Home' Australian Pharmacist : Australian Pharmacist May 2016 Contents Australian Pharmacist May 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
point of supply of medicines or aids
for incontinence. Pharmacy specific
resources such as PSA Self Care Fact
Cards may be a useful introduction, as
may be signposting people to reputable
web-based sources of information such
as the Better Health Channel (at: www.
One excellent dedicated source of
information for patients is the Continence
Foundation of Australia from whose
website (at: www.continence.org.au)
various information leaflets and resources
can be accessed or downloaded.
Mirabegron offers a welcome alternative
to the anticholinergic drugs, which are
well established in the management of
urge UI. Whilst mirabegron’s different
mode of action avoids some of the
adverse effects that can plague use of
anticholinergics, there are some safety
signals emerging regarding the potential
for mirabegron-related hypertension. On
this basis, and in common with all new
drugs, especially those that are the first in
their respective classes, some additional
caution in use is warranted.
1. Continence Foundation of Australia. The facts. At: www.
2. Thirugnanasothy S. Managing urinary incontinence in older
people. BMJ 2010;341:c3835
3. Larsen TM, Toubro S, van Baak MA, et al. Effect of a 28-d
treatment with L-796568, a novel β3-adrenergic receptor
agonist, on energy expenditure and body composition in
obese men. Am J Clin Nutr 2002;76 (4):780–788.
4. Niu X, Watts VL, Cingolani OH, et al. Cardioprotective effect
of beta-3 adrenergic receptor agonism role of neuronal nitric
oxide synthase. J Am Coll Cardiol 2012;59(22):1979–87.
5. Summary of product characteristics: Betmiga 25 mg &
50 mg prolonged-release tablets. 2015. At: www.medicines.
6. Alexandre EC, Kiguti LR, Calmasini FB et al. Mirabegron
relaxes urethral smooth muscle by a dual mechanism
involving beta-3 adrenoreceptor activation and alpha-1
adrenoreceptor blockade Br J Pharmacol 2016;173:415–28.
7. Betmiga product information. Astellas Pharma Australia
8. Nitti VW, Auerbach S, Martin N, et al. Results of a
randomized phase III trial of mirabegron in patients with
overactive bladder. J Urol 2013;189(4):1388–95.
9. Khullar V, Amarenco G, Angulo JC, et al. Efficacy and
tolerability of mirabegron, a β (3)-adrenoceptor agonist, in
patients with overactive bladder: results from a randomised
European-Australian phase 3 trial. Eur Urol 2013;63(2):283–95.
10. Herschorn S, Barkin J, Castro-Diaz D, et al. A phase III,
randomized, double-blind, parallel-group, placebo-
controlled, multicentre study to assess the efficacy and safety
of the β3 adrenoceptor agonist, mirabegron, in patients with
symptoms of overactive bladder. Urology 2013;82(2):313–20.
11. Nitti VW, Khullar V, van Kerrebroeck P, et al. Mirabegron
for the treatment of overactive bladder: a prespecified
pooled efficacy analysis and pooled safety analysis of three
randomised, double-blind, placebo-controlled, phase III
studies. Int J Clin Pract 2013;67(7):619–32.
12. Chapple CR, Kaplan SA, Mitcheson D, et al. Randomized
double- blind, active-controlled phase 3 study to assess
12-month safety and efficacy of mirabegron, a beta(3)-
adrenoceptor agonist, in over- active bladder. Eur Urol
13. Chua ME, Lapitan M, Silangcruz JA, et al. Beta-3 adrenergic
receptor agonist for adult with overactive bladder. Cochrane
Database of Systematic Reviews 2015, Issue 3.
14. Medicine and Healthcare Products Regulatory Agency.
Mirabegron (Betmiga): risk of severe hypertension and
associated cerebrovascular and cardiac events. Drug Safety
Update 2015;9(3):1. At: www.gov.uk/drug-safety-update/
15. Lucas MG, Bedretdinova D, Berghmans LC, et al. Guidelines on
urinary incontinence European Association of Urology; 2016.
16. Imamura M, Williams K, Wells M, et al. Lifestyle interventions
for the treatment of urinary incontinence in adults. Cochrane
Database of Systematic Reviews 2015, Issue 12.
Australian Pharmacist Continuing Professional
Development (CPD) is a central element of PSA’s
CPD & PI program.
The CPD section is recognised under the PSA
CPD & PI program as a Group 2 activity. Members
can choose which articles they want to answer
questions on and get CPD credits based on the
questions they answer.
CPD credits are allocated based on the length of
the article and the complexity of the information
presented. A minimum of 6 out of 8 questions, 4 out
of 5 questions, or 3 out of 4 questions correct is
required for the allocation of Group 2 CPD credits.
PSA members can answer online at www.psa.org.au.
Login to submit your answers online. If you
do not have member access details, you can
request them via a link from the login page.
Select Submit Answers.
Select Australian Pharmacist CPD.
Submit your answers online before
1 July 2016 at www.psa.org.au and
receive automatic feedback.
1. Mirabegron is indicated for which
ONE of the following types of urinary
a) Functional UI.
b) Overflow UI.
c) Stress UI.
d) Urge UI.
2. In which ONE of the following patient
groups should the mirabegron dose
NOT exceed 25mg/day?
a) All patients.
b) Patients aged over 60 years.
c) Patients with severe renal impairment.
d) Patients with mild hepatic impairment.
3. Which ONE of the following
statements BEST summarises our
current understanding regarding the
relative effectiveness of mirabegron
a) Mirabegron is slightly less effective.
b) Mirabegron is similarly effective.
c) Mirabegron is slightly more effective.
d) Mirabegron is far more effective.
4. Which ONE of the following is NOT an
appropriate advice point for patients
a) Swallow the tablets whole.
b) Take the tablets 30–60 minutes before
c) Tablets can be taken with or without
d) Take the tablets once a day.
5. Which ONE of the following potential
mirabegron adverse effects has been
the focus of a recent safety update
b) Dry mouth.
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