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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?

 

 

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DAX-DL01 01

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