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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/08/26 10:15:18」(JST)

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Tolterodine (Detrol, Detrusitol) is an antimuscarinic drug that is used for symptomatic treatment of urinary incontinence.^[1]

It is marketed by Pfizer in Canada and the United States by its brand name Detrol. In Egypt it is also found under the trade names Tolterodine by Sabaa and Incont L.A. by Adwia.

Use

Detrusor overactivity (DO, contraction of the muscular bladder wall) is the most common form of UI in older adults. It is characterized by uninhibited bladder contractions causing an uncontrollable urge to void. Urinary frequency, urge incontinence and nocturnal incontinence occur. Abnormal bladder contractions that coincide with the urge to void can be measured by urodynamic studies. Treatment is bladder retraining,^[2] pelvic floor therapy or with drugs that inhibit bladder contractions such as oxybutinin and tolterodine.

Pharmacology

Tolterodine acts on M₂ and M₃ ^[3] subtypes of muscarinic receptors whereas older antimuscarinic treatments for overactive bladder act more specifically on M₃ receptors. It is marketed and manufactured by Pfizer.

Tolterodine, although it acts on all types of receptors, has fewer side effects than oxybutynin (M₃ and M₁ selective, but more so in the parotid than in the bladder) as tolterodine targets the bladder more than other areas of the body. This means that less drug needs to be given daily (due to efficient targeting of the bladder) and so there are fewer side effects.^{[citation needed]}

Side effects of tolterodine

Known side effects:

Xerostomia (dry mouth)
Decreased gastric motility (upset stomach)
Headache
Constipation
Dry eyes
Sleepiness
Urinary Retention

The following reactions have been reported in patients who have taken tolterodine since it has become available:

Allergic reactions including swelling
Rapid heartbeat or abnormal heartbeat
Accumulation of fluid in the arms and legs
Hallucinations

Contraindications:

Not to be used in patients with myasthenia gravis and angle closure glaucoma.

References

^ Philip Van Kerrebroeck; Karl Kreder; Udo Jonas; Norm Zinner; Alan Wein (2001). "Tolterodine once-daily: superior efficacy and tolerability in the treatment of the overactive bladder1". Urology. 57 (3): 414–421. doi:10.1016/s0090-4295(00)01113-4.
^ Bladder retraining ichelp.org Interstitial Cystitis Association Accessed July 13, 2012
^ [1] Archived November 26, 2012, at the Wayback Machine.

External links

Detrol - FDA factsheet
Tolterodine

UpToDate Contents

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1. 夜間頻尿：臨床症状、診断、および治療治療 nocturia clinical presentation diagnosis and treatment
2. Treatment of urinary incontinence in women
3. 男性の尿失禁 urinary incontinence in men
4. 小児における膀胱機能障害のマネージメント management of bladder dysfunction in children
5. 男性における下部尿路症状 lower urinary tract symptoms in men

English Journal

Characteristics of antimuscarinic responders versus suboptimal responders in a randomized clinical trial of patients with overactive bladder symptoms.

Grenabo L1, Herschorn S2, Kaplan SA3, Cardozo L4, Scholfield D5, Arumi D6, Carlsson M7, Chapman D7, Ntanios F7.
Current medical research and opinion.Curr Med Res Opin.2017 Oct;33(10):1731-1736. doi: 10.1080/03007995.2017.1361914. Epub 2017 Aug 29.
PMID 28758802

Persistence and adherence to overactive bladder medications in Japan: A large nationwide real-world analysis.

Kato D1, Uno S1, Van Schyndle J2, Fan A2, Kimura T1.
International journal of urology : official journal of the Japanese Urological Association.Int J Urol.2017 Oct;24(10):757-764. doi: 10.1111/iju.13422. Epub 2017 Aug 22.
PMID 28833621

Novel Validated HPTLC Method for the Analysis of Two Binary Mixtures Containing Tamsulosin Hydrochloride with Antimuscarinic Agents.

El-Kimary EI1, Khamis EF1, Belal SF1, Abdel Moneim MM2.
Journal of chromatographic science.J Chromatogr Sci.2017 Sep 11:1-11. doi: 10.1093/chromsci/bmx081. [Epub ahead of print]
PMID 28977351

Japanese Journal

Muscarinic Receptor Binding of the Novel Radioligand, [³H]Imidafenacin in the Human Bladder and Parotid Gland

Journal of Pharmacological Sciences 124(1), 40-46, 2014
NAID 130003382631

Effects of ritobegron (KUC-7483), a novel β_3-adrenoceptor agonist, on both rat bladder function following partial bladder outlet obstruction and on rat salivary secretion : a comparison with the effects of tolterodine

Journal of smooth muscle research = 日本平滑筋学会機関誌 48(5), 115-124, 2012-12-01
NAID 10031151478

前期および後期高齢者の過活動膀胱に対するトルテロジンの有効性と安全性の検討

西日本泌尿器科 74(11), 605-613, 2012-11-20
NAID 10031128469

Related Pictures

تولتيرودين Tolterodine | المرسال Tolterodine Tartrate (Professional Patient Advice) - Drugs.com Buy Detrol (Tolterodine) 2mg Buy Detrol Tolterodine 4mg in USA Tolterodine tartrate - Pharma Detrusitol (Tolterodine L-tartrate) - United Pharmacies New Products for Pharmacists 03-10-2016 | Drug Topics tolterodine - patient information, description, dosage and directions.

★リンクテーブル★

リンク元	「トルテロジン」
拡張検索	「tolterodine tartrate」

「トルテロジン」

Tolterodine
Systematic (IUPAC) name
	(R)-2-[3-(diisopropylamino)-1-phenylpropyl]-4-methylphenol
Clinical data
Trade names	Detrol
AHFS/Drugs.com	Monograph
MedlinePlus	a699026
Pregnancy; category	AU: B3; US: C (Risk not ruled out); ;
Legal status
Legal status	AU: S4 (Prescription only); CA: ℞-only; UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Bioavailability	77%
Protein binding	Approximately 96.3%.
Biological half-life	1.9-3.7 hours
Identifiers
CAS Number	124937-51-5
ATC code	G04BD07 (WHO)
PubChem	CID 443879
IUPHAR/BPS	360
DrugBank	DB01036
ChemSpider	391967
UNII	WHE7A56U7K
KEGG	D00646
ChEBI	CHEBI:9622
ChEMBL	CHEMBL1382
Chemical data
Formula	C22H31NO
Molar mass	325.488 g/mol
	SMILES Cc1ccc(c(c1)[C@H](CCN(C(C)C)C(C)C)c2ccccc2)O ;
	InChI InChI=1S/C22H31NO/c1-16(2)23(17(3)4)14-13-20(19-9-7-6-8-10-19)21-15-18(5)11-12-22(21)24/h6-12,15-17,20,24H,13-14H2,1-5H3/t20-/m1/s1 ; Key:OOGJQPCLVADCPB-HXUWFJFHSA-N ;
(verify)

　　[★]

英: tolterodine
化: 酒石酸トルテロジン, tolterodine tartrate
商: デトルシトール

概念

抗コリン薬の一種で、膀胱に選択性の高いムスカリン受容体拮抗薬。

適応

過活動膀胱における尿意切迫感、頻尿及び切迫性尿失禁

禁忌

デトルシトールカプセル

尿閉、閉塞隅角緑内障、重篤な心疾患、麻痺性イレウス、[[胃アトニー・腸アトニー、重症筋無力症、本剤に対する過敏症

用法用量