Question

Diagnosis: Uncontrolled Type II DM, HTN, and urinary incontinence Hmong postmenopausal woman presenting with Type II diabetes mellitus, hypertension, and urinary incontinence. She reports that she often cannot get to the bathroom in time when she feels the urge to urinate. She also wets herself when she laughs or sneezes. She is very embarrassed about this problem and has decreased her excursions from the house because of it. She drinks six cups of coffee a day. She does not follow a special diet. She takes hydrochlorothiazide for hypertension and metformin for DM. Today her HgbA1C is 12. She wants treatment for her urinary complaints. Discuss specific treatment goals for pharmacotherapy. Discuss the drug therapy a CNP would likely prescribe and why. Discuss the parameters for monitoring the success of the therapy. Discuss health promotion recommendations you would consider for this patient. Please provide evidence-based references.

Answer 1

Female patient diagnosed as uncontrolled Type 2 DM, HTN and urinary incontinence. HBA1C is 12 , she takes metfromin for DM and hydrochlorthiazide for HTN. Now she has problem with urination , she wets herself when she laughs or sneezes.

Treatment for Urinary incontinence:

• Anticholinergics:These medications can calm an overactive bladder and may be helpful for urge incontinence.
• Mirabegron: Used to treat urge incontinence , this medications relaxes baldder muscle and can increase the amount of urine your bladder can hold.
• Alpha blockers
• Topical estrogen