Orthostatic hypotension (severe drop in systolic blood pressure when standing up suddenly) and significantly increased risk of falls in the elderly population.Hallucinated presence of people not actually there (e.g.Lifelike objects indistinguishable from reality."Dancing" lines "spiders", insects form constants.Warping or waving of surfaces and edges.Visual, auditory, or other sensory hallucinations.Wandering thoughts inability to sustain a train of thought.Possible effects of anticholinergics include: However, in older adults they do appear to increase the risk of death. It is unclear whether they affect the risk of death generally. Long-term use may increase the risk of both cognitive and physical decline. Ocular symptoms (from eye drops): mydriasis, pupil dilation, and acute angle-closure glaucoma in those with shallow anterior chamber Ĭlinically the most significant feature is delirium, particularly in the elderly, who are most likely to be affected by the toxidrome.Delirium (often with hallucinations and delusions indistinguishable from reality).Until the beginning of the 20th century anticholinergic drugs were widely used to treat psychiatric disorders. Organophosphate based nerve agent poisoning, such as VX, sarin, tabun, and soman (atropine is favoured in conjunction with an oxime, usually pralidoxime) Īnticholinergics generally have antisialagogue effects (decreasing saliva production), and most produce some level of sedation, both being advantageous in surgical procedures.Sinus bradycardia due to a hypersensitive vagus nerve.Respiratory disorders (e.g., asthma, chronic bronchitis, and chronic obstructive pulmonary disease ).Insomnia, although usually only on a short-term basis.Genitourinary disorders (e.g., cystitis, urethritis, and prostatitis).Gastrointestinal disorders (e.g., peptic ulcers, diarrhea, pyloro spasm, diverticulitis, ulcerative colitis, nausea, and vomiting).Extrapyramidal symptoms, a potential side-effect of antipsychotic medications.Dizziness (including vertigo and motion sickness-related symptoms).Medical uses Īnticholinergic drugs are used to treat a variety of conditions: The term "anticholinergic" is typically used to refer to antimuscarinics which competitively inhibit the binding of ACh to muscarinic acetylcholine receptors such agents do not antagonize the binding at nicotinic acetylcholine receptors at the neuromuscular junction, although the term is sometimes used to refer to agents which do so. In broad terms, anticholinergics are divided into two categories in accordance with their specific targets in the central and peripheral nervous system and at the neuromuscular junction: antimuscarinic agents, and antinicotinic agents ( ganglionic blockers, neuromuscular blockers). The nerve fibers of the parasympathetic system are responsible for the involuntary movement of smooth muscles present in the gastrointestinal tract, urinary tract, lungs, sweat glands, and many other parts of the body. These agents inhibit the parasympathetic nervous system by selectively blocking the binding of ACh to its receptor in nerve cells. Not to be confused with Anti-cholinesterase.Īnticholinergics ( anticholinergic agents) are substances that block the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system.
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