Urology: overactive bladder drug choice: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: overactive bladder drug choice

Sample item

An 80-year-old woman with overactive bladder develops constipation, dry mouth and confusion on oxybutynin. Which alternative drug acts through a different mechanism and avoids these effects?

ATamsulosin, an alpha-1 antagonistBMirabegron, a beta-3 adrenergic agonistCDuloxetine, a serotonin and noradrenaline reuptake inhibitorDBethanechol, a muscarinic agonist

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Mirabegron, a beta-3 adrenergic agonist

Mirabegron stimulates beta-3 receptors in the detrusor, causing relaxation and increased bladder capacity without anticholinergic effects. Blood pressure should be monitored. Antimuscarinics are best avoided in the elderly with cognitive impairment.

Option by option

A. Tamsulosin, an alpha-1 antagonist
Tamsulosin treats outflow obstruction in men and does not treat detrusor overactivity.
B. Mirabegron, a beta-3 adrenergic agonist (correct)
Correct. Mirabegron relaxes the detrusor through beta-3 receptors, without anticholinergic effects.
C. Duloxetine, a serotonin and noradrenaline reuptake inhibitor
Duloxetine is used for stress incontinence by increasing urethral sphincter tone.
D. Bethanechol, a muscarinic agonist
Bethanechol stimulates detrusor contraction and would worsen urgency.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Mirabegron, a beta-3 adrenergic agonist. Mirabegron stimulates beta-3 receptors in the detrusor, causing relaxation and increased bladder capacity without anticholinergic effects.

Why is "Tamsulosin, an alpha-1 antagonist" not the answer?

Tamsulosin treats outflow obstruction in men and does not treat detrusor overactivity.

Why is "Duloxetine, a serotonin and noradrenaline reuptake inhibitor" not the answer?

Duloxetine is used for stress incontinence by increasing urethral sphincter tone.

Why is "Bethanechol, a muscarinic agonist" not the answer?

Bethanechol stimulates detrusor contraction and would worsen urgency.

What concept does this question test?

It tests Urology: overactive bladder drug choice in General Surgery. Blood pressure should be monitored. Antimuscarinics are best avoided in the elderly with cognitive impairment.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: overactive bladder drug choice?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.