Tolterodine: a new antimuscarinic agent for the treatment of the overactive bladder

Treatment efficacy of tolterodine versus belladonna mixture in children with idiopathic overactive bladder

Objectives

Children with symptoms of urinary urgency, frequency and incontinence are common in the clinic. The aim of the present study was to compare the tolerability and efficacy of tolterodine, a bladder-selective muscarinic receptor antagonist, with belladonna mixture, a traditional anticholinergic drug, in the treatment of idiopathic overactive bladder in children.

Methods

Children aged 5–10 years with a history of diurnal urgency, frequency and incontinence were randomly divided into two groups. Participants in group 1 were given tolterodine 1 mg twice a day for 14 days. If the results were found to be mildly ineffective, after the first 14 days of therapy, prolonged course with 2 mg twice a day was given. In group 2, the children were treated with belladonna mixture 5 mL twice a day for 14 days. Anticholinergic side effects were recorded during the therapy and efficacy was evaluated with voiding diary recorded by the parents at the beginning and end of therapy.

Results

A total of 668 cases were included in this study and 334 for each 25 group (496 boys and 172 girls). Evident anticholinergic side effects which could cease the therapy, such as dry mouth, constipation, mood changes, irritability, and so on, exhibited only on 2% of participants in the tolterodine group but 69% in the belladonna mixture group (p≤0.05). The symptoms of detrusor overactivity disappeared or significantly improved in 80% of children in the tolterodine group and 37% in the belladonna mixture (p≤0.05) group.

Conclusions

Tolterodine had better tolerability and efficacy than belladonna mixture in treating overactive bladder in children.

Biomedical applications of microemulsion through dermal and transdermal route

Microemulsions are thermodynamically stable, transparent, colloidal drug carrier system extensively used by the scientists for effective drug delivery across the skin. It is a spontaneous isotropic mixture of lipophilic and hydrophilic substances stabilized by suitable surfactant and co-surfactant. The easy fabrication, long-term stability, enhanced solubilization, biocompatibility, skin-friendly appearance and affinity for both the hydrophilic and lipophilic drug substances make it superior for skin drug delivery over the other carrier systems. The topical administration of most of the active compounds is impaired by limited skin permeability due to the presence of skin barriers. In this sequence, the microemulsion represents a cost-effective and convenient drug carrier system which successfully delivers the drug to and across the skin. In the present review work, we compiled various attempts made in last 20 years, utilizing the microemulsion for dermal and transdermal delivery of various drugs. The review emphasizes the potency of microemulsion for topical and transdermal drug delivery and its effect on drug permeability.

Solifenacin in multiple sclerosis patients with overactive bladder: a prospective study

Objective. To assess the efficacy and the effect on Qol of solifenacin for the treatment of OAB in MS patients. Patients and Methods. Thirty MS patients suffering from OAB were treated with solifenacin 5/10 mg for 8 weeks. The first 4 weeks patients received solifenacin 5 mg. At week 4 patients could request a dose increase to 10 mg. The efficacy was evaluated at 8 weeks. Results. After 4 weeks of treatment, 28 patients reported acceptable or no side effects. 17 continued the study with the 10 mg dosage, and 11 stayed on 5 mg solifenacin. Two patients withdrew from the study due to side effects. Solifenacin 5/10 mg for 8 weeks resulted in a significant decrease in number of micturitions and number of pads used per day compared to baseline. Also the severity of urgency prior to voiding decreased significantly, and an increase was seen in the volume per void. Twenty out of 30 patients chose to continue solifenacin therapy after termination of the study. The majority of patients reported global QoL improvement. Conclusions. Solifenacin is effective in the treatment of MS patients with OAB symptoms. This is the first study with solifenacin in a specific neurogenic patient group with a neurogenic disease-specific QoL outcome measure (MS-QoL 54).