trospium


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Related to trospium: Trospium chloride, Sanctura

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.
References in periodicals archive ?
Oxybutynin is listed as General Benefit and all other agents (darifenacin, fesoterodine, solifenacin, tolterodine, trospium and mirabegron), only require a limited use code on prescriptions.
Instead of trospium chloride, the microspheres are loaded with barium sulfate, which enables the analysis of the microstructure with a micro-computer tomography scanner ([micro]CT).
Visco presented an analysis of 231 women who participated in the ABC trial, which compared the safety and efficacy of a 6-month regimen of anticholinergic medications (solifenacin or trospium) to a single 100-U injection of Botox (N.
In cases where failure-to-store is the primary disorder, oxybutynin, tolterodine or trospium are useful.
Options include oral antimuscarinics agents such as darffenacin, fesoterodine, oxybutynin, solifenacin, tolterodine or trospium. (See table for a list of agents, associated brand names and recommended dosages.)
* Anticholinergic drugs, such as oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), darifenacin (Enablex), trospium (Sanctura) or solifenacin (Vesicare)
Available agents include darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium. There is no evidence of differential efficacy between the above antimuscarinics, but there are different side effect profiles for each drug.
Antimuscarinics include darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium, which all have similar efficacy, In general, patients with more severe symptoms have a greater degree of response to medications, regardless of which medication is chosen.
Antimuscarinics, such as oxybutynin, tolterodine, darifenacin, solifenacin, fesoterodin, and trospium chloride are the only oral drug class to demonstrate a positive benefit-to-risk ratio.
(19) Oksibutinin hidrok-lorid kadar uzun donem sonuclari bulunmasa da, propiverin, trospium ve tolterodin tercih edilebilecek diger ajanlar.
For urge incontinence, your doctor may prescribe antispasmodic medications such as oxybutynin (Ditropan), tolterodine (Detrol), or trospium chloride (Sanctura), which relax muscles to help prevent episodes caused by urgency and frequency.
Pharmacotherapy (anticholinergic medication) includes any form of oxybutynin, tolterodine, trospium chloride, solfenacin, or darifenacin.