Urology - Other agents

Interstitial cystitis

pentosan polysulfate (Elmiron ®)

Dosing (Adults): 100mg orally three times a day.

Urinary retention

Bethanecol (Urecholine ® )

Drug Category: Cholinergic Agonist. Indication: Nonobstructive urinary retention and retention due to neurogenic bladder.

Dosing (Adults):
Urinary retention, neurogenic bladder, and/or bladder atony:
Oral: Initial: 10-50 mg 2-4 times/day (some patients may require dosages of 50-100 mg 4 times/day). To determine effective dose, may initiate at a dose of 5-10 mg, with additional doses of 5-10 mg hourly until an effective cumulative dose is reached. Cholinergic effects at higher oral dosages may be cumulative.
SubQ: Initial: 2.575 mg, may repeat in 15-30 minutes (maximum cumulative initial dose: 10.3 mg); subsequent doses may be given 3-4 times daily as needed (some patients may require more frequent dosing at 2.5- to 3-hour intervals).
Chronic neurogenic atony may require doses of 7.5-10 mg every 4 hours.

Gastroesophageal reflux (unlabeled): Oral: 25 mg 4 times/day.

Supplied: [Tablet: 5 mg, 10 mg, 25 mg, 50 mg]

Hemorrhagic Cystitis

Alum irrigation

An astringent that induces hemostasis by precipitating protein over the bleeding surface. Since it has low cell permeability, its action is limited to the cell surface and interstitial spaces.
Usual concentration: 1 percent alum bladder irrigation (base solution usually saline). Reserved for moderate to severe hematuria/bladder hemorrhage. Average instillation rate: 250-300 ml/hour. In mild cases, saline continuous bladder irrigation or suprahydration may be used.

Treatment of Hemorrhagic Cystitis

Disclaimer

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David F. McAuley, Pharm.D., R.Ph. GlobalRPh Inc.

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