Applying the basic principles, therapy guides to our hypothetical cases can be constructed. The 60 year old man with postoperative abdominal perineal resection with hypertension and parkinsonism may well need a transurethral resection of the prostate; however, other options include decreasing his anticholinergic-type medications, such as antiparkinsonism medications, changing his hypertensive therapy from beta blockers such as propranolol and metoprolol to alpha blockers such as methyldopa and prazosin. Bethanacol would seldom be helpful alone, but with an alpha blocker could help if not contraindicated by the presence of vascular disease. The second example, a 45 year old woman with stress incontinence, may be assisted with improved storage by an anticholinergic agent, an alpha enhancer, a mucosal enhancer, and if pertinent, switching hypertensive therapy from an alpha blocker to a beta blocker. The last example, a T10 paraplegic with a spastic, hyperreflexic bladder, can have improved storage with anticholinergics, decreased sphincter tone with alpha blockers, as well as decreased sphincter tone with alpha blockers, as well as decreased spasms through suppression of hyperactive spinal cord activity with baclofen.

译文

运用基本原理,可以为我们的假设病例构建治疗指南。患有高血压和帕金森氏症的术后会阴腹部会阴切除术的60岁男性很可能需要经尿道前列腺电切术。但是,其他选择包括减少他的抗胆碱能型药物(例如抗帕金森病药物),将他的高血压治疗从β受体阻滞剂(如心得安和美托洛尔)改为α受体阻滞剂(如甲基多巴和哌唑嗪)。单独使用Bethanacol很少会有所帮助,但是如果没有血管疾病的禁忌,使用α受体阻滞剂可能会有所帮助。第二个例子是一名患有压力性尿失禁的45岁女性,可以通过抗胆碱能药,α增强剂,粘膜增强剂来改善储存,并在适当的情况下将高血压治疗从α阻滞剂转换为β阻滞剂。最后一个例子是截瘫的T10痉挛性,高反射性膀胱炎,使用抗胆碱能药物可改善储存,使用α受体阻滞剂可降低括约肌张力,使用α受体阻滞剂可降低括约肌张力,并通过抑制过度活跃的脊髓活动来减少痉挛用巴氯芬。

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