A 67-year-old man is evaluated 2 days after open colectomy because he has suprapubic discomfort and inability to void. His temperature is 37.1°C, blood pressure is 128/76 mmHg, and heart rate is 82/min. His abdomen is mildly distended, and bedside ultrasound shows a markedly enlarged bladder containing approximately 600 mL of urine. Digital rectal examination reveals a normal-sized prostate. He has no history of glaucoma, asthma, or benign prostatic hyperplasia. Which of the following drugs is most appropriate to stimulate detrusor contraction in this patient?
- A)Tamsulosin
- B)Oxybutynin
- C)Atropine
- D)BethanecholGABARITO
- E)Phenylephrine
Explicação
Bethanechol is a direct muscarinic agonist that increases detrusor muscle contraction and relaxes the internal urethral sphincter. A postoperative patient with urinary retention and bladder distention without evidence of obstruction is the classic setting for ... Ver explicação completa e trilha adaptativa →