I heard a urologist saying he uses this to increase urine output in women. Is this something you have seen?
He described a couple of patients who had swollen legs and abdomen, nausea, very little urine output, non-specific, odd-sounding abdominal pains intermittently. He also puts these folks on macrodantin low dose nightly for a couple of weeks, keeps up with their BUN and creatinine, and checks them for various causes of obstruction of urine outflow. Hard to tell whether they have obstructive uropathy or renal failure.
Interesting to hear him discuss it. Anyone familiar with this?
I am guessing here but is this a brand name for Tamslosin? The hospital I am working in at the moment prescribes it all the time for renal calculi. In another place I saw it prescribed for 2 women who had MS which was causing urinary retention and they had quite bad spasms in their hands and were unable to straight cath themselves. It worked quite well for one and no real change for the other woman
Specializes in Peds Urology,primary care, hem/onc.
I am a pediatric urology APN and we use this as well. There are several alpha blockers we use. Flomax(tamsulosin)/ Cardura (doxazosin)/Hytrin (terazosin). We typically use hytrin in our old kids (teenagers) when they have kidney stones. It helps relax the smooth muscle in the ureter to increase the chances of passing the stone. We use Cardura and Flomax in our kids that have dysfunctional voiding(inability to empty their bladders, intermitent flow etc). A lot of these girls get chronic UTIs and are frequently wetting. For some kids, it is very helpful (especially if they don't respond to anticholinergics (ditropan/vesicare etc). Some of them it saves them from having to cath themselves. I would think it could be used the same way in adults as well (men and women) in addition to the traditional use. I have gone to urology conferences where the indications for these meds has been discussed/studied but I am not sure how freely that is available to find.
Specializes in ICU/Cosmetic Sx/Lasers/Education/School/.
Wow Evelyn, urinary frequency and working as a nurse seem incompatible, any tips you could share? Patients have asked me what they can do about their frequency, so I am wondering what you recommend.
Thanks for giving a full description of how flomax works on the bladder neck, I was aware that this is the reason for giving it to both men and women and I have seen it work successfully on a couple of women.
regards
dishes
Time Management is the key and knowing the location of the bathrooms on your unit. I worked ICU for several years and it was not a huge problem. We had several bathrooms for staff on our unit at AAMC. Never hold your bladder for those that get frequent UTI, drink plenty of water, and if you must drink tea, soft drinks or coffee; it really should be decaf. I go between drinking both. You can try bladder retraining, but that did not work for me, as I have a solitary kidney that is enlarged with a bladder that is really small, had the dilations, etc and nothing seemed to really help. I have learned to live with it. I have to say the Flomax is helping a lot (0.4 mg) and the Elavil for sleep at night is helping as well b/c one of the s/e is urinary retention. Now working in the OR as I do now (Director of Nursing Surgical Services and OR Nurse) I have to sometimes leave the OR to pee. As I can only hold about 200 cc in my bladder and it is very uncomfortable, pushing close to 250 cc and I am in tears. I know this because of the study I just had done about a month ago. Terrible, the doctor even said I have an extremely small bladder and he was going to do surgery once again, place me under anesthesia and stretch the bladder and the urethra for the third time or fourth, maybe, can't quite remember. I am unable to empty my bladder and I get spasms a lot in my kidney and even when I try to urinate, so he said let's go ahead and give Flomax a try if you want before proceeding with surgery. So I opted for that. I don't want to do it again. I was just had a urethral dilation the same time I had the cysto and CMG/EMG so I really was not game for it. So far the med is working. (Vesicare did not work and had horrible s/e)(Detrol LA was the extreme, I was unable to urinate:Scary). I will keep up with this medication as long as it works and when I build a tolerance I will increase to 0.8mg. I am fortunate that my doctor just gives me samples that he has in his office. Eventually, I am sure he will start writing the script for it, but some insurance companies don't want to pay for it for women because it is considered experimental in women.
1. Drink Plenty of Water (stay hydrated)
2. Sit on the toilet to try to completely empty your bladder
3. See a urologist if it continues
4. Avoid Caffeinated Beverages
5. Cranberry Pills are good to help prevent frequent UTI (as long as theirs not contraindications for taking it)
6. Know where the BR are located
7. Have someone watch your rooms for you when you step away (Make staff aware if you have to)
It is not impossible to be a nurse with frequent trips to the bathroom. Teamwork and Time Management is the key!
It is possible and it can be done. The OR I work (we are like family 10 yrs working with each other so far and still counting), they know and they understand and when we moved to another building that we had built for our Medical Boutique the doctor had a bathroom built right across the hall from the OR. If I am in the OR and open the door, I am looking straight across the hall and there is the BR door! With the spa like bathroom. I'm lucky to have a solid working foundation like this team of people. Truly caring and understanding.:redpinkhe:yeah::heartbeat
Main thing with Flomax for women is to give it at bedtime. Our urologists use it to "relax the bladder". It's the sudden drop in BP that is risky for women (well all patients) and that's why its an HS med.
Thanks for sharing your experience evelyn, I will recommend your tips to my patients who are having similar problems.
I am glad the flomax and elavil are working for you. I hope the insurance will consider covering the cost of flomax. Maybe your urologist could write a letter to the insurance company informing them of your uncommon clinical circumstances and request exceptional access to flomax?
At my workplace, when insurance denies coverage for a drug, our urologist may write to the insurer and describe the drugs that were intially tried and failed. And will also explain that the flomax is working and that the priority for the patient, the health care provider is to prevent kidney damage and this should also be a priority for the insurance company.
Your insurance company may get on board with approving the flomax when they have documentation warning them that denying it, could cost them a lot more in the future.
Main thing with Flomax for women is to give it at bedtime. Our urologists use it to "relax the bladder". It's the sudden drop in BP that is risky for women (well all patients) and that's why its an HS med.
Huh. I always gave it (well, to the one patient I had on it) qam.
Yup, Flomax can cause sudden, sharp drops in BP. One of the reasons the packaging says to avoid operating equipment, etc.
A nurse on our floor had to take it after her kidney stone surgery and wound up in the ER after passing out at home after taking a dose. Great bruises and not just from the IV start. Freaked her kids and husband out. BP was 84/40 when EMS arrived at her home.
Specializes in ICU/Cosmetic Sx/Lasers/Education/School/.
Thanks for sharing your experience evelyn, I will recommend your tips to my patients who are having similar problems.
I am glad the flomax and elavil are working for you. I hope the insurance will consider covering the cost of flomax. Maybe your urologist could write a letter to the insurance company informing them of your uncommon clinical circumstances and request exceptional access to flomax?
At my workplace, when insurance denies coverage for a drug, our urologist may write to the insurer and describe the drugs that were intially tried and failed. And will also explain that the flomax is working and that the priority for the patient, the health care provider is to prevent kidney damage and this should also be a priority for the insurance company.
Your insurance company may get on board with approving the flomax when they have documentation warning them that denying it, could cost them a lot more in the future.
regards
dishes
My urologist and myself are actually seeing how it works or me first before he starts writing the prescription for it. In order for me not to waste money on it if it does not work. He gave me a months supply for free. So far so good. No side effects at all.
Specializes in ICU/Cosmetic Sx/Lasers/Education/School/.
Main thing with Flomax for women is to give it at bedtime. Our urologists use it to "relax the bladder". It's the sudden drop in BP that is risky for women (well all patients) and that's why its an HS med.
My Urologist ordered Flomax for me in the AM because I am taking Elavil HS, so if I were to take it at night I would most likely end up in the hospital with a low BP. He warned me that it may drop my BP by 5 points. I was a little apprehensive about taking it, but wanted to be able to go through a day without running to the BR every 30 minutes or so (about 50 times a day). You have to eat 30 minutes before taking and it states to take it 30 minutes after same meal each day. I had a light breakfast and a glass of water, waited 30 minutes and took the pill. I had already put a glass of water on the couch beside me (a large one) just in case my BP dropped. I would give myself a PO Fluid Bolus (better than nothing at all). I started getting a shaky. I checked my BP Pre Flomax (very first dose) 128/80, fifteen minutes after taking it my BP dropped to 95/70 shaky with a little bit of chest pain,felt heavy, not tight. I drank down the entire glass of water and then another. My BP went back to normal and I felt fine. The next two days no problem. After the third day I started to drink coffee before hand, instead of breakfast (I don't eat too much breakfast, although I know I should as this is the most important meal of the day, but I don't do it everyday, just sometimes) and have not had any issues since that first dose. So I am fine. It does not bother me during the day at all. It just helps with decreasing the amount of times I actually run to the BR and helps me empty my bladder which was my big problem. It would always stay half full with a very weak urine flow and would stop and start, dribble, etc (I'm sure you get the picture). It has worked some wonders for me. So day time works best for me taking it. Prescribing medications are individualized and based on other medications that you take.
I personaly am on Flowmax, I have chronic Kidney stones with combined hydronephrosis, so my urologist put me on it to reduse stones from getting caught up and causing damage. Not to mention i see this drug percribed in my pharmacy (where i work) at least once a month for women suffering similar problems
:heartbeat
K+MgSO4, BSN
1,753 Posts
I am guessing here but is this a brand name for Tamslosin? The hospital I am working in at the moment prescribes it all the time for renal calculi. In another place I saw it prescribed for 2 women who had MS which was causing urinary retention and they had quite bad spasms in their hands and were unable to straight cath themselves. It worked quite well for one and no real change for the other woman