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Anticholinergics: theoretical and clinical overview


Nishtala, PS and Salahudeen, MS and Hilmer, SN, Anticholinergics: theoretical and clinical overview, Expert opinion on drug safety, 15, (6) pp. 753-768. ISSN 1474-0338 (2016) [Refereed Article]

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Copyright 2016 Informa UK Limited, trading as Taylor & Francis Group

DOI: doi:10.1517/14740338.2016.1165664


Introduction: Anticholinergics are a class of medicines that block the neurotransmitter, acetylcholine, in the brain and peripheral tissues. Medicines with anticholinergic activity are widely prescribed for and used by older people for various medical conditions. One-third to one-half of the medicines commonly prescribed for older people have anticholinergic activity. Several studies have reported anticholinergic burden to be a predictor of cognitive and functional impairments in older people.

Areas covered:This article exemplifies the theoretical and clinical aspects of medicines with anticholinergic activity, including pharmacology (definition of medicines that possess anticholinergic activity, antimuscarinic receptors, therapeutic and adverse effects), epidemiology, measures and effects of cumulative anticholinergic burden in older adults, and clinical recommendations. In addition, the gaps in the literature have been identified for future research.

Expert opinion: Many medicines that are commonly prescribed to older people have a degree of anticholinergic activity that can contribute to anticholinergic burden. Anticholinergic burden, measured in several ways that consider number, dose and/or degree of anticholinergic activity of medicines, has shown to be a predictor of adverse health and functional outcomes. The anticholinergic burden on older people should be minimised by avoiding, reducing dose and deprescribing medicines with anticholinergic activity where clinically possible.

Item Details

Item Type:Refereed Article
Keywords:Anticholinergic; anticholinergic medicine; antimuscarinic; anticholinergic burden; anticholinergic adverse effect; acetylcholine; older people; muscarinic receptor; anticholinergic risk scale; anticholinergic mechanism; anticholinergic overview; anti
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Salahudeen, MS (Dr Mohammed Salahudeen)
ID Code:125368
Year Published:2016
Web of Science® Times Cited:76
Deposited By:Pharmacy
Deposited On:2018-04-15
Last Modified:2018-05-29

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