Mechanisms of Autonomic Drug Action on the Bladder Outlet
Pharmacologic manipulation of the bladder outlet is a relatively new undertaking. Most of the currently used drugs have not been rationally developed or selected to specifically alter known physiologic processes in the lower urinary tract. On the contrary, the urinary tract effects of these agents have been recognized primarily through clinical observation of “side effects” in patients being treated for diseases of the cardiovascular, gastrointestinal, and central nervous systems. In fact, much of the current research interest in the neuroanatomy, neurophysiology, and neuropharmacology of the urinary bladder and its outlet was initiated by attempts to understand the basic mechanisms responsible for these “side effects.” Many of these pharmacologic agents exert their effects by altering the function of the autonomic nervous system; these mechanisms of action are the subject of this chapter. Drugs that act by other means are discussed elsewhere.
KeywordsNerve Terminal Bladder Neck Adrenergic Receptor Cholinergic Receptor Bladder Contraction
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