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Topic: Anticholinergic

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	eMedicine - Toxicity, Anticholinergic : Article by John J Bruns, Jr, MD
		Pathophysiology: Substances with anticholinergic properties competitively antagonize acetylcholine muscarinic receptors; this predominantly occurs at peripheral (eg, heart, salivary glands, sweat glands, GI tract, GU tract) postganglionic parasympathetic muscarinic receptors.
		In 2003, the Toxic Exposure Surveillance System reported 3094 symptomatic anticholinergic drug presentations with unintentional ingestions in 52%, intentional ingestions in 38%, and adverse reactions occurring in 7% of cases; moderate morbidity (requiring specific treatment) was reported in 20%, major morbidity (life-threatening) in 3.7%, and death in 5 cases (case-fatality proportion = 0.16%).
		Most anticholinergic agents have large volumes of distribution and are highly protein-bound; therefore, hemodialysis and hemoperfusion are ineffective treatment methods.
	www.emedicine.com /emerg/topic36.htm (2981 words)

	ANTICHOLINERGIC TOXICITY (Site not responding. Last check: )
		Anticholinergic medications are commonly prescribed for elderly patients, often resulting in drug-induced delirium.
		Anticholinergic toxicity can be differentiated from delirium tremens and sympathomimetic toxicity by the presence of dry skin and the absence of bowel sounds.
		Complications from anticholinergic toxicity occur secondary to hyperthermia, arrhythmias, seizures, and circulatory collapse.
	www.heacamjournal.com /htdocs/pages/art/55-tox.html (1121 words)

	Anticholinergic - Wikipedia, the free encyclopedia
		An anticholinergic agent is a member of a class of pharmaceutical compounds which serve to reduce the effects mediated by acetylcholine in the central nervous system and peripheral nervous system.
		Anticholinergics are typically reversible competitive inhibitors of one of the two types of acetylcholine receptors, and are classified according to the receptors that are affected: antimuscarinic agents operate on the muscarinic acetylcholine receptors, and antinicotinic agents operate on the nicotinic acetylcholine receptors.
		Many other drugs have anticholinergic properties, including cyclic antidepressants and the common allergy medications diphenhydramine (Benadryl) and its 8-chlorotheophylline salt dimenhydrinate (Dramamine), which are used medically for antihistaminergic and antiemetic purposes, and sometimes recreationally for their psychoactive effects.
	en.wikipedia.org /wiki/Anticholinergic (399 words)

	Anticholinergic Poisoning Associated with an Herbal Tea -- New York City, 1994
		Anticholinergic syndrome was diagnosed, and the NYCPC was notified.
		Previous reports of inadvertent anticholinergic poisoning resulting from contamination of foods with plants containing belladonna alkaloids have included consumption of hamburger seasoned with seeds from Angels' trumpet (Brugmansia X candida) (2) and consumption of contaminated honey (3), Chinese herbs (4), or porridge (5).
		In 1993, a total of 959 incidents of anticholinergic poisoning associated with consumption of plants containing belladonna alkaloids were reported to poison-control centers in the United States (6); 15 persons had symptoms requiring hospitalization.
	www.cdc.gov /mmwr/preview/mmwrhtml/00036554.htm (1170 words)

	Hybrid Publishing -- Serum Anticholinergic Activity and Delirium (Site not responding. Last check: )
		Because delirium is associated with medications that cause an increase in serum anticholinergic levels, treatment of delirium should take into account the pharmacologic profiles of prescribed agents and their likelihood of conferring additional anticholinergic burden to the patient, especially elderly patients and those taking many medications.
		Anticholinergic toxicity, cognitive impairment, and delirium are known to be associated.
		Anticholinergic delirium is common and replicable, especially in elderly patients with dementia.
	hybridpub.com /eldercare/cme703_tune.html (999 words)

	Anticholinergic therapy for overactive bladder symptoms - Tips from Other Journals American Family Physician - Find ...
		Pharmacologic treatment of overactive bladder symptoms is based on the use of anticholinergic drugs that block the parasympathetic pathways and reduce detrusor muscle contraction.
		Anticholinergic agents also were consistently associated with improvements in measures of bladder capacity.
		The authors conclude that therapy with an anticholinergic agent results in small improvements in symptoms and urodynamic measures when compared with placebo but is associated with significant side effects, especially dry mouth.
	www.findarticles.com /p/articles/mi_m3225/is_11_68/ai_111036459 (483 words)

	ANTICHOLINERGIC SYNDROME: DX, RX
		Substances with anticholinergic properties competitively antagonize acetylcholine muscarinic receptors; this predominantly occurs at peripheral (eg, heart, salivary glands, sweat glands, GI tract, GU tract) postganglionic parasympathetic muscarinic receptors.
		Anticholinergic syndrome commonly follows the ingestion of a wide variety of prescription and over-the-counter medications.
		Most anticholinergic agents have large volumes of distribution and are highly protein-bound; therefore, hemodialysis and hemoperfusion are ineffective treatment methods.
	www.rashaduniversity.com /asansyndxrx.html (1323 words)

	Anticholinergic therapy for chronic asthma in children over two years of age
		Anticholinergic drugs are widely used in the management of both acute and chronic asthma in children.
		Anticholinergic, anti muscarinic bronchodilators such as ipratropium bromide are frequently used in the management of childhood airway disease.
		One study (comparing anticholinergics with placebo) reported a statistically significant increase in PD 20 but this was not found in another study (comparing anticholinergics with a beta-2 agonist).
	www.cochrane.org /reviews/en/ab003535.html (710 words)

	AGS: Olanzapine Has No Anticholinergic Effects in Elderly Patients With Dementia (Site not responding. Last check: )
		In particular, it has anticholinergic activity that might be expected to be detrimental in the elderly, demented patients in whom it is sometimes used to treat psychosis and agitation.
		Peripheral anticholinergic events were measured using the UKU autonomic symptom subscale, while the Mini Mental State Exam was used to evaluate cognitive impairment.
		So we have proposed one reason for that may be that the kind of anticholinergic activity that we have is what is considered to be the "good" kind.
	www.pslgroup.com /dg/1FAC96.htm (485 words)

	Anticholinergic definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms
		Anticholinergic definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms
		Anticholinergic: The action of certain medications that inhibit the transmission of parasympathetic nerve impulses and thereby reduce spasms of smooth muscle (such as that, for example, in the bladder).
		MedicineNet does not provide medical advice, diagnosis or treatment.
	www.medterms.com /script/main/art.asp?articlekey=2281 (169 words)

	p000321a - Anticholinergic Syndrome (Site not responding. Last check: )
		The postmortem benztropine level was elevated, leading to the attribution of death to anticholinergic toxicity.
		This case serves to illustrate the difficulties in distinguishing features of anticholinergic toxicity and neuroleptic malignant syndrome.
		Diagnosis of this potentially fatal condition rests on a detailed history and observation of peripheral and central anticholinergic signs.
	www.emory.edu /WHSCL/grady/amreport/litsrch99/p000321a.html (249 words)

	s000321a - Anticholinergic Syndrome (Site not responding. Last check: )
		A young schizophrenic patient who developed a typical episode of NMS during abrupt withdrawal of long-acting neuroleptic combined with anticholinergic treatment is described.
		The appearance of NMS after discontinuation of antidopaminergic treatment seems to be in conflict with the hypodopaminergic theory of this adverse effect.
		It is suggested that simultaneous withdrawal of both anticholinergic and neuroleptic medications, mainly long-acting neuroleptics, seems to be a risk factor for NMS.
	www.emory.edu /WHSCL/grady/amreport/litsrch99/s000321a.html (572 words)

	© Priory Lodge Education Limited, 1996.
		The administration of anticholinergic drugs to patients with tardive dyskinesia was found to lead to exacerbation of tardive dyskinesia (Turek et al, 1972; Chouinard et al, 1979), while withdrawal of anticholinergic medication led to a significant reduction in the severity of tardive dyskinesia (Burnett et al, 1980; Reunanen et al, 1988).
		Anticholinergic effects of these drugs may also result in delayed gastric evacuation of a neuroleptic, decreased absorption from the gut and also increased metabolism as a result of enzyme induction (Bolvig et al, 1979).
		The WHO consensus statement on the use of anticholinergic drugs recommends the continuation of anticholinergic drugs for approximately three months after which a slow reduction in doses of anticholinergic drugs should be tried.
	www.priory.com /psych/frames/advan.htm (1335 words)

	Anticholinergic medications for cerebral palsy - [Medication] (Site not responding. Last check: )
		Anticholinergic medications reduce uncontrollable body movements in people who have dystonic cerebral palsy.
		Anticholinergic medications are used to treat muscle stiffness, tremors, and spasms.
		Anticholinergics should not be taken along with antihistamine medications that can be bought without a prescription (such as Benadryl) to treat colds, the flu, or allergies; using anticholinergics with antihistamines further increases mouth dryness and dryness in other moist, mucous-lined areas in the body.
	www.bcbswny.com /kbase/topic/detail/drug/ue5187/detail.htm (261 words)

	Which anticholinergic drug for overactive bladder symptoms in adults
		Anticholinergic drugs can reduce the overactivity of the bladder muscle, and the feeling of urgency.
		The review found that there are several anticholinergic drugs prescribed for adults with overactive bladder symptoms.
		Randomised trials in adults with overactive bladder symptoms or detrusor overactivity that compared one anticholinergic drug with another, or two doses of the same drug.
	www.cochrane.org /reviews/en/ab005429.html (753 words)

	Anticholinergic (Site not responding. Last check: )
		Anticholinergic drugs have been marketed OTC in cough- cold drug products to relieve excessive secretions of the nose and eyes, symptoms that are commonly associated with hay fever, allergy, rhinitis, and the common cold.
		Atropine sulfate for oral use as an anticholinergic is probably safe at dosages that have been used in marketed cough-cold products (0.2 to 0.3 milligram); however, there are inadequate data to establish general recognition of the effectiveness of this ingredient.
		Belladonna alkaloids for inhalation use, as contained in Atropa belladonna and Datura stramonium, are neither safe nor effective as an OTC anticholinergic.
	www.fda.gov /cder/otcmonographs/anticholinergic/anticholinergic(310.533).htm (427 words)

	Drugs and Aging, THE MERCK MANUAL OF HEALTH & AGING
		Anticholinergic effects include confusion, blurred vision, constipation, dry mouth, light-headedness, difficulty starting and continuing to urinate, and loss of bladder control (urinary incontinence).
		When anticholinergic effects are undesirable, another drug can sometimes be used instead.
		Drugs with anticholinergic effects include many commonly used drugs: some antidepressants (used to treat depression), some antipsychotic drugs (used to treat loss of contact with reality, or psychosis), and many antihistamines (contained in nonprescription sleep aids, cold remedies, and allergy drugs).
	www.merck.com /pubs/mmanual_ha/sec2/ch06/ch06a.html (2062 words)

	Acute anticholinergic syndrome (Treatment Guide)
		This toxidrome has central and peripheral components: The central anticholinergic signs and symptoms include altered mental status, disorientation, incoherent speech, delirium, hallucinations, agitation, violent behaviour, somnolence, coma, central respiratory failure, and, rarely, seizures.
		The peripheral anticholinergic syndrome includes hyperthermia, mydriasis, dry mucosa membranes, dry, hot and red skin, peripheral vasodilatation, tachycardia, diminished bowel motility (even paralytic ileus), and urinary retention.
		In more severe cases of anticholinergic syndrome, cardiac rhythm should be monitored and blood pressure frequently measured.
	www.intox.org /databank/documents/treat/treate/trt05_e.htm (422 words)

	PHA 4140 - Gastrointestinal and Nutrition Section (Site not responding. Last check: )
		It should be readily apparent that the aminoalcohol ether anticholinergics possess a large component of antihistaminic activity, while the aminoalcohol ether antihistamines have considerable anticholinergic activity.
		The aminoalcohol ether anticholinergic agents are used primarily for their anti Parkinson effects.
		In the aminoalcohol series, it is apparent that the aminoester moiety is not required for anticholinergic activity, since the alcohol moiety in these compounds can serve as a suitable prosthetic for the carboxy functionality.
	wiz2.pharm.wayne.edu /module/gastromed.html (2170 words)

	Anticholinergic drugs linked to mental impairment in elderly people (Site not responding. Last check: )
		Anticholinergic drugs may lead to mild cognitive (mental) impairment in elderly people, finds a study published online by the BMJ today.
		These drugs are commonly used in elderly patients to treat illnesses such as irritable bowel syndrome, urinary incontinence, and Parkinson's disease, so it is important that doctors are aware of this effect, say the researchers.
		Given the aim of identifying mild cognitive impairment is the early treatment of dementia, people with mild cognitive impairment due to anticholinergic drugs could be in the absurd situation of receiving pro-cholinergic drugs to counteract the effects of anticholinergic agents, say the authors.
	www.eurekalert.org /pub_releases/2006-01/bmj-adl013106.php (259 words)

	Reducing prescribing of highly anticholinergic antidepressants for elderly people: randomised trial of group versus ...
		Results An intention to treat analysis found a 26% reduction in the rate of starting highly anticholinergic antidepressants in elderly people (95% confidence interval -4% to 48%) in the individual intervention arm and 45% (8% to 67%) in the group intervention arm.
		The use of less anticholinergic antidepressants increased by 40% (6% to 83%) in the individual intervention arm and 29% (-7% to 79%) in the group intervention arm.
		Conclusions Both the individual and the group visits decreased the use of highly anticholinergic antidepressants and increased the use of less anticholinergic antidepressant in elderly people.
	www.findarticles.com /p/articles/mi_m0999/is_7287_322/ai_72789290 (698 words)

	Association of Anticholinergic Load With Impairment of Complex Attention and Memory in Schizophrenia -- Minzenberg et ...
		Association of Anticholinergic Load With Impairment of Complex Attention and Memory in Schizophrenia -- Minzenberg et al.
		Hitri A, Craft RB, Fallon J, Sethi R, Sinha D: Serum neuroleptic and anticholinergic activity in relationship to cognitive toxicity of antiparkinson agents in schizophrenic patients.
		Tune L, Carr S, Hoag E, Cooper T: Anticholinergic effects of drugs commonly prescribed for the elderly: potential means for assessing risk of delirium.
	ajp.psychiatryonline.org /cgi/content/full/161/1/116 (4120 words)

	Anticholinergic medications for urinary incontinence in women
		Anticholinergic medications block nerves that control bladder muscle contractions and allow for relaxation of the bladder smooth muscle.
		Anticholinergic medications are used to treat urge incontinence, also called overactive bladder.
		Anticholinergic medications may cause drowsiness or blurred vision that could interfere with your ability to drive or to operate machinery.
	www.webmd.com /hw/female_incontinence/te7892.asp (434 words)

	Anticholinergic medications
		Anticholinergic medications are a group of medications used to relieve cramps, reduce uncontrollable movements, prevent bladder spasms, relax the lung airways, and dry the nose and chest.
		Anticholinergics are used to treat stomach cramps, Parkinson's disease, colds, chronic obstructive pulmonary disease (COPD), urinary incontinence, and muscle spasms from cerebral palsy.
		Anticholinergics relax and enlarge (dilate) the airways in the lungs, making breathing easier (bronchodilators).
	www.webmd.com /hw/health_guide_atoz/sta123311.asp (151 words)

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