RESUMO
Flavoxate is a smooth muscle relaxant widely used to treat urgency and urge incontinence. It has been used in an unblinded, uncontrolled clinical trial in 14 urology departments in universities and major hospitals in the People's Republic of China involving 361 patients with urgency/incontinence of various types. Patients were given 200 mg three times daily, orally, for 2 weeks, although 33 patients received a daily dosage of 1200 mg. Frequency, urgency, dysuria, nocturia and incontinence were assessed and scored clinically prior to and after treatment. Three departments also included urodynamic investigations, e.g. monitoring of the end-residual volume. Results from 336 evaluable patients indicate that 228 (67%) were completely cured of urgency/incontinence symptoms, 66 (20%) were improved and 42 (13%) patients were unchanged. Flavoxate was also effective in 77.4% of patients refractory to previous anti-cholinergic treatment. Treatment did not increase the end-residual volume and adverse events occurred only in four (1.3%) patients, two (0.6%) of which discontinued the therapy. The 1200 mg dose produced a complete cure in 82% of patients and improvement in the remaining 18%, with no side-effects. In conclusion, flavoxate is an effective and well tolerated treatment for urgency/incontinence of various causes.
Assuntos
Flavonoides/uso terapêutico , Flavoxato/uso terapêutico , Incontinência Urinária/tratamento farmacológico , Transtornos Urinários/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Ensaios Clínicos como Assunto , Feminino , Flavoxato/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Incontinência Urinária/etiologia , Transtornos Urinários/etiologiaRESUMO
Flavoxate hydrochloride at a daily dosage of 600 mg was compared to a daily dosage of 1200 mg for the treatment of unstable bladder. Twenty-seven patients were treated for 4 weeks in a double-blind, randomized, parallel-group trial. Clinically, both schedules were equally successful. In urodynamic terms, however, particularly with respect to uninhibited detrusor contractions, 1200 mg/day was significantly superior to 600 mg/day. Tolerability was excellent for both regimens. The side-effect free treatment of urgency and urge incontinence is of paramount importance for a patient's quality of life.
Assuntos
Flavonoides/administração & dosagem , Flavoxato/administração & dosagem , Doenças da Bexiga Urinária/tratamento farmacológico , Adolescente , Adulto , Ensaios Clínicos como Assunto , Esquema de Medicação , Feminino , Flavoxato/efeitos adversos , Flavoxato/uso terapêutico , Humanos , Contração Muscular/efeitos dos fármacos , Bexiga Urinária/fisiopatologia , Doenças da Bexiga Urinária/fisiopatologiaRESUMO
Kounis syndrome is the concurrence of acute coronary syndromes with conditions associated with mast cell activation including allergic or hypersensitivity and anaphylactic or anaphylactoid insults. We present a case of acute myocardial infarction associated with an allergic reaction in a 73-year-old Italian woman with recent implantation of stents.
Assuntos
Antipirina/análogos & derivados , Hipersensibilidade a Drogas/complicações , Flavoxato/efeitos adversos , Infarto do Miocárdio/induzido quimicamente , Idoso , Anti-Inflamatórios não Esteroides/efeitos adversos , Antipirina/efeitos adversos , Hipersensibilidade a Drogas/tratamento farmacológico , Hipersensibilidade a Drogas/imunologia , Feminino , Humanos , Infarto do Miocárdio/imunologia , Infarto do Miocárdio/terapia , Parassimpatolíticos/efeitos adversosRESUMO
BACKGROUND: A 54-year-old woman presented with a 3-week history of fatigue and with jaundice that began 2 days before admission. She had been undergoing treatment with flavoxate for urinary incontinence (for 2 months before admission) and with tibolone for climacteric syndrome (for 6 months before admission). Laboratory tests revealed elevated concentrations of aminotransferases, bilirubin, gamma-glutamyltransferase and alkaline phosphatase. Liver biopsy revealed histological evidence of subacute, drug-induced liver damage. INVESTIGATIONS: Physical examination, liver function tests, serology tests, autoantibody tests, genetic analysis of the TATA box of the UGT1A1 gene, ultrasonography and CT scan; MRI cholangiography; liver biopsy. DIAGNOSIS: Drug-related hepatitis in a patient with Gilbert's syndrome. MANAGEMENT: Flavoxate and tibolone were discontinued. Liver function test results improved progressively and normalized after almost 2 months.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Flavoxato/efeitos adversos , Doença de Gilbert/genética , Glucuronosiltransferase/genética , Norpregnenos/efeitos adversos , Doença Aguda , Doença Hepática Induzida por Substâncias e Drogas/complicações , Doença Hepática Induzida por Substâncias e Drogas/patologia , Climatério , Feminino , Flavoxato/uso terapêutico , Seguimentos , Doença de Gilbert/complicações , Humanos , Imuno-Histoquímica , Testes de Função Hepática , Pessoa de Meia-Idade , Mutação , Norpregnenos/uso terapêutico , Medição de Risco , Incontinência Urinária/complicações , Incontinência Urinária/tratamento farmacológicoRESUMO
To investigate the effect of flavoxate (Urispadol) treatment on patients with symptomatic benign prostatic hypertrophy (BPH), with the main weight on the irritative symptoms, a randomized, double-blind, parallel-group, placebo-controlled and multicenter investigation was carried out. Seventy patients entered the study, 37 were allocated to flavoxate treatment on a daily dose of 1,200 mg (400 mg t.i.d.) for 12 weeks, and 33 patients were allocated to placebo treatment. In spite of a sufficient power, the study did not discriminate the two treatment groups in a statistically significant way (p > 0.05), when considering the main endpoints: the irritative symptom score and the global patient evaluation. Conservative treatment of micturition disorders accompanying BPH with flavoxate in doses of 1,200 mg/day cannot be recommended for clinical use.