USMLE

Oxybutynin Solifenacin Tolterodine

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Anticholinergics
  1. Atropine (Homatropine and Tropicamide)
  2. Glycopyrrolate
  3. Hyoscyamine & Dicyclomine
  4. Oxybutynin Solifenacin Tolterodine
  5. Scopolamine

Summary

Oxybutynin, solifenacin, and tolterodine are drugs that work by antagonizing muscarinic receptors. By blocking muscarinic signalling in the bladder, they can reduce bladder contractions and treat urge urinary incontinence, which is also known as overactive bladder. As anticholinergic drugs, these drugs should be used with caution in elderly patients.

Key Points

  • Oxybutynin, Solifenacin, Tolterodine
    • Mechanism
      • Muscarinic Antagonist
    • Clinical Uses
      • Reduce bladder spasms and urge urinary incontinence (overactive bladder)
        • Due to blockade of M3 receptors on bladder detrusor muscle (contractor muscle)
    • Adverse effects
      • Avoid in elderly patients due to delirium risk (Beer’s Criteria)