ADRs Affecting the Urinary System

The kidneys provide the final common pathway for the clearance of most drugs and their metabolites. Consequently, they are exposed to high concentrations of potentially toxic metabolites that can cause renal damage, especially in the presence of pre-existing renal disease.⁶ For example, the chronic use of NSAIDs can lead to direct nephrotoxicity called analgesic nephropathy, related to the inhibition of prostaglandin synthetase resulting in reduced glomerular blood flow and acute renal failure.^6,8,42

Urinary incontinence is the involuntary loss of urine. Diuretics, alcohol, and caffeine increase urine production leading to increased frequency, urgency and nocturia.⁴³ Calcium-channel blocking agents, anticholinergic drugs, alpha-adrenergic agonists, and skeletal muscle relaxants may cause urinary retention and overflow incontinence.⁴³ Opioid analgesics can cause urinary retention, and like psychotropic drugs such as sedative hypnotics, benzodiazepines, antidepressants, and antipsychotic agents may affect incontinence by blunting awareness to void.⁴³