title: Pharmacokinetic considerations for therapies used to treat interstitial cystitis.
abstract: BACKGROUND
  Interstitial cystitis (IC) or bladder pain syndrome (BPS) is defined as supra-pubic pain related to bladder filling. IC is characterized by a particular symptom complex with no identifiable causes; as with bladder hypersensitivity it is usually associated with urinary frequency and urgency with bladder pain. No current treatments have a significant impact on symptoms over time.
  
  
  METHODS
  This systematic review examines the pharmacokinetic aspects and adverse event of present IC therapy to highlight appropriate treatment to improve the symptoms of IC. This article reviews material obtained via Medline, PubMed, and EMBASE literature searches up to October 2013.
  
  
  CONCLUSIONS
  The correct approach to IC should consider a multidisciplinary team of specialists and a multimodal treatment package that include psychotherapy, behavior change, physical activation, and analgesic treatment. Unfortunately, a single therapeutic target for IC is not yet known. With regard to pathophysiology and therapy, there is more to discover. The first insult damages the bladder urothelium, hence vehicles that lead the drug to penetrate the wall of the bladder might be a novel strategic approach.
authors.affiliation: University of Pavia, Fondazione IRCCS, Policlinico San Matteo, Department of Obstetrics and Gynecology , 19 Viale Camillo Golgi, 27100 Pavia , Italy +390382503722 ; +390382503885 ; s.bogliolo@smatteo.pv.it.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gardella
authors.forename: Daniele
authors.initials: D
authors.lastname: Porru
authors.forename: Massimo
authors.initials: M
authors.lastname: Allegri
authors.forename: Stefano
authors.initials: S
authors.lastname: Bogliolo
authors.forename: Anna Daniela
authors.initials: AD
authors.lastname: Iacobone
authors.forename: Cristina
authors.initials: C
authors.lastname: Minella
authors.forename: Rossella Elena
authors.initials: RE
authors.lastname: Nappi
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
mesh_terms: D000283:Administration, Intravesical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D001521:Behavior Therapy; D003131:Combined Modality Therapy / Q000009:adverse effects; D018856:Cystitis, Interstitial / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006801:Humans; D056747:Immunomodulation; D008407:Mast Cells / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D017699:Pelvic Pain / Q000209:etiology / Q000517:prevention & control; D011613:Psychotherapy; D001743:Urinary Bladder / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D019459:Urothelium / Q000187:drug effects / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000929:Antidepressive Agents, Tricyclic