From the Guidelines
Desire is a complex human emotion that should be understood and managed as part of emotional intelligence and personal development. When considering the medical aspect of desire, particularly in relation to overactive bladder (OAB), it's essential to prioritize the patient's quality of life (QoL) and address their symptoms effectively 1.
Key Considerations
- The impact of OAB on a patient's QoL is significant, and many suffer with symptoms for an extended period before seeking medical advice 1.
- Historically, treatment of OAB has followed a stepwise progression, but the new framework emphasizes shared decision-making to select the best therapy based on the patient's needs and desires 1.
- Treatment options for OAB have been grouped categorically, allowing patients to select from multiple categories simultaneously to best suit their individual wishes 1.
Diagnosis and Treatment
- Dipstick or microscopic urinalysis should be performed in all patients with symptoms suggestive of OAB, and urine culture should be performed if urinalysis is suggestive of infection and/or hematuria 1.
- Telemedicine is a viable option for patients with OAB, but it may not allow for all elements of the initial in-office evaluation, and an in-office visit should be considered for patients who do not respond to therapy 1.
Patient-Centered Approach
- The new framework for treating OAB prioritizes patient-centered care, emphasizing the importance of shared decision-making and selecting therapies based on the patient's needs, desires, and side effect tolerance 1.
- By understanding and addressing the patient's desires and concerns, healthcare providers can develop effective treatment plans that improve QoL and reduce the burden of OAB symptoms 1.
From the Research
Desloratadine Overview
- Desloratadine is a nonsedating, peripheral histamine H(1)-receptor antagonist used to treat allergic disorders such as seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR), and chronic idiopathic urticaria (CIU) 2, 3, 4.
- It has a rapid onset of effect, efficacy throughout a 24-hour dosage interval, and sustained efficacy in these allergic conditions, as demonstrated in placebo-controlled trials 2, 5.
Efficacy and Safety
- Desloratadine has been shown to be effective in controlling both nasal and non-nasal symptoms of SAR, including nasal congestion, and in treating CIU 3, 4, 5.
- It has a favorable safety profile, with no significant differences in adverse events compared to placebo, and does not cause sedation or prolong the corrected QT (QTc) interval 2, 3, 6, 5.
- Desloratadine can be administered without regard to concurrent intake of food and grapefruit juice, and has negligible potential for drug interactions mediated by several metabolic systems 2, 3, 6, 5.
Pharmacology and Mechanism of Action
- Desloratadine is a highly selective peripheral H1 receptor antagonist that inhibits the expression of cell adhesion molecules, inhibits the generation and release of inflammatory mediators and cytokines, and attenuates eosinophil chemotaxis, adhesion, and superoxide generation 3, 6.
- It has a half-life of 21-24 hours, permitting once-daily dosing, and no specific cautions are required with respect to administration in renal or hepatic failure 6, 5.