American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of agents help reduce bladder spasms in patients with multiple sclerosis?

1. Antidepressants

2. Anticholinergic agents

3. Beta-agonists

4. Calcium channel blockers

The correct answer is: Anticholinergic agents

Anticholinergic agents are effective in reducing bladder spasms for patients with multiple sclerosis because they work by blocking the action of acetylcholine, a neurotransmitter that plays a key role in stimulating bladder contractions. Overactivity of the bladder is a common symptom in individuals with multiple sclerosis, often leading to urgency, frequency, and incontinence. By inhibiting acetylcholine, anticholinergic medications help to relax the bladder muscle, thereby decreasing spasms and providing symptomatic relief. While other classes of drugs may have roles in different contexts or for other symptoms associated with multiple sclerosis, they do not primarily target bladder spasms. Antidepressants, for example, might help with mood or pain management but are not directed at bladder dysfunction. Beta-agonists typically affect smooth muscle relaxation in the airway, which does not translate to bladder muscle management. Lastly, calcium channel blockers can have varying effects on muscle contractions and might not specifically address the hyperactivity of bladder muscles in this scenario. Thus, anticholinergic agents are the most appropriate and effective choice for managing bladder spasms in this patient population.