Sphincter says what Micturition

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Sphincter says what? Micturition!

• By Angi, Shelly, Anna, and Sarah

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The question

• Describe the normal reflex of micturition and
  explain the possibility of using drugs from the
  following classes to treat spastic bladder
  according to their action and possible side
  effects
• parasympathomimetic
• parasympatholytic
• sympathomimetic, and
• sympatholytic.

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The Micturition Reflex

• When the bladder is empty the sympathetic neurons
  fire inducing the relaxed stage of the Detrusor
  muscle. The external sphincter is under tonic
  contraction.
• As the bladder fills the stretch receptors send
  efferent messages to the CNS which stimulates the
  parasympathetic neurons to fire leading to
  contraction of the Detrusor muscles which pushes
  urine down, opening the internal sphincter. When
  you are ready to go your somatic neurons are
  inhibited causing the external sphincter to relax
  and urine to flow.

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Hyperactive bladder and incontinence

• Hyperactive bladder is the number one cause of
  incontinence (loss of control) in older adults.
• Either because the neurological pathways have
  slowed down, are improperly synchronized, or
  because of some physical defect in the bladder.
• The result is leakage no friends

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The drugs

• Parasympathomimetic
• Parasympatholytic
• Sympathomimetic
• Sympatholytic

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Parasympathomimetic Drugs

• Mimics Parasympathetic activity
• Directly stimulates the cholinergic receptor
  sites where Ach from parasympathetic neurons
  bind.
• This increases the tone of the Detrusor muscle
• Inhibits Acetylcholinesterase
• Causing Ach to accumulate resulting in continued
  contraction

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DO NOT TAKE PARASYMPATHOMIMETIC DRUGS FOR
HYPERACTIVE BLADDER!!!!
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Parasympatholytic Drugs

• Antagonizes parasympathetic activity
• Blocks Cholinergic receptors for Ach
• thus blocking Detrusor contraction

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PARASYMPATHOLYTIC DRUGS WOULD HELP A HYPERACTIVE
BLADDER!!!
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Sympathomimetic Drugs

• Mimics the sympathetic response
• Binds to Adrenergic receptors causing relaxation
  of the Detrusor muscle

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SYMPATHOMIMETIC DRUGS WOULD HELP WITH A
HYPERACTIVE BLADDER!!!
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Sympatholytic Drugs

• Antagonizes sympathetic activity
• Blocks the Adrenergic receptors
• Sympathetic firing cannot relax the Detrusor
  muscle

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DO NOT TAKE SYMPATHOLYTIC DRUGS FOR A HYPERACTIVE
BLADDER!!!
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In conclusion

• Help with voiding urine
• Parasympathomimetic and Sympatholytic
• Help with storage of urine
• Parasympatholytic and Sympathomimetic