臨床泌尿器科61巻8号

2007年07月発行

特集 過活動膀胱のすべて

過活動膀胱の治療―3）薬物療法

著者： 吉田正貴¹ 桝永浩一¹ 村上滋孝¹ 稲留彰人¹

所属機関： ¹熊本大学大学院医学薬学研究部泌尿器病態学分野

ページ範囲：P.611 - P.617

文献概要

要旨　過活動膀胱の薬物治療では，抗コリン薬が第1選択薬として用いられ，有効性と安全性が十分に確立されてはいるが，使用にあたっては抗ムスカリン作用に基づく全身の副作用（口内乾燥，便秘，霧視，排尿障害や残尿増加，認知機能への影響など）への注意が必要である。最近，膀胱選択性の高い新規抗コリン薬が発売され，選択肢が増えてきている。また，新規作用機序の薬剤の開発も行われており，そのような薬剤では抗ムスカリン作用に基づく副作用を回避できる可能性がある。前立腺肥大症に伴う過活動膀胱に対しては，α₁ブロッカーが第1選択薬である。α₁ブロッカーと抗コリン薬の併用で，さらなる症状の改善が期待されるものの，残尿増加や尿閉などには十分注意が必要である。

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