretion.
Half-life: 20 hr.

Time/action profile (anticholinergic effects)

ROUTEONSETPEAKDURATION
POunknown5–6 hr24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Gastric or urinary retention, uncontrolled angle-closure glaucoma or risk for these conditions.
Use Cautiously in: Bladder outflow obstruction;Gastrointestinal obstructive disorders (ulcerative colitis, intestinal atony, myasthenia gravis);Controlled angle-closure glaucoma (use only if necessary and with careful monitoring);CCr <30 mL/min (dose ↓ recommended);Moderate to severe hepatic impairment; Obstetric / Lactation: Use only if benefit justifies risks to fetus/newborn; Pediatric: Safety not established; Geriatric: May have↑ sensitivity to anticholinergic effects; ↓ dose may be required.

Adverse Reactions/Side Effects

Central nervous system

  • headache (most frequent)
  • confusion
  • dizziness
  • drowsiness
  • fatigue
  • hallucinations

Ear, Eye, Nose, Throat

  • blurred vision

Gastrointestinal

  • constipation (most frequent)
  • dry mouth (most frequent)
  • dyspepsia

Genitourinary

  • urinary retention
  • urinary tract infection

Miscellaneous

  • angioedema (life-threatening)
  • fever
  • heat stroke

Interactions

Drug-Drug interaction

May interact with other drugs that compete for tubular secretion.Metformin may ↓ levels.↑ risk of anticholinergic effects with other drugs having anticholinergic properties.

Route/Dosage

Oral (Adults) 20 mg twice daily or 60 mg once daily (XR dose form).
Oral (Adults ≥75 yr) Based on tolerability, dose may be ↓ to 20 mg once daily.

Renal Impairment

Oral (Adults) CCr <30 mL/min—20 mg once daily at bedtime.

Availability (generic available)

Tablets: 20 mg
Extended release tablets: 60 mg

Nursing implications

Nursing assessment

  • Monitor voiding pattern and intake and output ratios.

Potential Nursing Diagnoses

Impaired urinary elimination (Indications)

Implementation

  • Oral: Administer 1 hr prior to meals or on an empty stomach.

Patient/Family Teaching

  • Instruct patient to take as directed. If a dose is skipped, take next dose 1 hr prior to next meal.
  • May cause drowsiness, dizziness, and blurred vision. Caution patient to avoid driving and other activities requiring alertness until response to medication is known. Advise patient to avoid alcohol; may increase drowsiness.
  • Advise patient to notify health care professional immediately of signs and symptoms of angioedema (edema of the tongue or laryngopharynx, difficulty breathing) occur.
  • Caution patient that heat prostration (fever and heat stroke due to decreased sweating) may occur when trospium is taken in a hot environment.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected, or if breast feeding.

Evaluation/Desired Outcomes

  • Increased bladder capacity and decreased symptoms of overactive bladder.
Drug Guide, © 2015 Farlex and Partners