Гиперактивный мочевой пузырь у мультиморбидных больных. Что нужно помнить?
Гиперактивный мочевой пузырь у мультиморбидных больных. Что нужно помнить?
Коршунова Е.С., Коршунов М.Н. Гиперактивный мочевой пузырь у мультиморбидных больных. Что нужно помнить? Consilium Medicum. 2018; 20 (7): 41–45. DOI: 10.26442/2075-1753_2018.7.41-45
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Korshunova E.S., Korshunov M.N. Hyperactive bladder in multimorbid patients. What should be remembered? Consilium Medicum. 2018; 20 (7): 41–45. DOI: 10.26442/2075-1753_2018.7.41-45
Гиперактивный мочевой пузырь у мультиморбидных больных. Что нужно помнить?
Коршунова Е.С., Коршунов М.Н. Гиперактивный мочевой пузырь у мультиморбидных больных. Что нужно помнить? Consilium Medicum. 2018; 20 (7): 41–45. DOI: 10.26442/2075-1753_2018.7.41-45
________________________________________________
Korshunova E.S., Korshunov M.N. Hyperactive bladder in multimorbid patients. What should be remembered? Consilium Medicum. 2018; 20 (7): 41–45. DOI: 10.26442/2075-1753_2018.7.41-45
Мультиморбидность (коморбидность) – это сочетание у одного больного двух и/или более хронических заболеваний, патогенетически взаимосвязанных между собой или совпадающих по времени у пациента вне зависимости от активности каждого из них. По мнению Всемирной организации здравоохранения, в период между 2000 и 2050 г. доля населения мира в возрасте более 60 лет удвоится с около 11 до 22%. Возрастет и доля больных, страдающих несколькими хроническими заболеваниями. Сегодня помимо терапевтов с проблемой мультиморбидности сталкиваются и узкие специалисты. В статье рассматриваются вопросы лечения больных с гиперактивным мочевым пузырем с позиций коморбидности, необходимости понимания патогенеза основных заболеваний человечества и фармакокинетики лекарственных средств.
Multimorbidity (comorbidity) is a presence of two or more co-occurring chronic diseases in one patient that are pathogenically inter-related or simultaneous irrespective of disease activity. According to the World Health Organization analysis, between 2000 and 2050 years the percentage of people older than 60 years will double from 11% to 22%. The proportion of patients with comorbid chronic diseases will also increase. Apart from therapists, specialized doctors also face the problem of multimorbidity nowadays. The article discusses treatment of hyperactive bladder patients from the perspective of comorbidity and understanding of major diseases pathogenesis and pharmacologic agents pharmacokinetics.
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8. Stewart WF, Van Rooyen JB, Cundiff GW et al. Prevalence and burden of overactive bladder in the United States. W J Urol 2003; 20: 327–36.
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15. Robinson D, Cardozo L, Milsom I et al. Oestrogens and overactive bladder. Neurourol Urodyn 2014; 33 (7): 1086-91. DOI: 10.1002/nau.22464
16. Yamaguchi C, Sakakibara R, Uchiyama T et al. Overactive bladder in diabetes: a peripheral or central mechanism? Neurourol Urodyn 2007; 26 (6): 807–13.
17. Mansfield KJ, Liu L, Mitchelson FJ et al. Muscarinic receptor subtypes in human bladder detrusor and mucosa, studied by radioligand binding and quantitative competitive RT–PCR: changes in ageing. Br J Pharm 2005; 144: 1089–99.
18. Ikeda K, Kobayashi S, Suzuki M et al. M3 receptor antagonism by the novel antimuscarinic agent solifenacin in the urinary bladder and salivary gland. Naunyn-Schmiedeberg’s Arch Pharmacol 2002; 366: 97–103.
19. Pietzko A, Dimpfel W, Schwantes U, Topfmeier P. Influences of trospium chloride and oxybutynin on quantitative EEG in healthy volunteers. Eur J Clin Pharmacol 1994; 47: 337–43.
20. Katz IR, Sands LP, Bilker W et al. Identification of medications that cause cognitive impairment in older people: the case of oxybutynin chloride. J Am Geriatr Soc 1998; 46 (1): 8–13.
21. Womack KB, Heilman KM. Tolterodine and memory: dry but forgetful. Arch Neurol 2003; 60 (5): 771–3.
22. Callegari E, Malhotra B, Bungay PJ et al. A comprehensive non-clinical evaluation of the CNS penetration potential of antimuscarinic agents for the treatment of overactive bladder. Br J Clin Pharmacol 2011; 72 (2): 235–46. DOI: 10.1111/j.1365-2125.2011.03961.x
23. Ferguson DR, Kennedy I, Burton TJ. ATP is released from rabbit urinary bladder epithelial cells by hydrostatic pressure changes – a possible sensory mechanism? J Physiol 1997; 505: 503–11.
24. Hanna-Mitchell AT, Beckel JM, Barbadora S et al. Non-neuronal acetylcholine and urinary bladder urothelium. Life Sci 2007; 80: 2298–302.
25. Kim Y, Yoshimura N, Masuda H et al. Intravesical instillation of human urine after oral administration of trospium, tolterodine and oxybutynin in a rat model of detrusor overactivity. BJU Int 2005; 97: 400–3.
26. Ortiz de Montellano, Paul R. Cytochrome P450: structure, mechanism, and biochemistry. 3rd ed. New York: Kluwer Academic/Plenum Publishers, 2005.
27. Guay DRP. Clinical pharmacokinetics of drugs used to treat urge incontinence. Clin Pharmacokinet 2003; 42: 1243–85.
28. Ohtake A, Saitoh C, Yuyama H. Pharmacological characterization of a new antimuscarinic agent, solifenacin succinate, in comparison with other antimuscarinic agents. Biol Pharm Bull 2007; 30: 54–8.
29. Chapple CR, Khullar V, Gabriel Z. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol 2008; 54: 543–62.
30. Crewe HK, Lennard MS, Tucker GT. The effect of selective serotonin re-uptake inhibitors on cytochrome P4502D6 (CYP2D6) activity in human liver microsomes. 1992/09/01 ed. Br J Clin Pharmacol 1992; 34: 262–5.
31. Yaïch M, Popon M, Médard Y. In-vitro cytochrome P450 dependent metabolism of oxybutynin to N-deethyloxybutynin in humans. Pharmacogenetics 1998; 8 (5): 449–51.
32. Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther 2013; 138: 103–41.
________________________________________________
1. Van den Akker M, Buntinx F, Metsemakers JF et al. Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 1998; 51 (5): 367–75.
2. http://www.who.int/ageing/ageing-global-strategy-draft1-ru.pdf
3. Vertkin A.L., Skotnikov A.S. Komorbidnost. Lechashchiy vrach. 2013; 8: 66–8. [in Russian]
4. Von Stillfried D, Czihal T, Leibner M. Development of urology due to the demographic change. Praxisforum Urdogie. Leipzig. 29.09.2012.
5. Ouslander JG, Kane RL, Abrass IB. Urinary incontinence in elderly nursing home patients. JAMA 1982; 248: 1194–8.
6. Diokno AC, Estanol MVC, Ibrahim IA et al. Prevalence of urinary incontinence in community dwelling men: a cross sectional nationwide epidemiological survey. Int Urol Nephrol 2007; 39: 129–36.
7. Wu JM, Vaughan CP, Goode PS et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstetr Gynecol 2014; 123: 141–8.
8. Stewart WF, Van Rooyen JB, Cundiff GW et al. Prevalence and burden of overactive bladder in the United States. W J Urol 2003; 20: 327–36.
9. Irwin DE, Milsom I, Hunskaar S et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006; 50 (6): 1306–14.
10. Brown JS, McGhan WF, Chokroverty S. Comorbidities associated with overactive bladder. Am J Manag Care 2000; 6 (Suppl. 11): S574–9.
11. Rubin EB, Buehler AE, Halpern SD. States Worse Than Death Among Hospitalized Patients With Serious Illnesses. JAMA Intern Med 2016; 176 (10): 1557–9. DOI: 10.1001/jamainternmed.2016.4362
12. Lushnikova E.L., Nepomniashchikh L.M., Neimark A.I. i dr. Rol' strukturno-funktsional'nykh izmenenii gladkomyshechnykh kletok detruzora i predstatel'noi zhelezy v razvitii giperaktivnogo mochevogo puzyria. Fundamental'nye issledovaniia. 2012; 5 (1): 68–73. [in Russian]
13. Korshunova E.S. Diagnostika i lechenie simptomov nizhnikh mochevykh putei u bol'nykh bolezn'iu Parkinsona v sochetanii i bez dobrokachestvennoi giperplazii prostaty. Avtoref. dis. … kand. med. nauk. M., 2006. [in Russian]
14. Lüthje P, Hirschberg AL, Brauner A. Estrogenic action on innate defense mechanisms in the urinary tract. Maturitas 2014; 77 (1): 32–6. DOI: 10.1016/j.maturitas.2013.10.018
15. Robinson D, Cardozo L, Milsom I et al. Oestrogens and overactive bladder. Neurourol Urodyn 2014; 33 (7): 1086-91. DOI: 10.1002/nau.22464
16. Yamaguchi C, Sakakibara R, Uchiyama T et al. Overactive bladder in diabetes: a peripheral or central mechanism? Neurourol Urodyn 2007; 26 (6): 807–13.
17. Mansfield KJ, Liu L, Mitchelson FJ et al. Muscarinic receptor subtypes in human bladder detrusor and mucosa, studied by radioligand binding and quantitative competitive RT–PCR: changes in ageing. Br J Pharm 2005; 144: 1089–99.
18. Ikeda K, Kobayashi S, Suzuki M et al. M3 receptor antagonism by the novel antimuscarinic agent solifenacin in the urinary bladder and salivary gland. Naunyn-Schmiedeberg’s Arch Pharmacol 2002; 366: 97–103.
19. Pietzko A, Dimpfel W, Schwantes U, Topfmeier P. Influences of trospium chloride and oxybutynin on quantitative EEG in healthy volunteers. Eur J Clin Pharmacol 1994; 47: 337–43.
20. Katz IR, Sands LP, Bilker W et al. Identification of medications that cause cognitive impairment in older people: the case of oxybutynin chloride. J Am Geriatr Soc 1998; 46 (1): 8–13.
21. Womack KB, Heilman KM. Tolterodine and memory: dry but forgetful. Arch Neurol 2003; 60 (5): 771–3.
22. Callegari E, Malhotra B, Bungay PJ et al. A comprehensive non-clinical evaluation of the CNS penetration potential of antimuscarinic agents for the treatment of overactive bladder. Br J Clin Pharmacol 2011; 72 (2): 235–46. DOI: 10.1111/j.1365-2125.2011.03961.x
23. Ferguson DR, Kennedy I, Burton TJ. ATP is released from rabbit urinary bladder epithelial cells by hydrostatic pressure changes – a possible sensory mechanism? J Physiol 1997; 505: 503–11.
24. Hanna-Mitchell AT, Beckel JM, Barbadora S et al. Non-neuronal acetylcholine and urinary bladder urothelium. Life Sci 2007; 80: 2298–302.
25. Kim Y, Yoshimura N, Masuda H et al. Intravesical instillation of human urine after oral administration of trospium, tolterodine and oxybutynin in a rat model of detrusor overactivity. BJU Int 2005; 97: 400–3.
26. Ortiz de Montellano, Paul R. Cytochrome P450: structure, mechanism, and biochemistry. 3rd ed. New York: Kluwer Academic/Plenum Publishers, 2005.
27. Guay DRP. Clinical pharmacokinetics of drugs used to treat urge incontinence. Clin Pharmacokinet 2003; 42: 1243–85.
28. Ohtake A, Saitoh C, Yuyama H. Pharmacological characterization of a new antimuscarinic agent, solifenacin succinate, in comparison with other antimuscarinic agents. Biol Pharm Bull 2007; 30: 54–8.
29. Chapple CR, Khullar V, Gabriel Z. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol 2008; 54: 543–62.
30. Crewe HK, Lennard MS, Tucker GT. The effect of selective serotonin re-uptake inhibitors on cytochrome P4502D6 (CYP2D6) activity in human liver microsomes. 1992/09/01 ed. Br J Clin Pharmacol 1992; 34: 262–5.
31. Yaïch M, Popon M, Médard Y. In-vitro cytochrome P450 dependent metabolism of oxybutynin to N-deethyloxybutynin in humans. Pharmacogenetics 1998; 8 (5): 449–51.
32. Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther 2013; 138: 103–41.
Авторы
Е.С.Коршунова*1–3, М.Н.Коршунов3,4
1 ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России. 125284, Россия, Москва, 2-й Боткинский пр., д. 3;
2 ФГБНУ «Научный центр неврологии». 125367, Россия, Москва, Волоколамское ш., д. 80;
3 ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ. 121359, Россия, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а;
4 Российско-немецкий центр репродукции и клинической эмбриологии ЗАО «Поколение NEXT». 109544, Россия, Москва, ул. Школьная, д. 40–42
*e_korshunova@mail.ru
________________________________________________
E.S.Korshunova*1–3, M.N.Korshunov3,4
1 National Medical Research Center of Radiology of the Ministry of Health of the Russian Federation. 125284, Russian Federation, Moscow, 2-i Botkinskii pr., d. 3;
2 Research Center of Neurology. 125367, Russian Federation, Moscow, Volokolamskoe sh., d. 80;
3 Central State Medical Academy of the President of the Russian Federation. 121359, Russian Federation, Moscow, ul. Marshala Timoshenko, d. 19, str. 1a;
4 Russian-German Center for Reproduction and Clinical Embryology of Generation NEXT. 109544, Russian Federation, Moscow, ul. Shkol'naia, d. 40–42
*e_korshunova@mail.ru