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A number of medications can cause urinary incontinence in men and women. Diuretics such as hydrochlorothiazide Esidrix, Hydrodiuril, Oretic , furosemide Lasix , bumetanide Bumex , triamterene with hydrochlorothiazide Maxzide. This leads to significant central nervous system side effects, including sedation, drowsiness, somnolence, fatigue, cognitive decline, psychomotor effects, and loss of coordination. These antihistamines are more selective on peripheral H1 receptors and have a lower affinity for cholinergic and alpha-adrenergic receptor sites, which reduces the risk of anticholinergic and central nervous system side effects.

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A number of medications can cause urinary incontinence in men and women. Medications that can cause urinary incontinence Published. The second-generation nonsedating antihistamines generally are considered as safer alternatives for use in older adults who require treatment for allergic rhinitis and other allergy symptoms. These antihistamines have low receptor specificity and interact with both peripheral and central histamine receptors and readily cross the blood-brain barrier. Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence. Because delirium and hallucinations can result from the use of anticholinergics including sedating antihistamines, patients receiving these medications are at risk of being prescribed antipsychotic medications.

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Antihistamines such as diphenhydramine Benadryl and chlorpheniramine Chlor-Trimeton. The first H1 sedating antihistamines have been available for more than 60 years and were synthesized based on a chemical structure similar to that used to develop cholinergic muscarinic antagonists, tranquilizers, and antihypertensive agents. Healthcare professionals working in long term care communities and skilled nursing facilities should work with families, prescribers, and other members of the healthcare team to discourage the use of first-generation antihistamines and other highly anticholinergic medications in older patients. Other sleep aids often contain the antihistamine doxylamine eg, Unisom. Cognitive decline, falls, and behaviors such as hallucinations, delirium, and agitated aggressive behaviors may result in affected patients being hospitalized or admitted to long term care facilities. These medications decrease gastric acid secretion in the stomach by antagonizing the effects of histamine at H2 receptors found in gastrointestinal parietal cells. These sedating antihistamines often are used alone or in combination with other ingredients in cold and cough medications, and over-the-counter OTC sleep aid products.

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Description: These include the first-generation H1 antagonists, or sedating antihistamines eg, diphenhydramine, chlorpheniramine , and second-generation H1 receptor blockers, or nonsedating antihistamines eg, loratadine, cetirizine. Other sleep aids often contain the antihistamine doxylamine eg, Unisom. First-generation antihistamines are widely available without a prescription and commonly used to treat allergic symptoms, including rhinitis, conjunctivitis, pruritus, eczema, urticaria, and anaphylactic reactions. The first H1 sedating antihistamines have been available for more than 60 years and were synthesized based on a chemical structure similar to that used to develop cholinergic muscarinic antagonists, tranquilizers, and antihypertensive agents. These antihistamines have low receptor specificity and interact with both peripheral and central histamine receptors and readily cross the blood-brain barrier. Older adults are especially sensitive to the central nervous system- and anticholinergic-related side effects of sedating antihistamines because of decreased cholinergic neurons or receptors in the brain, reduced hepatic and renal function, and increased blood-brain permeability. Regardless of practice setting, healthcare professionals should take steps to increase the awareness of side effects associated with first-generation antihistamines. Antihistamine medications block or reduce histamine-mediated effects at one of four identified histamine receptors see Table 1 below.
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