anticholinergic drugs list
Anticholinergic drugs cover a wide range of medications. They help manage many health conditions. By blocking acetylcholine, these drugs affect muscle work, digestion, peeing, and spit1. They’re vital for treating COPD, overactive bladder, and digestive issues. They’re also helpful for asthma, dizziness, and car sickness2. Plus, doctors use them as muscle relaxers for surgery, making anesthesia easier to handle2.
However, these meds pose risks, mainly for the elderly. They could lead to problems like memory loss, confusion, and a higher chance of getting dementia3. It’s crucial for both doctors and patients to know these side effects. They should always check if the benefits of using such drugs outweigh these risks.
Key Takeaways
- Anticholinergic drugs block the action of the neurotransmitter acetylcholine, impacting various bodily functions.
- These medications are used to treat a variety of conditions, including COPD, overactive bladder, and gastrointestinal disorders.
- Anticholinergics can also be used as muscle relaxants during surgical procedures.
- Older adults are at an increased risk of adverse effects, such as confusion, memory loss, and an elevated risk of dementia, when using anticholinergic medications.
- Healthcare providers and patients should carefully consider the benefits and risks when using anticholinergic drugs, especially in the elderly population.
What are Anticholinergic Drugs?
Definition and Mechanism of Action
Anticholinergic drugs block the work of acetylcholine. This is a key neurotransmitter in the cholinergic system4. Acetylcholine helps control muscle movements and digestion5. By stopping acetylcholine from binding to its receptors, anticholinergics change how signals move through the body. This leads to their benefits in several health conditions.
Acetylcholine is key for the cholinergic system’s normal functions. This system controls involuntary body actions5. Anticholinergic drugs stop acetylcholine, which blocks these natural processes4. Knowing this, doctors can use anticholinergics wisely, understanding their effects and risks well.
“Anticholinergic drugs are a class of medications that work by blocking the action of acetylcholine, a crucial neurotransmitter involved in the cholinergic system.”
The cholinergic system is important for many body processes. Anticholinergic drugs affect this system to work5. Doctors need to know how these drugs work. This helps in choosing if and how to use them, especially in older patients who might be more sensitive to their side effects6.
Common Uses of Anticholinergic Medications
Anticholinergic drugs are used for many health issues7. There are over 600 medicines that act this way7. They are great for COPD, Parkinson’s disease, and more7.
In COPD, drugs like ipratropium and tiotropium open the airways7. This makes breathing easier and reduces symptoms7. For Parkinson’s, benztropine and trihexyphenidyl help with muscle problems and tremors7. Drugs like oxybutynin and tolterodine treat overactive bladder by calming the bladder muscles7.
Anticholinergics also help with many other health problems8. They are good for stomach issues, kidney and gallstones, allergies, and preventing sickness when traveling8. Medications such as scopolamine and atropine play a special role in some treatments and poisoning cases7.
But, these drugs can also cause problems like headaches and memory issues7. They might speed up the heart or slow down digestion7. It’s important to watch out for bad reactions, especially for people with certain diseases7.
Overall, anticholinergic drugs have many uses8. They help with breathing, nerve problems, and more. Doctors must consider the good and bad of these drugs very carefully7.
anticholinergic drugs list
Anticholinergic drugs, available both over-the-counter and by prescription, can greatly impact the body, especially the elderly9. They are connected to specific side effects. This includes issues like sedation, confusion, and dry mouth. Elderly people are particularly at risk. Roughly 1/3 of those with dementia use these drugs. They may also add to behavioral problems and psychosis in people with dementia9.
Over-the-Counter Anticholinergics
Common OTC anticholinergics are:
- Diphenhydramine (Benadryl, Tylenol PM, Advil PM)
- Brompheniramine (Dimetapp)
- Dimenhydrinate (Dramamine)
- Doxylamine (Unisom SleepTabs)
Prescription Anticholinergics
Prescription anticholinergics have a long list for various medical uses5. Medications such as Thorazine and Atropine are on this list. They are often used to treat conditions like depression and Parkinson’s disease10.
Using multiple anticholinergic drugs, especially ones with more effect, can lead to issues like poorer brain function and health decline10. The risks are higher for older adults, especially those over 655.
It’s key for doctors and patients to weigh the effects of anticholinergic drugs against their benefits. Safer choices should always be looked at first9105.
How Anticholinergics Work
Anticholinergic drugs stop acetylcholine, a key neurotransmitter, from working. Acetylcholine helps with things like moving muscles and normal organ activities5. By blocking acetylcholine, anticholinergics reduce muscle movements and help treat issues like a too-active bladder or breathing problems, among others11.
Anticholinergics come from certain plants, like the Deadly Nightshade. They were used long ago to help with breathing problems. Within the respiratory system, different receptors respond to acetylcholine in various ways11. Tiotropium, a type of anticholinergic, works by focusing on these receptors in the airways, making breathing easier11.
For conditions like COPD, anticholinergics are as good as or better than other common medications11. They’re often taken by inhaling the medicine. This can help with how well your lungs work and how you feel overall11.
Yet, anticholinergics can also have downsides, such as affecting memory and thinking, especially in the elderly10. It’s really important to talk to a doctor before starting these drugs. They should know about possible risks5.
Potential Side Effects of Anticholinergic Drugs
Anticholinergic drugs treat several conditions well, but they also bring side effects12. These effects can be both short and long term. They include things like dry mouth, blurry vision, and constipation12. Older people might feel them more. They might even stop using these drugs because of the side effects12.
Short-Term Side Effects
Some common short-term side effects of anticholinergics are:
- Dry mouth
- Blurred vision
- Constipation
- Drowsiness
- Confusion
- Decreased sweating
Long-Term Risks and Concerns
In the long term, there are also risks to consider13. Studies link these drugs to more falls in the elderly. They also suggest a connection with delirium and a higher risk of dementia13. Long-term use, especially in the elderly, may increase these risks2.
Doctors avoid prescribing anticholinergics for older people because of this risk. They can lead to confusion, memory loss, and other mental issues. Recent research supports this, showing a possible link to dementia. The American Geriatrics Society advises against using these drugs in the elderly2 because of the potential severe side effects2.
“Anticholinergics should be used cautiously in individuals with unstable heart conditions, postural hypotension, glaucoma, chronic constipation, atonic bowel, severe colitis, urinary obstruction, and cognitive impairment.”12
12 These drugs may also interact with other medications. Especially with drugs that have cholinergic or anticholinergic effects12.
| Anticholinergic Medication | Therapeutic Uses | Safety Considerations |
|---|---|---|
| Oxybutynin | Effective for palmar and axillary hyperhidrosis in 50% of patients treated with 5 mg twice daily12. | – |
| Glycopyrrolate | Has lower neurological and ocular side effects compared to other anticholinergics and is available in topical and oral formulations. Oral glycopyrrolate is effective for various types of hyperhidrosis and has shown effectiveness in two thirds of patients in a retrospective study12. | – |
| Propantheline | Can be used topically and orally for hyperhidrosis, with a dose of 15-30 mg four times per day12. | – |
2 Anticholinergics can lead to several side effects. These may include dry mouth, constipation, and memory issues2. They can cause trouble urinating, confusion, and delirium too2.
2 Sandoz recalled several lots of orphenadrine citrate 100mg ER tablets. They did this because the tablets had a dangerous substance, nitrosamine, in them2. This substance is known to cause cancer2.
Precautions and Warnings
Anticholinergic drugs have important precautions and warnings. Patients and healthcare providers need to understand them. For some people with specific health conditions, these drugs may make their symptoms worse. They could also increase the chances of harmful side effects13.
Conditions that Increase Risk
Some health conditions put people at a higher risk from anticholinergic drugs. Those with dementia, cognitive issues, or Alzheimer’s should be careful. These drugs might worsen memory problems and cause delirium13. Older adults can also be more affected by anticholinergic side effects, like falls or confusion13.
If someone has glaucoma, an enlarged prostate, or trouble peeing, they should use these drugs with caution2. The same is true for individuals with heart issues. They could face more problems from anticholinergic medications14.
When prescribing these drugs, doctors must weigh the risks against the benefits. This is especially true for older patients or those with certain health problems. Close monitoring and using the smallest effective dose can lower the risk of side effects2.
“Anticholinergics can put individuals at risk of heat exhaustion and heat stroke due to decreased sweating.”2
To wrap up, knowing the risks of anticholinergic drugs is crucial for both healthcare providers and patients. It’s important to balance these risks with the potential benefits. Thorough monitoring and using the smallest effective dose are key for safe use.
Safe Use of Anticholinergics
Many elderly people take anticholinergic drugs for their health15. Taking them correctly is very important to stay safe and avoid bad effects15. Always listen to your doctor’s advice when using these medicines.
It’s crucial to take the right amount of anticholinergic medication at the right times15. Drink plenty of water because these drugs can make you stop sweating15. You should also avoid taking too many different anticholinergic drugs15.
Tell your doctor about all your health issues and the medicines you’re taking before starting anticholinergics15. Watch out for signs like feeling very sleepy, confused, or having a fast heartbeat, which might mean you’re taking too much15. Don’t stop your anticholinergic medicine suddenly, as this can cause health problems15.
By following these simple steps, you can use anticholinergic medicines safely. This can help you get better without facing as many bad side effects15.
| Medication | Brand Names | Uses |
|---|---|---|
| Akineton | Benztropine | Parkinson’s disease, extrapyramidal side effects16 |
| Artane | Trihexyphenidyl | Parkinson’s disease, dystonia16 |
| Bentyl | Dicyclomine | Irritable bowel syndrome, intestinal spasms16 |
| Buscopan | Hyoscine butylbromide | Antispasmodic, gastrointestinal cramps16 |
| Sanctura | Trospium | Overactive bladder, urinary incontinence16 |
| Vesicare | Solifenacin | Overactive bladder, urinary incontinence16 |
Doctors use a lot of different anticholinergic medicines to help with various health problems17. These medicines can treat allergies, bladder issues, heart conditions, lung diseases, and more. They work in different ways to make you feel better17.
You can buy some anticholinergic drugs without a prescription17. For example, Benadryl is one you might know. Others need a doctor’s prescription, like medicines for the bladder, heart, pain, and for your brain or mental health17.
Although anticholinergic drugs can help, they can also have bad effects17. These side effects can be small, like a dry mouth, or very serious. In older adults, they might make problems like Alzheimer’s worse17. It’s important for your doctor and you to work together to balance the good and bad of these treatments151617.
Special Considerations for Older Adults
Cognitive Impact and Dementia Risk
Older adults face a higher risk from certain medications18. This risk is because their body changes a lot with age. For instance, they can have a weaker barrier that protects the brain. Also, their liver and kidney may not work as well as before. These changes make them more likely to have problems with their thinking and memory. They might even develop dementia if they use these medications18.
Research shows that taking these medications for a long time can be bad. It’s linked to moving less, thinking slower, and maybe getting dementia. Older adults can have more than double the normal risk of brain problems if they take a lot of these drugs18. Even those who don’t have memory problems yet could be at a bigger risk for the future. Without these medications, the risk is lower18.
These medications are used for many different health issues18. But, they can make older people more likely to fall and break bones. This is because they can make you sleepy, hard to focus, and blur your vision18.
Because of how the body changes with age, older people might end up taking more of these drugs. This could be due to having more than one health problem that needs these drugs. The advice is to always check if these drugs are really necessary for older adults. Doing this can help in keeping them safe from any medicine problems19.
“Older adults are particularly vulnerable to the adverse effects of anticholinergic medications. Due to age-related changes in the body, including a more permeable blood-brain barrier and reduced liver and kidney function, older individuals are at a higher risk of experiencing cognitive impairment and an increased incidence of dementia when using these drugs.”
| Outcome | Findings |
|---|---|
| Chair Standing Ability | Reduced19 |
| Gait Speed | Slower19 |
| Physical Performance | Poorer19 |
| Falls Risk | Increased19 |
| Mortality | Increased19 |
Using these medications has been linked to a few issues for older people with frailty19. They find it harder to stand up from a chair. Their walking speed also slows down. It affects how well they can perform physical tasks. They are more likely to fall and, sadly, more likely to die19.
But not all results are the same. For things like grip strength and how they perform daily tasks, the findings vary19. The medicine also doesn’t seem to affect how they move between different frailty stages, their mental state, or reactions to certain anxiety drugs19.
For people with frailty, the evidence points to these medicines making it hard to stand up, walk quickly, or do things physically. This increases the risks of falling and dying19. However, their memory and daily life activities don’t seem to get worse because of these drugs19.
This review calls for more studies. These studies can help us understand better if these medicines should be used by older people with frailty. Right now, the info we have is not enough, and there are many ways we need to improve the research191820.
Conclusion
In short, anticholinergic drugs can help treat many health conditions. But, they come with risks, especially for older people. Studies show they might harm thinking, physical health, and even cause early death21.
Older adults might face more issues. Using more than one medication increases these risks. So, doctors should think carefully before giving these drugs. They should also look for other options when possible. This way, patients and doctors can choose better treatments to stay safe22.
Anticholinergics can work well for some but require careful use in the elderly. Research shows a significant number of older people get these drugs, with many being for mental health reasons23. Doctors must watch out for side effects. They should switch to safer drugs if needed, to keep their patients well2122.
This article’s goal is to help everyone involved make better choices about these drugs. Knowing the potential dangers and when to use them can improve care. Together, we aim to make treatments safer, especially for those most at risk23.
FAQ
What are anticholinergic drugs?
Anticholinergic drugs stop acetylcholine, a key neurotransmitter, from working. They prevent acetylcholine from reaching its spots, stopping the signal it carries.
What are the common uses of anticholinergic medications?
They help with many health issues like COPD, overactive bladder, and dizziness. They can aid in treating asthma, motion sickness, and even some types of poisoning.
They might also help control problems like insomnia and Parkinson’s disease.
What are some examples of anticholinergic drugs?
You can get anticholinergics with a prescription or over the counter. Some familiar ones include Benadryl, Tylenol PM, and Dramamine.
Others are Dimetapp and Unisom SleepTabs.
What are the potential side effects of anticholinergic drugs?
Short-term effects might be a dry mouth and sleepy eyes. Some people might get constipated or feel confused. They can also sweat less.
Using these drugs for a long time might affect memory and thinking, especially in older adults.
What precautions should be taken when using anticholinergic medications?
It’s important to be careful, especially if you have certain health conditions. Be sure to take the right amount and always talk to your doctor about your other medicines.
Drink plenty of water and try to not use too many anticholinergic drugs at the same time.
Are older adults at higher risk for adverse effects from anticholinergic drugs?
Yes, older adults face more risks with these drugs. Their bodies change with age, making these drugs more likely to affect their memory and brain function. This can lead to problems like cognitive issues and dementia.
