Hey all, welcome back to the real-life pharmacology podcast. I thank you for listening today.

The drug of the day today is going to be Vibigran. Brand name is Gemtessa. And this medication is

a medication used for overactive bladder. It's relatively new, probably out in the last 02 to 4 years here.

Dosing of this medication for overactive bladder, 75 milligrams once a day.

So pretty straightforward.

No titration, which can be an advantage or a disadvantage.

No titration, no going to higher dose,

but it's very simple if you're prescribing this medication to use in that respect.

So mechanistically, how does this drug work?

How does it help overactive bladder?

So it is a selective beta-3 agonist. And if you remember previously,

I have talked about mirror background. So that'd be a good one to go back and review. If you're,

you know, on your urology unit in your pharmacology classes, you might want to go find that podcast as well at the real life pharmacology.com website.

And mechanistically, this drug works like Mirabegroen, it relaxes detruser's smooth muscle,

which allows for greater urine storage in the bladder.

Ultimately, that greater storage helps alleviate some of the signs and symptoms of

overactive bladder, having to go to the bathroom all the time there.

So Vibigran is very selective, so that is great. So if you remember some of our other

beta agonist pharmacology, so beta two agonists, that's going to be on the lungs. It's going to help

with breathing, that type of thing. Beta 1 activates the heart if we stimulate or if we have an agonist at beta 1 receptors,

that's going to increase heart rate and potentially blood pressure as well.

So Vibagron with that selectivity, hopefully only at beta 3, with its dosing, hopefully we're not causing any of those other effects on beta 1 and beta 2 receptors, particularly beta 1 and the cardiovascular issues there.

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