Anticholinergic drugs

Atropine is an anticholinergic and antimuscarinic agent that can result in CNS and cardiac excitation, photophobia, palpitations, tachycardia, constipation and difficulty urinating.

Belladona and opium can be associated with photophobia, constipation, difficulty urinating, and somnolence.

Belladona and opium supplied as a suppository with 16.2 mg of belladona and 60mg of opium.

Dicyclomine is anticholinergic and antispasmodic.

Glycopyrrolate can be used as a preoperative medication on order to reduce salivary, tracheobronchial, and pharyngeal secretions, as well as decreasing the acidity of gastric secretion.

Glycopyrrolate also used in conjunction with neostigmine, a neuromuscular blocking reversal agent, to prevent neostigmine’s muscarinic effects such as bradycardia.

Glycopyrrolate also used to reduce excessive saliva.

Glycopyrrolate reduces the body’s sweating ability, it can even cause fever and heat stroke in hot environments.

Glycopyrrolate can be associated with dry mouth, difficulty urinating, headaches, diarrhea, constipation, induces drowsiness or blurred vision, an effect exacerbated by the consumption of alcohol.

Glycopyrrolate usually administered IV/IM.

Hyoscyamine anticholinergic and antimuscarinic agent associated with nausea, vomiting, drowsiness, delirium and coma.

Methscopolamine an antimucularinic and anticholinergic agent which mat cause thermoregulatory abnormalites, diarrhea and CNS effects.

Scopolamine anticholinergic and antimuscularinic drug: patches (contain 1.5 mg) q 72 hours achieve maximum blood levels in 12 hours, subcutaneous, intravenous or intramuscular dose 0.3-0.6 mg q 4-8 h.

Scopolamine may precipitate dementia, and acute glaucoma. . Excess scopolamine can be treated with phsostigmine intravenously.

A relationship exists in the elderly between such agents and global cognitive function, psychomotor speed, visual and declarative memory and learning.

In a retrospective study of 592 elderly an accelerated decline of psychomotor speed and executive functioning was associated with anticholinergic usage (Botiggi).

Continuous use of agents among 372 elderly patients revealed an associated with poorer performance on cognitive function (Ancelin).

Use is a strong predictor of mild cognitive impairment.

In a study of 544 community dwelling older male individuals with hypertension exposure to such agents resulted in poor performance of verbal memory over a 2 year period (Han L).

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