Pharmacology Urinary & Renal Meds #5

Question

A patient taking oxybutynin for urinary incontinence asks why she is having trouble having bowel movements. What is the appropriate response from the nurse?

Answers

  1. Oxybutynin decreases the need to void, as well as the need to relieve the bowels.
    • Rationale:

      This answer is not correct because although it does decrease the need to void by decreasing bladder contractions, it does not decrease the need to relieve the bowels. The feeling or need to relieve the bowels is not affected.

  2. Oxybutynin relaxes the muscle contractions in the bowel and bladder to control frequency.
    • Rationale:

      This answer is not correct since relaxation of the bowel muscles does not cause constipation. Oxybutynin does, however, relax the bladder muscles to decrease contractions, slowing down urine frequency.

  3. Oxybutynin increases muscle spasticity, resulting in constipation.
    • Rationale:

      This answer is not correct because oxybutynin does not increase muscle spasticity. Oxybutynin suppresses muscle spasticity so the bladder does not contract.

  4. Oxybutynin suppresses peristalsis in the gut, resulting in constipation.
    • Rationale:

      This answer is correct because although oxybutynin relaxes the bladder muscle, anticholinergics inhibit motility in the intestines. This causes constipation because the muscles are not moving the waste through the intestines and out the rectum in an appropriate amount of time. Acetylcholine also decreases saliva production. Salvia helps moisten and break down foods. Decrease in salvia can also cause constipation.

Overview

Oxybutynin is an anticholinergic drug that is prescribed for overactive bladder. It suppresses peristalsis in the gut, resulting in constipation.

Explanation

Learning Outcomes

Oxybutynin is an anticholinergic drug. Anticholinergics block acetylcholine which inhibit spasms of smooth muscles. Side effects include dry mouth, urinary retention, constipation and blurred vision. Anticholinergics are not recommended in patients with dementia or cognitive impairment due to their ability of crossing the blood brain barrier. This results in increased cognitive impairment and exacerbation of dementia.

Test Taking Tip

Anticholinergics: Can’t see, can’t spit, can’t pee, can’t sh**.

Video Rationale