Common medications and their mechanisms of affecting bladder function
| MEDICATION CLASS CONTRIBUTING TO URINARY INCONTINENCE | MECHANISM OF EFFECT |
|---|---|
| Anticholinergics (TCAs, medications for urinary urgency, antihistamines, skeletal muscle relaxants, antiparkinsonian agents, antipsychotics) | Inhibit bladder contraction and result in urinary retention; sedation |
| Opiates | Relax bladder; fecal impaction; sedation |
| Diuretics | Increased urine output; can have a substantial effect in the elderly |
| Sedatives and hypnotics | Impair cognition; functional incontinence |
| Angiotensin-converting enzyme inhibitors | Can cause cough and precipitate stress incontinence |
| Calcium channel blocker | Relax bladder and can cause retention |
| α-Adrenergic agents | Increase sphincter tone, contributing to overflow or retention |
| α-Adrenergic blockers | Decrease sphincter tone, contributing to stress incontinence |
| Cyclooxygenase-2 selective NSAIDs and thiazolidinediones | Fluid retention and resulting nocturnal diuresis |
NSAID—nonsteroidal anti-inflammatory drug, TCA—tricyclic antidepressant.