Featured Research

from universities, journals, and other organizations

Certain medications associated with increased risk of urinary retention in men with COPD

Date:
May 23, 2011
Source:
JAMA and Archives Journals
Summary:
Men with chronic obstructive pulmonary disease (COPD) who are treated with inhaled anticholinergic drugs appear to have an increased risk of developing urinary retention (inability to urinate), according to a new report.

Men with chronic obstructive pulmonary disease (COPD) who are treated with inhaled anticholinergic drugs appear to have an increased risk of developing urinary retention (inability to urinate), according to a report in the May 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The article is part of the journal's Less Is More series.

Chronic obstructive pulmonary disease is a progressive respiratory disorder in which inflammation or blockage in the lungs makes breathing difficult. According to background information in the article, it affects 10 percent of people age 40 years and older. Inhaled anticholinergic medications (IACs) help the airway's muscles relax and reduce obstructions in airflow. However, the authors note, "there is uncertainty about whether IACs cause clinically important systemic anticholinergic effects."

In previous clinical trials of these medications, a connection was noticed with acute urinary retention (AUR), an inability to urinate which is considered a medical emergency. The authors note that AUR can lead to serious complications. "Understanding the risk of AUR associated with IAC therapy would help to identify those at risk for this complication," they explain.

Anne Stephenson, M.D., Ph.D., from St. Michael's Hospital, Toronto, Canada, and colleagues conducted a study using data from Ontario's universal health insurance program. They selected individuals ages 66 years or older with COPD and searched the data for treatment with IACs and development of AUR between April 2003 and March 2009. Researchers further segmented the data by patients' IAC regimens.

Among the original cohort of 565,073 patients with COPD, a total of 9,432 men and 1,806 women developed AUR. "This relationship was not statistically significant in women," the researchers write, but was significant in men. Among IAC users, the odds of AUR were about 40 percent higher in men who had been using IACs for one month or less and about 80 percent higher in men with an enlarged prostate gland. Simultaneous use of both short-acting and long-acting IACs significantly elevated men's odds of AUR.

"Physicians should highlight for patients the possible connection between urinary symptoms and inhaled respiratory medication use to ensure that changes in urinary flow (ie, incomplete voiding, urinary incontinence, and decreased urinary flow) are reported to the physician prescribing the IAC," explain the authors. They add that the odds of AUR may be reduced by taking the lowest effective dose of IACs and avoiding combinations that raise a patient's risk. "Physicians and the public need to be aware of the potential for this significant adverse event," they conclude, "so that preventive measures and potential therapy can be considered."

Commentary: Deciding Whether, and When, to Treat COPD with IACs

In a commentary accompanying the article, Sonal Singh, M.D., M.P.H., from The Johns Hopkins University in Baltimore and Curt D. Furberg, M.D., Ph.D., from Wake Forest University, Winston-Salem, N.C., note that IACs do not completely stall the progress of COPD or keep patients alive longer. "Therefore, information on serious adverse effects associated with IACs can potentially alter their benefit-harm assessment," they observe. Besides the urological complications found by Stephenson and colleagues, previous studies have connected this category of drugs with cardiovascular events and mortality. An alternate therapy, corticosteroids, has been associated with an increased risk of serious pneumonia. Ultimately, write Singh and Furberg, "Physicians should inform patients with COPD about the risk of AUR associated with IACs and determine the optimal choice of therapy for their patients after eliciting patient preferences for various patient-oriented outcomes in a shared decision-making context."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Anne Stephenson; Dallas Seitz; Chaim M. Bell; Andrea Gruneir; Andrea S. Gershon; Peter C. Austin; Longdi Fu; Geoffrey M. Anderson; Paula A. Rochon; Sudeep S. Gill. Inhaled Anticholinergic Drug Therapy and the Risk of Acute Urinary Retention in Chronic Obstructive Pulmonary Disease: A Population-Based Study. Archives of Internal Medicine, 2011; 171 (10): 914-920 DOI: 10.1001/archinternmed.2011.170
  2. Sonal Singh; Curt D. Furberg. Inhaled Anticholinergics for Chronic Obstructive Pulmonary Disease: Comment on 'Inhaled Anticholinergic Drug Therapy and the Risk of Acute Urinary Retention in Chronic Obstructive Pulmonary Disease'. Archives of Internal Medicine, 2011; 171 (10): 920-922 DOI: 10.1001/archinternmed.2011.171

Cite This Page:

JAMA and Archives Journals. "Certain medications associated with increased risk of urinary retention in men with COPD." ScienceDaily. ScienceDaily, 23 May 2011. <www.sciencedaily.com/releases/2011/05/110523161153.htm>.
JAMA and Archives Journals. (2011, May 23). Certain medications associated with increased risk of urinary retention in men with COPD. ScienceDaily. Retrieved September 16, 2014 from www.sciencedaily.com/releases/2011/05/110523161153.htm
JAMA and Archives Journals. "Certain medications associated with increased risk of urinary retention in men with COPD." ScienceDaily. www.sciencedaily.com/releases/2011/05/110523161153.htm (accessed September 16, 2014).

Share This



More Health & Medicine News

Tuesday, September 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

EU Ministers and Experts Meet to Discuss Ebola Reponse

EU Ministers and Experts Meet to Discuss Ebola Reponse

AFP (Sep. 15, 2014) The European Commission met on Monday to coordinate aid that the EU can offer to African countries affected by the Ebola outbreak. Duration: 00:58 Video provided by AFP
Powered by NewsLook.com
Despite The Risks, Antibiotics Still Overprescribed For Kids

Despite The Risks, Antibiotics Still Overprescribed For Kids

Newsy (Sep. 15, 2014) A new study finds children are prescribed antibiotics twice as often as is necessary. Video provided by Newsy
Powered by NewsLook.com
FDA Eyes Skin Shocks Used at Mass. School

FDA Eyes Skin Shocks Used at Mass. School

AP (Sep. 15, 2014) The FDA is considering whether to ban devices used by the Judge Rotenberg Educational Center in Canton, Massachusetts, the only place in the country known to use electrical skin shocks as aversive conditioning for aggressive patients. (Sept. 15) Video provided by AP
Powered by NewsLook.com
Respiratory Virus Spreads To Northeast, Now In 21 States

Respiratory Virus Spreads To Northeast, Now In 21 States

Newsy (Sep. 14, 2014) The respiratory virus Enterovirus D68, which targets children, has spread from the Midwest to 21 states. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins