Med. praxi. 2020;17(3):182-189 | DOI: 10.36290/med.2020.035

Anticholinergic drugs and cumulation of their side effects in elderly

MUDr. Michal Prokeš, PharmDr. Josef Suchopár
DrugAgency, a. s., Praha

The cumulative effect of using multiple medicines with anticholinergic effect is called anticholinergic burden. Such effects may have an adverse impact on the patient's cognition and which can increase the risk of dementia especially in elderly, as has been showen in several large studies. The aim of this review article is to inform physicians of the risk of anticholinergic drugs, as prescribing of anticholinergics is not a rare event even in patients at high risk of dementia. It is desirable that physicians carefully asses the benefits and risks of medicinal products and, if possible, lower the anticholinergic burden in their patients. Lists of anticholinergic drugs should be routinely used not only in research, but also in everyday clinical practice to quantify anticholinergic burden at seniors.

Keywords: anticholinergic drugs, dementia, anticholinergic burden.

Published: June 18, 2020  Show citation

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Prokeš M, Suchopár J. Anticholinergic drugs and cumulation of their side effects in elderly. Med. praxi. 2020;17(3):182-189. doi: 10.36290/med.2020.035.
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    References

    1. Červený R, Topinková E. Geriatrie. Novelizace 2014. Doporučené diagnostické a terapeutické postupy pro všeobecné praktické lékaře. Centrum doporučených postupů pro praktické lékaře, SVL.
    2. Fialová D, Topinková E, Ballóková A, Matějovská-Kubešová H. Expertní konsenzus ČR 2012 v oblasti léčiv a lékových postupů potenciálně nevhodných ve stáří. Klin Farmakol Farm 2013; 27(1): 18-28.
    3. SÚKL. Léčiva potenciálně nevhodná ve stáří. Farmakoterapeutické informace 2006; 10-11
    4. Topinková E. Nežádoucí účinky antimuskarinik na centrální nervový systém. Urol List 2012; 01(1): 69-74.
    5. Boustani MA, Campbell NL, Munger S, et al. Impact of anticholinregics: a review and practical application. Aging Health 2008; 4(3): 311-320. Go to original source...
    6. Carnahan RM, Lund BC, Perry PJ, et al. The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol. 2006 Dec; 46(12): 1481-1486. Go to original source... Go to PubMed...
    7. Ancelin ML, Artero S, Portet F, et al. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMU 2006; 332: 455-459. Go to original source... Go to PubMed...
    8. Han L, Agostini JV, Allore HG. Cumulative anticholinergic exposure is associated with poor memory and executive function in older men. J Am Geriatr Soc. 2008 Dec; 56(12): 2203-2210. Go to original source... Go to PubMed...
    9. Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med. 2008 Mar 10; 168(5): 508-513. Go to original source...
    10. Ehrt U, Broich K, Larsen JP, et al. Use of drugs with anticholinergic effect and impact on cognition in Parkinson's disease: a cohort study. J Neurol Neurosurg Psychiatry. 2010 Feb; 81(2): 160-165. Go to original source...
    11. Sittironnarit G, Ames D, Bush AI, Faux N, et al. Effects of anticholinergic drugs on cognitive function in older Australians: results from the AIBL study. Dement Geriatr Cogn Disord. 2011; 31(3): 173-178. Go to original source...
    12. Databáze lékových interakcí DrugAgency, a.s., http://lekoveinterakce.cz/, vstup 2. 12. 2012.
    13. Durán CE, Azermai M, Vander Stichele RH. Systematic review of anticholinergic risk scales in older adults. Eur J Clin Pharmacol 2013; 69(7): 1485-1496. Go to original source...
    14. Salahudeen MS, Duffull SB, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015 Mar 25; 15: 31. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-015-0029-9 (staženo 28. 11. 2019) Go to original source...
    15. Cai X, Cambpell N, Callahan C, Boustani M. Ling-term anticholinergic use and the aging brain. Alzheimers Dement 2013; 9(4): 377-385. Go to original source...
    16. Gray SL, Anderson ML, Dublin S, et al. Cumulative use of strong anticholinrgic medications and incident dementia. JAMA Intern Med 2015; 175(3): 401-407. Go to original source...
    17. Pfistermeister B, Tümena T, Gassmann K-G, et al. Anticholinergic burden and cognitive function in a lagre German cohort of hospitalized geriatric patients. PLoS One. 2017 Feb 10; 12(2): e0171353. Go to original source... Go to PubMed...
    18. Richardson K, Fox C, Maidment I, et al. Anticholinergic drugs and risk of dementia: case-control study. BMJ. 2018 Apr 25; 361: k1315. Go to original source...
    19. Coupland CA, Trevor-Hill, Dening T, et al. Anticholinergic drug exposure and the risk of dementia. A nestad case-control study. JAMA Intern Med 2019; 179(8): 1084-1093. Go to original source...
    20. Mašata J. Anticholinergní látky v léčbě hyperaktivního močového měchýře. Remedia 2007; 17(1): 89-100.
    21. Matoušková M. Solifenacin. Remedia 2009; 19(3): 170-175.

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