Week 5 Discussion
MP is a 55-year-old woman who presents with complaint of inability to hold urine. She describes incidents where laughing or coughing results in a small to moderate release of urine. She has started wearing Peri Pads to avoid embarrassment.
Past Medical History
Six vaginal deliveries, all to full term
Osteoarthritis
Postmenopausal
Medications
Boniva, 150 mg once a month
Calcium, 500 mg daily
Vitamin D3, one daily
Family History
Mother, alive and well; hypertension, type 2 diabetes
Father, deceased; cardiovascular disease, myocardial infarction at age 77
Social History
No alcohol intake
Previous smoker
Walks 2 miles/day
Physical Examination
Vital signs normal
Palpation of uterus suggests enlargement
Labs
Liver function: Normal
Discussion Questions
1. What factors in MP’s history would help support a diagnosis of overactive bladder?
2. The clinician prescribes oxybutynin 10 mg (extended-release). What does MP need to know about this drug?
3. If oxybutynin is ineffective, the clinician could use mirabegron, a beta-3 agonist. What does MP need to know about this new drug?